What most captures the physician's interest when evaluating a multiparameter monitor in a Neonatal ICU? – A simulation study

OBJECTIVE: To assess the gaze of physicians in the Neonatal ICU setting when evaluating a multiparameter monitor to determine the presence/absence of vital sign alterations. METHODS: Pediatricians' gaze was tracked when they evaluated a 30-second video of a multiparametric monitor on a screen. They assessed one of three scenarios: Normal, Tachycardia, or Hyperoxia. Eight areas of interest (AOI) were defined: Heart rate(HR), Electrocardiogram(ECG), SpO₂, Pulse wave(PulseW), Respiratory rate(RR), Respiration curve(Resp.C), Blood pressure(BP), and Temperature(Temp.). Gaze fixation on each AOI was analyzed in three periods:0-3, 0-5, 0-10 s. Generalized estimating equations were used to evaluate the effect of the parameters/scenarios on the participants' likelihood of gaze fixation on each AOI. RESULTS: Eighty physicians (86% female; 35.3 ± 8.2 years old) were evaluated. At 0-3 s, 0-5 s, and 0-10 s, the percentage of physicians who fixed their gaze on each AOI was, respectively:HR: 93, 96, 98%; ECG: 73, 79, 89%; SpO2: 75, 94, 95%; PulseW: 86, 88, 98%; RR: 48, 80, 95%; Resp.C: 26, 49, 73%; BP: 35, 63, 98%; Temp: 31, 53, 91%. Compared with HR, the likelihood of gaze fixation was lower at 0-3 s, for ECG (Odds Ratio-OR: 0.21), SpO2 (OR: 0.24), RR (OR: 0.07), RespC (OR: 0.03), BP (OR: 0.04) and Temp (OR: 0.04); at 0-5 s, for ECG (OR: 0.14), RR (OR; 0.16), Resp.C (OR: 0.04), BP (OR: 0.07) and Temp (OR: 0.04); and at 0-10 s, only for Resp.C (OR: 0.07). CONCLUSION: In the neonatal ICU setting, when assessing the monitor, HR attracts physicians' initial attention, followed by oximetry parameters.