Human Factors Analysis of the CardioQuick Patch ®: A Novel Engineering Solution to the Problem of Electrode Misplacement during 12-lead Electrocardiogram Acquisition

Raymond R. Bond, Dewar Finlay, James McLaughlin, Daniel Guldenring, Andrew Cairns, Alan Kennedy, Robert Deans, Albert Waldo, Aaron Peace

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

IntroductionThe CardioQuick Patch ® (CQP) has been developed to assist operators in accurately positioning precordial electrodes during 12-lead electrocardiogram (ECG) acquisition. This study describes the CQP design and assesses the device in comparison to conventional electrode application.Methods20 ECG technicians were recruited and a total of 60 ECG acquisitions were performed on the same patient model over four phases: (1) all participants applied single electrodes to the patient; (2) all participants were then re-trained on electrode placement and on how to use the CQP; (3) participants were randomly divided into two groups, the standard group applied single electrodes and the CQP group used the CQP; (4) after a one day interval, the same participants returned to carry out the same procedure on the same patient (measuring intra-practitioner variability). Accuracy was measured with reference to pre-marked correct locations using ultra violet ink. NASA-TLK was used to measure cognitive workload and the Systematic Usability Scale (SUS) was used to quantify the usability of the CQP.ResultsThere was a large difference between the minimum time taken to complete each approach (CQP = 38.58 s vs. 65.96 s). The standard group exhibited significant levels of electrode placement error (V1 = 25.35 mm ± 29.33, V2 = 18.1 mm ± 24.49, V3 = 38.65 mm ± 15.57, V4 = 37.73 mm ± 12.14, V5 = 35.75 mm ± 15.61, V6 = 44.15 mm ± 14.32). The CQP group had statistically greater accuracy when placing five of the six electrodes (V1 = 6.68 mm ± 8.53 [p <0.001], V2 = 8.8 mm ± 9.64 [p = 0.122], V3 = 6.83 mm ± 8.99 [p <0.001], V4 = 14.90 mm ± 11.76 [p <0.001], V5 = 8.63 mm ± 10.70 [p <0.001], V6 = 18.13 mm ± 14.37 [p <0.001]). There was less intra-practitioner variability when using the CQP on the same patient model. NASA TLX revealed that the CQP did increase the cognitive workload (CQP Group = 16.51% ± 8.11 vs. 12.22% ± 8.07 [p = 0.251]). The CQP also achieved a high SUS score of 91 ± 7.28.ConclusionThe CQP significantly improved the reproducibility and accuracy of placing precordial electrodes V1, V3-V6 with little additional cognitive effort, and with a high degree of usability.
LanguageEnglish
Pages911-918
JournalJournal of Electrocardiology
Volume49
Issue number6
Early online date18 Aug 2016
DOIs
Publication statusPublished - Nov 2016

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Statistical Factor Analysis
Electrocardiography
Electrodes
United States National Aeronautics and Space Administration
Workload
Equipment Design
Ink
Lead

Keywords

  • ECG
  • Electrodes
  • Medical Device
  • Usability
  • Human Factors

Cite this

@article{f1f125abedb24c9fb148b155d8839d5e,
title = "Human Factors Analysis of the CardioQuick Patch {\circledR}: A Novel Engineering Solution to the Problem of Electrode Misplacement during 12-lead Electrocardiogram Acquisition",
abstract = "IntroductionThe CardioQuick Patch {\circledR} (CQP) has been developed to assist operators in accurately positioning precordial electrodes during 12-lead electrocardiogram (ECG) acquisition. This study describes the CQP design and assesses the device in comparison to conventional electrode application.Methods20 ECG technicians were recruited and a total of 60 ECG acquisitions were performed on the same patient model over four phases: (1) all participants applied single electrodes to the patient; (2) all participants were then re-trained on electrode placement and on how to use the CQP; (3) participants were randomly divided into two groups, the standard group applied single electrodes and the CQP group used the CQP; (4) after a one day interval, the same participants returned to carry out the same procedure on the same patient (measuring intra-practitioner variability). Accuracy was measured with reference to pre-marked correct locations using ultra violet ink. NASA-TLK was used to measure cognitive workload and the Systematic Usability Scale (SUS) was used to quantify the usability of the CQP.ResultsThere was a large difference between the minimum time taken to complete each approach (CQP = 38.58 s vs. 65.96 s). The standard group exhibited significant levels of electrode placement error (V1 = 25.35 mm ± 29.33, V2 = 18.1 mm ± 24.49, V3 = 38.65 mm ± 15.57, V4 = 37.73 mm ± 12.14, V5 = 35.75 mm ± 15.61, V6 = 44.15 mm ± 14.32). The CQP group had statistically greater accuracy when placing five of the six electrodes (V1 = 6.68 mm ± 8.53 [p <0.001], V2 = 8.8 mm ± 9.64 [p = 0.122], V3 = 6.83 mm ± 8.99 [p <0.001], V4 = 14.90 mm ± 11.76 [p <0.001], V5 = 8.63 mm ± 10.70 [p <0.001], V6 = 18.13 mm ± 14.37 [p <0.001]). There was less intra-practitioner variability when using the CQP on the same patient model. NASA TLX revealed that the CQP did increase the cognitive workload (CQP Group = 16.51{\%} ± 8.11 vs. 12.22{\%} ± 8.07 [p = 0.251]). The CQP also achieved a high SUS score of 91 ± 7.28.ConclusionThe CQP significantly improved the reproducibility and accuracy of placing precordial electrodes V1, V3-V6 with little additional cognitive effort, and with a high degree of usability.",
keywords = "ECG, Electrodes, Medical Device, Usability, Human Factors",
author = "Bond, {Raymond R.} and Dewar Finlay and James McLaughlin and Daniel Guldenring and Andrew Cairns and Alan Kennedy and Robert Deans and Albert Waldo and Aaron Peace",
year = "2016",
month = "11",
doi = "10.1016/j.jelectrocard.2016.08.009",
language = "English",
volume = "49",
pages = "911--918",
journal = "Journal of Electrocardiology",
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}

Human Factors Analysis of the CardioQuick Patch ®: A Novel Engineering Solution to the Problem of Electrode Misplacement during 12-lead Electrocardiogram Acquisition. / Bond, Raymond R.; Finlay, Dewar; McLaughlin, James; Guldenring, Daniel; Cairns, Andrew; Kennedy, Alan; Deans, Robert; Waldo, Albert; Peace, Aaron.

In: Journal of Electrocardiology, Vol. 49, No. 6, 11.2016, p. 911-918.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Human Factors Analysis of the CardioQuick Patch ®: A Novel Engineering Solution to the Problem of Electrode Misplacement during 12-lead Electrocardiogram Acquisition

AU - Bond, Raymond R.

AU - Finlay, Dewar

AU - McLaughlin, James

AU - Guldenring, Daniel

AU - Cairns, Andrew

AU - Kennedy, Alan

AU - Deans, Robert

AU - Waldo, Albert

AU - Peace, Aaron

PY - 2016/11

Y1 - 2016/11

N2 - IntroductionThe CardioQuick Patch ® (CQP) has been developed to assist operators in accurately positioning precordial electrodes during 12-lead electrocardiogram (ECG) acquisition. This study describes the CQP design and assesses the device in comparison to conventional electrode application.Methods20 ECG technicians were recruited and a total of 60 ECG acquisitions were performed on the same patient model over four phases: (1) all participants applied single electrodes to the patient; (2) all participants were then re-trained on electrode placement and on how to use the CQP; (3) participants were randomly divided into two groups, the standard group applied single electrodes and the CQP group used the CQP; (4) after a one day interval, the same participants returned to carry out the same procedure on the same patient (measuring intra-practitioner variability). Accuracy was measured with reference to pre-marked correct locations using ultra violet ink. NASA-TLK was used to measure cognitive workload and the Systematic Usability Scale (SUS) was used to quantify the usability of the CQP.ResultsThere was a large difference between the minimum time taken to complete each approach (CQP = 38.58 s vs. 65.96 s). The standard group exhibited significant levels of electrode placement error (V1 = 25.35 mm ± 29.33, V2 = 18.1 mm ± 24.49, V3 = 38.65 mm ± 15.57, V4 = 37.73 mm ± 12.14, V5 = 35.75 mm ± 15.61, V6 = 44.15 mm ± 14.32). The CQP group had statistically greater accuracy when placing five of the six electrodes (V1 = 6.68 mm ± 8.53 [p <0.001], V2 = 8.8 mm ± 9.64 [p = 0.122], V3 = 6.83 mm ± 8.99 [p <0.001], V4 = 14.90 mm ± 11.76 [p <0.001], V5 = 8.63 mm ± 10.70 [p <0.001], V6 = 18.13 mm ± 14.37 [p <0.001]). There was less intra-practitioner variability when using the CQP on the same patient model. NASA TLX revealed that the CQP did increase the cognitive workload (CQP Group = 16.51% ± 8.11 vs. 12.22% ± 8.07 [p = 0.251]). The CQP also achieved a high SUS score of 91 ± 7.28.ConclusionThe CQP significantly improved the reproducibility and accuracy of placing precordial electrodes V1, V3-V6 with little additional cognitive effort, and with a high degree of usability.

AB - IntroductionThe CardioQuick Patch ® (CQP) has been developed to assist operators in accurately positioning precordial electrodes during 12-lead electrocardiogram (ECG) acquisition. This study describes the CQP design and assesses the device in comparison to conventional electrode application.Methods20 ECG technicians were recruited and a total of 60 ECG acquisitions were performed on the same patient model over four phases: (1) all participants applied single electrodes to the patient; (2) all participants were then re-trained on electrode placement and on how to use the CQP; (3) participants were randomly divided into two groups, the standard group applied single electrodes and the CQP group used the CQP; (4) after a one day interval, the same participants returned to carry out the same procedure on the same patient (measuring intra-practitioner variability). Accuracy was measured with reference to pre-marked correct locations using ultra violet ink. NASA-TLK was used to measure cognitive workload and the Systematic Usability Scale (SUS) was used to quantify the usability of the CQP.ResultsThere was a large difference between the minimum time taken to complete each approach (CQP = 38.58 s vs. 65.96 s). The standard group exhibited significant levels of electrode placement error (V1 = 25.35 mm ± 29.33, V2 = 18.1 mm ± 24.49, V3 = 38.65 mm ± 15.57, V4 = 37.73 mm ± 12.14, V5 = 35.75 mm ± 15.61, V6 = 44.15 mm ± 14.32). The CQP group had statistically greater accuracy when placing five of the six electrodes (V1 = 6.68 mm ± 8.53 [p <0.001], V2 = 8.8 mm ± 9.64 [p = 0.122], V3 = 6.83 mm ± 8.99 [p <0.001], V4 = 14.90 mm ± 11.76 [p <0.001], V5 = 8.63 mm ± 10.70 [p <0.001], V6 = 18.13 mm ± 14.37 [p <0.001]). There was less intra-practitioner variability when using the CQP on the same patient model. NASA TLX revealed that the CQP did increase the cognitive workload (CQP Group = 16.51% ± 8.11 vs. 12.22% ± 8.07 [p = 0.251]). The CQP also achieved a high SUS score of 91 ± 7.28.ConclusionThe CQP significantly improved the reproducibility and accuracy of placing precordial electrodes V1, V3-V6 with little additional cognitive effort, and with a high degree of usability.

KW - ECG

KW - Electrodes

KW - Medical Device

KW - Usability

KW - Human Factors

U2 - 10.1016/j.jelectrocard.2016.08.009

DO - 10.1016/j.jelectrocard.2016.08.009

M3 - Article

VL - 49

SP - 911

EP - 918

JO - Journal of Electrocardiology

T2 - Journal of Electrocardiology

JF - Journal of Electrocardiology

SN - 0022-0736

IS - 6

ER -