Sage Journals: Discover world-class research

Abstract

The perceptibiliy of auditory medical alarms is critical to patient health and safety. Unfortunately concurrently sounding alarms can interact in ways that can mask one or more of them: render them imperceptible. Masking may only occur in extremely speciﬁc and/or rare situations. Thus, experimentation is insufﬁcient for detecting it in all of the potential alarm conﬁgurations used in medicine. Therefore, there is a real need for computational methods capable of determining if masking exists in medical alarm conﬁgurations. In this work, we present such a method. Using a combination of formal modeling, psychoacoustic modeling, temporal logic speciﬁcation, and model checking, our method is able to prove whether a conﬁguration of alarms can interact in a way that produces masking. This paper motivates and presents this method, describes its implementation, demonstrates its power with an application, and outlines future developments.

Get full access to this article

View all access options for this article.

References

Alur

Dill

D. L.

(1994). A theory of timed automata. Theoretical Computer Science, 126(2), 183–235.

Bolton

M. L.

Bass

E. J.

Siminiceanu

R. I.

(2013). Using formal veriﬁcation to evaluate human-automation interaction in safety critical systems, a review. IEEE Transactions on Systems, Man and Cybernetics: Systems, 43, 488–503.

Bosi

Goldberg

R. E.

(2003). Introduction to digital audio coding and standards. New York: Springer.

Boyd

A. D.

(2010). Centralized telemetry monitoring center human factors report (Tech. Rep.). University of Illinois at Chicago.

Clarke

E. M.

Grumberg

Peled

D. A.

(1999). Model checking. Cambridge: MIT Press.

De Moura

Owre

Rue

Rushby

Shankar

Sorea

Tiwari

(2004). SAL 2. In Computer aided veriﬁcation (Vol. 3114, pp. 496– 500). Berlin: Springer.

Dutertre

Sorea

(2004). Timed systems in SAL (Tech. Rep. No. NASA/CR-2002-211858). SRI Internation.

ECRI Institute. (2012). Top 10 health technology hazards for 2013. Health Devices, 41.

Edworthy

(1994). The design and implementation of non-verbal auditory warnings. Applied Ergonomics, 25(4), 202–210.

10.

Edworthy

(2013). Medical audible alarms: A review. Journal of the American Medical Informatics Association, 20(3), 584–589.

11.

Emerson

E. A.

(1990). Temporal and modal logic. In van Leeuwen

Meyer

A. R.

Nivat

Paterson

Perrin

(Eds.), Handbook of theoretical computer science (pp. 995–1072). Cambridge: MIT Press.

12.

Fastl

Zwicker

(2006). Psychoacoustics: Facts and models (Vol. 22). Springer.

13.

IEC 60601-1-8. (2003). Medical electrical equipment -part 1-8. Geneva: International Electrotechnical Commission.

14.

Jayant

Johnston

Safranek

(1993). Signal compression based on models of human perception. Proceedings of the IEEE, 81, 1385–1422.

15.

Konkani

Oakley

Bauld

T. J.

(2012). Reducing hospital noise: A review of medical device alarm management. Biomedical Instrumentation & Technology, 46(6), 478–487.

16.

Lacherez

Seah

Sanderson

(2007). Overlapping melodic alarms are almost indiscriminable. Human Factors, 49(4), 637–645.

17.

Momtahan

Hetu

Tansley

(1993). Audibility and identiﬁcation of auditory alarms in the operating room and intensive care unit. Ergonomics, 36(10), 1159–1176.

18.

Moore

B. C. J.

(1996). Masking in the human auditory system. In Collected papers on digital audio bit-rate reduction (pp. 9–19). New York: Audio Engineering Society.

19.

Patterson

R. D.

Mayﬁeld

T. F.

Patterson

R. D.

Mayﬁeld

T. F.

(1990). Auditory warning sounds in the work environment [and discussion]. Philosophical Transactions of the Royal Society of London. B, Biological Sciences, 327(1241), 485–492.

20.

Schroeder

M. R.

Atal

B. S.

Hall

(1979). Optimizing digital speech coders by exploiting masking properties of the human ear. The Journal of the Acoustical Society of America, 66, 1647-1652.

21.

The Joint Commission. (April 8, 2013). Medical device alarm safety in hospitals. Sentinel Even Alert, 50.

22.

Toor

Ryan

Richard

(2008). Auditory masking potential of common operating room sounds: A psychoacoustic analsysis. In Anesthesiology 2008 (Vol. 109, p. A1207). Park Ridge: American Society of Anesthesiologists.

23.

Wing

J. M.

(1990). A speciﬁer’s introduction to formal methods. Computer, 23(9), 8, 10–22, 24.

24.

Zwicker

Terhardt

(1980). Analytical expressions for critical-band rate and critical bandwidth as a function of frequency. The Journal of the Acoustical Society of America, 68(5), 1523–1525.

An Approach to Model Checking the Perceptual Interactions of Medical Alarms

Abstract

Get full access to this article

References