A Pilot Study Comparing Mouse and Mouse-Emulating Interface Devices for Graphic Input

Adaptive interface devices make it possible for individuals with physical disabilities to use microcomputers and thus perform many tasks that they would otherwise be unable to accomplish. Special equipment is available that purports to allow functional access to the computer for users with disabilities. As technology moves from purely keyboard applications to include graphic input, it will be necessary for assistive interface devices to support graphics as well as text entry. Headpointing systems that emulate the mouse in combination with on-screen keyboards are of particular interest to persons with severe physical impairment such as high level quadriplegia. Two such systems currently on the market are the HeadMaster and the FreeWheel.

The authors have conducted a pilot study comparing graphic input speed using the mouse and two head-pointing interface systems on the Macintosh computer. The study used a single subject design with six able-bodied subjects, to establish a baseline for comparison with persons with severe disabilities. Results of these preliminary data indicated that the HeadMaster was nearly as effective as the mouse and that it was superior to the FreeWheel for graphics input. This pilot study, however, demonstrated several experimental design problems that need to be addressed to make the study more robust. It also demonstrated the need to include the evaluation of text input so that the effectiveness of the interface devices with text and graphic input could be compared.     

A pilot study comparing mouse and mouse-emulating interface devices for graphic input

Adaptive interface devices make it possible for individuals with physical disabilities to use microcomputers and thus perform many tasks that they would otherwise be unable to accomplish. Special equipment is available that purports to allow functional access to the computer for users with disabilities. As technology moves from purely keyboard applications to include graphic input, it will be necessary for assistive interface devices to support graphics as well as text entry. Headpointing systems that emulate the mouse in combination with on-screen keyboards are of particular interest to persons with severe physical impairment such as high level quadriplegia. Two such systems currently on the market are the HeadMaster and the Free Wheel. The authors have conducted a pilot study comparing graphic input speed using the mouse and two headpointing interface systems on the Macintosh computer. The study used a single subject design with six able-bodied subjects, to establish a baseline for comparison with persons with severe disabilities. Results of these preliminary data indicated that the HeadMaster was nearly as effective as the mouse and that it was superior to the Free Wheel for graphics input. This pilot study, however, demonstrated several experimental design problems that need to be addressed to make the study more robust. It also demonstrated the need to include the evaluation of text input so that the effectiveness of the interface devices with text and graphic input could be compared.     

Automated 'pain drawing' analysis by computer-controlled, patient-interactive neurological stimulation system.

We have developed a new method for the collection and analysis of pain drawings, as part of a computer-controlled, patient-interactive system for use with implanted neurological stimulators. The system has been tested in 44 patients with permanently implanted spinal cord stimulators for the relief of chronic, intractable pain. Patients interact directly with the system, using a graphics tablet, to enter pain drawings and corresponding outlines of their perceptions of stimulation paresthesias, for different stimulating pulse parameters and electrode geometries. Image analysis software has been developed to examine these data quantitatively. This precludes the inter-rater inconsistencies reported for manual pain drawing scoring techniques. A highly significant correlation has been observed between patients' analog ratings of the overlap of pain by paresthesias and the results of our automated analysis of graphic data. This in turn has been found to correlate with clinical observations of pain relief. The contemporary implantable stimulation devices supported by our system permit non-invasive selection of stimulating anodes and cathodes from a linear array of 4 electrodes. The 50 possible electrode combinations have certain geometric features, which we have entered into a multivariate statistical analysis, to determine their relationship with the overlap of pain by paresthesias. One particular configuration (cathode(s) flanked by anode(s) above and below) is significantly better, by this measure, than all the alternatives. This is consistent with prior clinical observations that this configuration is favored by patients whose systems have been adjusted by conventional, manual methods. Pain drawing' entry and analysis by a computerized, patient-interactive system has been useful in this specialized setting and may have broader applications.     

Integration of technology in a clinical research setting.

The use of wireless technology to collect and retrieve relevant patient data has been in use on many nursing units for the past decade. The technology continues to advance as it relates to patient data collection devices. The utilization of computers (in the form of a wireless tablet) is used in the General Clinical Research Unit (GCRC) at Howard University Hospital. The wireless technology is used for the compilation and retrieval of pertinent research data.     

Eliciting remote data entry system requirements for the collection of cancer clinical trial data

Information regarding the clinical course of a patient in a clinical trial is critical for cancer research. Nurses and clinical research associates must locate data stored in many formats and transfer data to paper case report forms. These forms are associated with a unique protocol document that specifies the set of data to be collected. This paper-based process involves a series of abstractions that pose a significant potential for error. Remote data entry has been advocated to facilitate and streamline the collection of clinical trial data. A systematic process to elicit system requirements from end-users is described as an approach to integrate computer technology with cancer research. Nurses and clinical research associates, as end-users of remote data entry, can provide invaluable input into the requirements necessary to develop an efficient and practical system. By incorporating this input, remote data entry can offer a potential benefit for preserving data integrity.     

Tablet technology during stroke recovery: a survivor’s perspective

Abstract

Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke is rising. Tablets have the potential to encourage engagement in therapeutic activities. We aimed to explore stroke survivor acceptability of and experience of tablet use during the first three months of stroke recovery. Design: A qualitative study using an inductive thematic approach incorporating the process of constant comparison was utilized to collect and analyse data. Setting: Community dwelling stroke survivors in metropolitan Newcastle, New South Wales, Australia. Participants: Twelve stroke survivors (8 male, 4 female; median age of 73 (IQR 58–83) years). Main outcome measures: Qualitative outcomes were participants’ perceptions using in-depth, semi-structured interviews. Results: Participants’ found tablets easy to use and beneficial. Most stroke survivors used the tablet to engage in therapeutic and leisure activities on most days during the three months. Three key themes emerged: (1) Getting established on the iPad: “It just became easier and easier”, (2) Technology as a means for increased stimulation: “Something to keep me interested”, and (3) Personal experiences of access to an iPad: “It’s been very helpful”. Conclusions: Incorporating tablet technology into the delivery of stroke rehabilitation appears to be feasible and acceptable at a patient level. This process has the potential to improve participation in therapeutic and or leisure; however further evaluation towards the impact of tablet technology on patient outcome and quality of life is required.

• Implications for Rehabilitation

• The use of tablet technology provides a platform to increase the variety and intensity of stroke therapy, both in the hospital setting and following discharge from hospital, facilitating physical, cognitive and social activity.

• Stroke survivors experienced increased participation in therapeutic activities, increased socialization and less inactivity and boredom through access to tablet technology.

• Tablet technology is feasible and acceptable at a patient level, providing preliminary support for the use of interactive computer devices during stroke recovery.

     

Portable computers used for respiratory care charting

We studied the feasibility of using a portable lap computer (PLC) for bedside documentation of respiratory care procedures. Three Radio Shack TRS-80 Model 100 (PLCs) were used to capture and transfer the charting by phone into the hospital information system (HIS). Charting on the PLC could be done anywhere at the convenience of the therapist. Transferring data from the PLC to the HIS could be accomplished from any patient room, since all had phone jacks. Once information was entered into the HIS, it became immediately available for review on all nursing station terminals. A 39-day study of 5,019 entries was conducted using 12 therapists of whom 6 were randomly selected to carry PLCs and the other 6 used conventional ward terminals. We found that: 1) There was no statistically significant difference between PLC and nursing terminal entry in productivity or promptness of reporting; 2) Ward terminals were generally available for entry; 3) Cost, maintenance, initial training required, and therapist preference favored ward entry. We conclude that a PLC can be used in a clinical setting as a means of collecting and reporting data from the bedside, and as an input device to a larger computer system, but offers considerable disadvantages in comparison to entry at conventional terminals on the HIS if they are readily accessible.Study conducted at the LDS Hospital.     

Managing Input During Assistive Technology Product Design

Many different sources of input are available to assistive technology innovators during the course of designing products. However, there is little information on which ones may be most effective or how they may be efficiently utilized within the design process. The aim of this project was to compare how three types of input—from simulation tools, professional therapists, and end users—affect the final design when they are provided during the course of the design process. Eight design teams were recruited to independently design a working prototype of an assistive device while receiving a particular type of input. Twenty potential users were recruited to evaluate each of the devices with respect to effectiveness and satisfaction. The results indicate that in some cases each type of input can have a positive effect on end user evaluation. Issues related to how input may be affected by design concept selection, stakeholder recruitment, and timely delivery of input are discussed.     

An IBM AT based monitoring system with touchscreen input

An IBM AT monitoring system is the current version of a series of monitoring system developments at Vanderbilt University. This system and its predecessors have been used in over 800 cases to date. Within the past year, this system has been upgraded with a new serial communications board and with touchscreen input.The new communications board has allowed improved communication with serial devices in the operating room, and will allow for additional devices to be added.The most dramatic improvement in the system has come from the addition of touchscreen input. Our present use of this feature has dramatically improved a casual users ability to input data into the computer system, extensions are possible to entirely get rid of the necessity of any keyboard input of data to the system under normal operations.Supported by the Study Center For Anesthesia Toxicology, VanderBilt University.