Comparison of Standard and Enhanced Pulse Oximeter Auditory Displays of Oxygen Saturation: A Laboratory Study With Clinician and Nonclinician Participants

BACKGROUND: When engaged in visually demanding tasks, anesthesiologists depend on the auditory display of the pulse oximeter (PO) to provide information about patients’ oxygen saturation (Spo₂). Current auditory displays are not always effective at providing Spo₂ information. In this laboratory study, clinician and nonclinician participants identified Spo₂ parameters using either a standard auditory display or an auditory display enhanced with additional acoustic properties while performing distractor tasks and in the presence of background noise. METHODS: In a counterbalanced crossover design, specialist or trainee anesthesiologists (n = 25) and nonclinician participants (n = 28) identified Spo₂ parameters using standard and enhanced PO auditory displays. Participants performed 2 distractor tasks: (1) arithmetic verification and (2) keyword detection. Simulated background operating room noise played throughout the experiment. Primary outcomes were accuracies to (1) detect transitions to and from an Spo₂ target range and (2) identify Spo₂ range (target, low, or critical). Secondary outcomes included participants’ latency to detect target transitions, accuracy to identify absolute Spo₂ values, accuracy and latency of distractor tasks, and subjective judgments about tasks. RESULTS: Participants were more accurate at detecting target transitions using the enhanced display (87%) than the standard display (57%; odds ratio, 7.3 [95% confidence interval {CI}, 4.4–12.3]; P < .001). Participants were also more accurate at identifying Spo₂ range using the enhanced display (86%) than the standard display (76%; odds ratio, 2.7 [95% CI, 1.6–4.6]; P < .001). Secondary outcome analyses indicated that there were no differences in performance between clinicians and nonclinicians for target transition detection accuracy and latency, Spo₂ range identification accuracy, or absolute Spo₂ value identification. CONCLUSIONS: The enhanced auditory display supports more accurate detection of target transitions and identification of Spo₂ range for both clinicians and nonclinicians. Despite their previous experience using PO auditory displays, clinicians in this laboratory study were no more accurate in any Spo₂ outcomes than nonclinician participants.