Kevin Purdy

Labeling of Medicines and Patient Safety: Evaluating Methods of Reducing Drug Name Confusion:

Objective: We report three experiments evaluating the proposal that highlighting sections of drug names using uppercase (“tall man”) lettering and/or color may reduce the confusability of similar drug names. Background: Medication errors commonly involve drug names that look or sound alike. One potential method of reducing these errors is to highlight sections of names on labels in order to emphasize the differences between similar products. Method: In Experiments 1 and 2, participants were timed as they decided whether similar name pairs were the same name or two different names. Experiment 3 was a recognition memory task. Results: Results from Experiments 1 and 2 showed that highlighting sections of words using tall man lettering can make similar names easier to distinguish if participants are aware that this is the purpose of the intervention. Results from Experiment 3 suggested that tall man lettering and/or color does not make names less confusable in memory but that tall man letters may increase attention. Conclusion: These findings offer some support for the use of tall man letters in order to reduce errors caused by confusion between drug products with look-alike names. Application: The use of tall man letters could be applied in a variety of visual presentations of drug names - for example, by manufacturers on packaging, labeling, and computer software, and in pharmacies on shelf labels. Additionally, this paper demonstrates two meaningful behavioral measures that can be used during product design to objectively assess confusability of packaging and labeling.

Eye movements of large populations: I. Implementation and performance of an autonomous public eye tracker.

This paper details the design and construction of an autonomous public eye tracker exhibit, which was installed at the National Gallery, London, in 2000/2001. For over 3 months, it functioned both as an informative exhibit and as a controlled eye movement experiment, gathering data from over 5,000 participants. The issues associated with automatic unattended recording of the eye movements of members of the public are discussed. The performance of the exhibit is examined, and its successes and problem areas are highlighted with regard to potential applications and future exhibits. The success of the project proves the viability of autonomous public eye trackers as both data-gatherers and public exhibits.

The influence of ‘Tall Man’ lettering on errors of visual perception in the recognition of written drug names

Visual errors in the perception of written drug names can reflect orthographic similarity amongst certain names. Drug names are typically printed in lowercase text. ‘Tall Man’ lettering, the capitalisation of the portions that differ amongst orthographically similar drug names, is employed in the field of medication labelling and prescribing to reduce medication errors by highlighting the area most likely to prevent confusion. The influence of textual format on visual drug name perception was tested amongst healthcare professionals (n = 133) using the Reicher-Wheeler task. Relative to lowercase text, Tall Man lettering improved accuracy in drug name perception. However, an equivalent improvement in accuracy was obtained using entirely uppercase text. Thus, character size may be a key determinant of perceptual accuracy for Tall Man lettering. Specific considerations for the manner in which Tall Man lettering might be best formatted and implemented in practice to reduce medication errors are discussed. Statement of Relevance:Tall Man lettering aims to prevent medication errors by reducing visual confusions amongst orthographically similar drug names. It was found that, compared to lowercase text, Tall Man lettering improved accuracy in drug name perception. Character size appeared to be a key determinant of perceptual accuracy for Tall Man lettering.

A blueprint for integrated eye-controlled environments

Eye-based environmental control requires innovative solutions for supporting effective user interaction, for allowing home automation and control, and for making homes more “attentive” to user needs. Several approaches have already been proposed, which can be seen as isolated attempts to address partial issues and specific sub-sets of the general problem. This paper aims at tackling gaze-based home automation as a whole, exploiting state-of-the-art technologies and trying to integrate interaction modalities that are currently supported and that may be supported in the near future. User–home interaction is sought through two, complementary, interaction patterns: direct interaction and mediated interaction. Integration between home appliances and devices and user interfaces is granted by a central point of abstraction and harmonization called House Manager. Innovative points can be identified in the wide flexibility of the approach which allows on one side to integrate virtually all home devices having a communication interface, and, on the other side, combines direct and mediated user interaction exploiting the advantages of both. A discussion of interaction and accessibility issues is also provided, justifying the presented approach from the point of view of human–environment interaction.

A new gaze-based interface for environmental control

This paper describes a new control system interface which utilises the users eye gaze to enable severely disabled individuals control electronic devices easily. The system is based upon a novel human computer interface, which facilitates simple control of electronic devices by predicting and responding to the users possible intentions, based intuitively upon their point of gaze. The interface responds by automatically pre-selecting and offering only those controls appropriate to the specific device that the user looks at, in a simple and accessible manner. It therefore affords the user conscious choice of the appropriate range of control actions required, which may be executed by simple means and without the need to navigate manually through potentially complex control menus to reach them. Two systems using the head-mounted and the remote eye tracker respectively are introduced, compared and evaluated in this paper.

Is airport baggage inspection just another medical image

A similar inspection situation to medical imaging appears to be that of the airport security screener who examines X-ray images of passenger baggage. There is, however, little research overlap between the two areas. Studies of observer performance in examining medical images have led to a conceptual model which has been used successfully to understand diagnostic errors and develop appropriate training strategies. The model stresses three processes of; visual search, detection of potential targets, and interpretation of these areas; with most errors being due to the latter two factors. An initial study is reported on baggage inspection, using several brief image presentations, to examine the applicability of such a medical model to this domain. The task selected was the identification of potential Improvised Explosive Devices (IEDs). Specifically investigated was the visual search behavior of inspectors. It was found that IEDs could be identified in a very brief image presentation, with increased presentation time this performance improved. Participants fixated on IEDs very early on and sometimes concentrated wholly on this part of the baggage display. When IEDs were missed this was mainly due to interpretative factors rather than visual search or IED detection. It is argued that the observer model can be applied successfully to this scenario.

Differences in coverage patterns in cervical cytology screening

The visual screening of cervical smears is a complex process requiring appropriate slide coverage to detect any unusual appearances without making any omission errors. In examining a smear the observer has both to move the microscope stage appropriately to bring different slide areas into view, plus visually search the information presented within the binocular visual field. This study examined the patterns of slide coverage by different individuals when they inspected liquid based cervical smears. A binocular microscope was first adapted in order to record both the physical movement of the stage by the observer and also to access the microscope’s visual field. An image of the area of the smear under the microscope was displayed on a PC monitor and observers’ eye movements were recorded as they searched this. By manually adjusting the microscope controls they also moved the stage and all stage movements and focussing were also recorded. The behaviour was examined of both novices and an expert screener as they searched a number of test cervical smears. It was found that novices adopted a regular examination pattern, which maximized slide coverage, albeit slowly. In contrast, the experienced screener covered the slides faster and more effectively ensuring more overlap between microscope fields.