RERC-AMI Project D1 (Tools): Team

Evaluation of Three Alternative Methods for Understanding Biomechanical Aspects of Medical Device Accessibility: MU-Lab Post Activity Questionnaires, MU-Lab Video Analyses with MVTA and MED-AUDIT

Objectives:

The overriding objective relates to Project D1: to evaluate the MU-Lab tool for a diversity of medical technologies and a diversity of individuals with disabilities, with a special focus on understanding the biomechanical aspects of accessibility. This human subject study also helps provide in-field experience with the MU-Lab, which will help evaluate and improve the functionality and robustness of the MU-Lab and PM.

Specific Objectives:

Use the MU-Lab to collect audio, video and questionnaire data of people with disabilities using medical devices (i.e. exam table, weight scales, hospital beds, dental chairs, x-ray, dental monitor).
Use the PM Section IIB Universal Design Analysis (conducted by the researcher both pre- and post-human subjects data collection) to determine any insights gained from using the MU-Lab to collect human subject data.
Use MVTA to identify barriers to use, person-device interactions, tasks involved in person-device interactions and assistive technology use with each medical device.
Compile MU-Lab PM data and MVTA analyses and MED-AUDIT scoring into cumulative report (photo(s) and description for each device) for expert review to determine the value added of the MU-Lab PM and MED-AUDIT as well as any accessibility insights gained from collecting human subject data and using MED-AUDIT.
Use MED-AUDIT to determine if Section I and II include all important/necessary tasks and device accessibility features as well as the value added of this tool (alternative data collection mode—without direct human subject involvement).
Prepare expert review packet: device information (photo(s) and description), cumulative PM/MVTA report for each medical device, MED-AUDIT, survey(s).

Subject Recruitment:

Participants with disabilities were recruited through several methods, including working with local agencies (i.e., IndependenceFirst, Badger Association of the Blind and Visually Impaired, Inc., the United Cerebral Palsy Association of Southeastern Wisconsin) and through distribution of a flyer. A pre-screening interview, conducted through the MU-Lab Protocol Manager (PM), was used to determine the subject’s demographic information (e.g., gender, age, race), impairments or health problems that cause difficulties (e.g., vision, hearing, arthritis), tasks that cause difficulties (e.g., reaching, pushing buttons, balance), assistive devices used (e.g., cane, walker, wheelchair) and opinions about any experiences, difficulties or discomforts with each medical device under investigation.
A total of 12 subjects with diverse disabilities (e.g. due to Cerebral Palsy, Spinal Cord Injury, Multiple Sclerosis, Muscular Dystrophy) participated in this study. Each completed three sessions of research, including one to Marquette College of Nursing, one to the Marquette School of Dentistry, and one to the RERC-AMI's Medical Device Accessibility and Usability Lab within biomedical engineering. Each visit involved the use of three medical devices.
Thus, each of the 12 subjects used each of nine different devices, including: an exam table, 2 weight scales, 2 hospital beds, 2 dental chairs, a dental monitor and portable x-ray.

Evaluation:

Evaluation of accessibility and usability is focused on biomechanics and positioning challenges (i.e. orienting into position, transferring, auditory sensing, visual sensing, tactile sensing, positioning/postural support, reaching, manipulation, leg strength/weight bearing on lower extremities, gross balance/postural control, exertion, safety).
Expert assessment of the value added and accessibility insights gained from 3 different data sources:
- from Project D1: MU-Lab post-activity patient questionnaires from the Protocol Manager,
- from Project D1: MVTA biomechanical barriers analysis of audio/video data collected with the MU-Lab (task-based event marking), an example of which is given in the image below, and
- from Project R3: MED-AUDIT Section I (required tasks) and Section II (device features present). Melissa has been the primary author of the Section II tool.
The first two of these involve the use of human subject data from the MU Lab tool that is the key output of Project D1, with the key distinction being that one focuses on the perceptions of the participant and the other on an event-based analysis of their performance. In contrast, the third does not involve data from a collection of human subjects with diverse abilities, but rather from a comprehensive accessibility analysis methodology. The way this component of the study is being set up, each approach will include a one-page summary of the key findings and insight for that approach.

Currently data is being evaluated for the 36 sessions, each involving 1-2 task-based trials with three different devices. A small subset of this data is also being used for the D1/R2 MVTA reliability study involving six raters.

It is expected that the thesis will be defended in July 2005.

Melissa Lemke has received assistance from the following colleagues for this study:

Supervisor: Dr. Jack Winters
From the core MU-Lab Team: Molly Follette Story, Dr. David Rempel, Dr. Sarma Danturthi, Sean Campbell, Alan Barr.
Assistance with data collection: Dr. Jill Winters (nursing), Dr. Michelle Robinson (dentistry), Farheen Shaikh (dentistry student), Lora Mielcarek (physical therapy graduate student), Elizabeth Omiatek (biomedical engineering graduate student).
MVTA data analysis (part-time students): Michael Baran, Danielle Richerkessing, Lora Mielcarek
From core MED-AUDIT R3 Team: Dr. Roger Smith, Dr. Kris Barnekow, Melinda Winter, Todd Schwanke, Eli Gratz, Rochelle Mendonca.