A visual representation of microbiological culture data improves comprehension: a randomized controlled trial

Area of Science:

• Medical Informatics
• Clinical Microbiology
• Health Services Research

Background:

• Electronic health records (EHR) often present microbiological culture data in a format that hinders clinical decision-making.
• Effective antibiotic stewardship requires timely access to and comprehension of past culture sensitivity results.

Purpose of the Study:

• To evaluate if a visual representation of past microbiological culture sensitivities improves provider comprehension compared to standard EHR text-based data.
• To assess the usability and impact of a novel visualization tool on clinical decision-making.

Main Methods:

• A prospective, unblinded, randomized controlled trial was conducted in an academic urban tertiary care center's emergency department.
• Providers were randomized to use either standard EHR functionality or a visual tool displaying past culture sensitivity data.
• Concordance with past results was measured using the kappa statistic; provider usability was assessed via Likert scales.

Main Results:

• Providers using the visual tool demonstrated significantly higher concordance with past culture results (kappa=0.69) compared to the control group (kappa=0.16).
• The visualization tool was associated with improved provider understanding and ease of use (P < .001).
• No significant differences were observed in antibiotic prescribing practices between the groups.

Conclusions:

• A visual representation of microbiological culture sensitivities enhances provider comprehension over traditional text-based EHR formats.
• This visual approach holds promise for improving the interpretation of microbiological data in clinical practice.