Evaluating Varied Label Designs for Use with Medical Devices: Optimized Labels Outperform Existing Labels in the Correct Selection of Devices and Time to Select

<div><p>Purpose</p><p>Effective standardization of medical device labels requires objective study of varied designs. Insufficient empirical evidence exists regarding how practitioners utilize and view labeling.</p><p>Objective</p><p>Measure the effect of graphic elements (boxing information, grouping information, symbol use and color-coding) to optimize a label for comparison with those typical of commercial medical devices.</p><p>Design</p><p>Participants viewed 54 trials on a computer screen. Trials were comprised of two labels that were identical with regard to graphics, but differed in one aspect of information (e.g., one had latex, the other did not). Participants were instructed to select the label along a given criteria (e.g., latex containing) as quickly as possible. Dependent variables were binary (correct selection) and continuous (time to correct selection).</p><p>Participants</p><p>Eighty-nine healthcare professionals were recruited at Association of Surgical Technologists (AST) conferences, and using a targeted e-mail of AST members.</p><p>Results</p><p>Symbol presence, color coding and grouping critical pieces of information all significantly improved selection rates and sped time to correct selection (α = 0.05). Conversely, when critical information was graphically boxed, probability of correct selection and time to selection were impaired (α = 0.05). Subsequently, responses from trials containing optimal treatments (color coded, critical information grouped with symbols) were compared to two labels created based on a review of those commercially available. Optimal labels yielded a significant positive benefit regarding the probability of correct choice ((P<0.0001) LSM; UCL, LCL: 97.3%; 98.4%, 95.5%)), as compared to the two labels we created based on commercial designs (92.0%; 94.7%, 87.9% and 89.8%; 93.0%, 85.3%) and time to selection.</p><p>Conclusions</p><p>Our study provides data regarding design factors, namely: color coding, symbol use and grouping of critical information that can be used to significantly enhance the performance of medical device labels.</p></div

Color Coding for Critical Information.

<p>In order to compare our labels which purposefully tested varied factors of graphic design with existing commercial labels, two label designs were created based upon a benchmarking study that we conducted with 20 commercial labels from six different brands (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165002#pone.0165002.g003" target="_blank">Fig 3</a>-depicting a trial with one of the two designs developed based on commercial labels).</p

Trial comprised of a Commercial Label.

<p>For the sake of comparison, two commercial labels (one depicted here as it would appear in a single trial) were created based on the results of a benchmarking we conducted with 20 labels for indwelling, urinary catheters comprising six brands. For each trial of the testing, yoked label sections were randomized positionally so that any effect of placement of the information on the screen was mitigated.</p

Estimated Time to Correct Selection.

<p>Comparison of the optimized label and two designs based on current commercial practice on time to make a correct choice: Estimated least square means (LSM) with estimated upper and lower limits. Differing letters indicate statistical significance.</p

Probability of Correct Selection.

<p>Comparison of the optimized label and two designs based on current commercial practice for probability of correct choice means with upper and lower limits. Differing letters indicate statistical significance.</p