Home Medical Monitoring Made Difficult?
March 12, 2001 -- We've all occasionally been stumped by instructions for some technical gadget, like a computer or a VCR. That's frustrating. But what if you're stumped by the instructions for a device you need to monitor your blood glucose because you're a diabetic. Well, that's dangerous, and common, according to a group of Georgia Institute of Technology researchers.
They write in a recent issue of Ergonomics in Design that inherent problems exist with both the instructions to some glucose monitors, and the monitors themselves, and that could be very harmful for someone suffering from the disease because patients must closely track their blood sugar level.
However, medical professionals specializing in treating some of the 16 million diabetics in the U.S. say the machines are so simple that even children can use them.
Regardless, a commonly used blood glucose meter that claimed to be as easy as 1-2-3 in fact required 52 sub-steps before getting to those three easy steps, according to the researchers. "A number of studies in the past have shown that people have trouble using the glucose monitors. We wanted to use human factors as a way to identify the problems and find solutions," Wendy Rogers, PhD, a Georgia Institute of Technology psychologist, tells WebMD.
Indeed, the small machines do play a crucial role in ensuring that diabetics get the proper amount of insulin, which controls blood sugar or glucose levels in their bodies. When glucose levels become too high, there can be irreparable damage to various organs in the body. Diabetes is a leading cause of heart attacks, hypertension, limb amputations, kidney failure, and stroke, and the No. 1 cause of blindness.
Rogers and her team had six people aged 20 to more than 70 try working a commonly used glucose monitor. In observing this practical test of the sugar-level meter, the researchers concluded that the device -- and both its written and video instructions -- was not sufficient to guarantee safe and accurate patient-conducted readings.
Rogers group, by analyzing the instructions with readability standards called the Flesch-Kincaid Grade Level analysis, were able to determine that the user's manual for the monitor was written at an eighth-grade reading level. With this, the scientists say that about 58% of the American population would be able to understand the directions for the monitor, while only half would comprehend the instructions for the test strips (which actually determine the level of blood sugar). According to Rogers, this means that 23 million people 25 years old or older wouldn't understand these directions.
In addition to doing the six-person observational study, the researchers also surveyed 26 diabetics to find out how much trouble they experience using a glucose meter. Forty percent of these participants said they were not comfortable using one until they had used it three or four times. Most of them learned how to use the device on their own, and about a third responded that a medical professional instructed them.