Data Model Requirements for a Digital Cognitive Aid for Anesthesia to Support Intraoperative Crisis Management

Research output: Contribution to journalResearch articleContributedpeer-review


  • Stefanie Schild - , Department of Medical Informatics (Author)
  • Julian Gruendner - , Department of Medical Informatics (Author)
  • Christian Gulden - , Department of Medical Informatics (Author)
  • Hans-Ulrich Prokosch - , Department of Medical Informatics (Author)
  • Michael St Pierre - , State Vocational Colleges at the University Hospital Erlangen (Author)
  • Martin Sedlmayr - , Institute for Medical Informatics and Biometry (Author)


OBJECTIVE: The aim of this study is to define data model requirements supporting the development of a digital cognitive aid (CA) for intraoperative crisis management in anesthesia, including medical emergency text modules (text elements) and branches or loops within emergency instructions (control structures) as well as their properties, data types, and value ranges.

METHODS: The analysis process comprised three steps: reviewing the structure of paper-based CAs to identify common text elements and control structures, identifying requirements derived from content, design, and purpose of a digital CA, and validating requirements by loading exemplary emergency checklist data into the resulting prototype data model.

RESULTS: The analysis of paper-based CAs identified 19 general text elements and two control structures. Aggregating these elements and analyzing the content, design and purpose of a digital CA revealed 20 relevant data model requirements. These included checklist tags to enable different search options, structured checklist action steps (items) in groups and subgroups, and additional information on each item. Checklist and Item were identified as two main classes of the prototype data model. A data object built according to this model was successfully integrated into a digital CA prototype.

CONCLUSION: To enable consistent design and interactivity with the content, presentation of critical medical information in a digital CA for crisis management requires a uniform structure. So far it has not been investigated which requirements need to be met by a data model for this purpose. The results of this study define the requirements and structure that enable the presentation of critical medical information. Further research is needed to develop a comprehensive data model for a digital CA for crisis management in anesthesia, including supplementation of requirements resulting from simulation studies and feasibility analyses regarding existing data models. This model may also be a useful template for developing data models for CAs in other medical domains.


Original languageEnglish
Pages (from-to)190-199
Number of pages10
JournalApplied Clinical Informatics
Issue number1
Publication statusPublished - Jan 2020

External IDs

PubMedCentral PMC7065980
Scopus 85081906590
ORCID /0000-0002-9888-8460/work/142254088



  • Anesthesia, Checklist, Intraoperative Care/methods