Human Factors Critique of the AgaMatrix
Contents
1. urn red Numbered steps The Owner s Guide numbers the steps in an operational sequence which should help users find their place in an operational sequence as well as avoid skipping a step Illustrations The Owner s Guide illustrations have an appropriate amount of detail and pleasing artistic style Their simplicity and bold outlines enhances their legibility when viewed by users who have blurred vision or are reading the document in dim lighting conditions Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 27 8 F anse Lanc a Rotate Its are out of seri i results from oean IOWnN IN ue to fall CAL 1 is the he WaveSense ah jlucose Call farg t If you mmended y set the arma ira Control Solution Rang 100 130 mg dL e Text format Important items in the Owner s Guide are relatively conspicuous and therefore likely to draw the reader s attention For example headings steps in a process and areas of importance in illustrations are marked in blue text and symbols Weaknesses e Reference to test strip codes There are a couple of instances in the Control Solution Leaflet where the document incorrectly refers to entering a proper code into the meter however the WaveSense Jazz doesn t require the user to enter a test strip code e Temperate discrepancy The Control Solution Leaflet indicates the solutions temperature limitation as 36 F2. wiklund research amp design Human Factors Critique of the AgaMatrix WaveSense Jazz September 27 2010 Prepared for Roche Diagnositics Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 2 TABLE OF CONTENTS a o A A 3 E ERNE RS A EAT Pee Tene RET oe RET 4 ag Fea bY t EEEE I O O EE E NOR ra ee ae 4 DOCUMENTS usted lla tadas dalt ados 5 ll ll O eapae oa oeecaeae 5 SIMA Yi laa 6 ARS SS In nels 8 ASA A 24 POCO PEO E O 8 A E O NR a acer Meter SO t Ware Assessment il bale 18 A Gino ptt aeiceacan ade eee etude dante E E dense cacaede tee etaeeenee tae 18 MAS A A AN NN ate aise RA IR 20 Learning Tools ASES MENE caccias can See iniia EE soma usec nba E EEEE E nua Reece EE E Ga 26 SE SU SUN S aaece Gece ii pias 26 WV SAIS SSS A RR AN 27 Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 3 INTRODUCTION Roche Diagnostics retained Wiklund Research amp Design Inc WR amp D to perform a human factors critique of the WaveSense Jazz blood glucose system shown below S0 WaveSense KO ACCURACY AgaMatrix WaveSense Jazz blood glucose system components We based our critique on human factors standards and user interface design conventions as well as the professional judgment we have developed from designing and evaluating other diabetes management products including glucose meters insulin pumps infusion sets and diabetes
3. MEAL Letter substitutions Several screens display letter substitutions for the letters M and W that are difficult to read due to the odd appearance that arises from their formation of adjacent 7 segment arrays as opposed to a 7 x 5 pixel for instance see sample M below Wiklund R D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 24 Text Due to the pixel matrix the majority of screen items are pixilated Words such as AVG look similar to AUG which can be a source of confusion for some users JAZZ Lack of confirmation When users change a setting such as the HYPER number they have to re enter the HYPER menu item to ensure that their changes were saved by the system because upon pressing the Checkmark button the screen changes back to the menu Test strip insertion The meter does not alert the user if s he inserts the test strip upside down Rather the display stays blank However the meter does not accept the strip if is it inserted backwards which could help users find the correct strip orientation Tagging There does not appear to be a way for users to tag a BG result in other manners For example some users may want to label results from when they were sick or when they used an alternate site for testing Graph feature The meter s Graph menu displays users trend graphs over set periods of time However the graphs do not have
4. conveniently permits the user to test his or her blood without removing the meter from its carrying case Agamatrix Jazz packaging e Battery compartment The battery compartment is easy to locate on the device s backside and open using a fingernail rather than a tool Agamatrix Jazz battery compartment e Test strip bottle The test strip bottle is easy to open because its cap has an extended lip on the opposite side from the hinge Agamatrix Jazz test strip vial and strips Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 e Lancet cap The lancet cap ensures the user is not punctured by the needle while loading the lancet into the device Additionally the lancet needle can conveniently and safely be re covered using the lancet cap for normal trash disposal Lancet cap e Lancet holder cup Lancets are relatively easy to insert into the lancing device However due to the octagonal shape of the lancet and the circular shape of the holder cup some users particularly with decreased dexterity may have trouble connecting the pieces e Lancing device Overall the lancing device provides good aural and tactile feedback The cocking mechanism and release button give a definitive click when activated the lancing device cap snaps into place to indicate proper connection and the lancing dial provides tactile feedback when a number is locked in to place These features may he
5. data management software applications WR amp D s Michael Wiklund President a Certified Human Factors Professional with over two decades of medical industry experience led the WaveSense Jazz critique He was supported by Maya Jackson Human Factors Specialist and Echo Kirk Human Factors Assistant both of whom have formal human factors training In the course of our critique we identified design strengths and shortcomings However readers should note the fundamentally subjective nature of our findings even in cases where they are linked to established standards and conventions This is the nature of a critique as compared to some kind of objective performance measurement Moreover our findings should not be regarded as equivalent to end user opinions Although we are confident in our findings other human factors professionals might draw different conclusions regarding the WaveSense Jazz s interactive qualities Moreover actual users might draw different conclusions as well The balance of this report presents our critique starting with an overview of the product continuing with a summary of our findings and concluding with a discussion of design strengths and shortcomings It does not draw detailed comparisons between the WaveSense Jazz and other blood glucose systems but rather assesses the WaveSense Jazz primarily on its own merits Note that this report is intended for Roche s internal use rather than public release AAMI HE
6. labeled axes so users must memorize the axes labels or have the Owner s Guide available to determine the axes labels Even with the Owner s Guide it is difficult to determine the bar graph values This will likely frustrate users rather than help them view their trending BG values Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 25 200 ym m Sa w M E vx 36 IRE wWAM DH Fach bar r atest result ave vertical unde rage from 3 days Each senas a test result average trom 1 day Each On th right side of the vec ot The Most recent resus una represents 50 mg dL The most recent result is on the right side of the screen be IMPORTANT Averages above 300 mg dl will not represented ia the trend graphs Each bar represents a test Vertical unit represents 50 C Tt0e from 1 day Each recent resurs On the right side ofthe pediros The most User manual pages describing graph format left graph for trending month center graph for trending 2 weeks right e Stats feature The meter s Stat feature displays the user s average BG rating along with the standard deviation and average number of readings over the past 14 days However users may be confused by the average number of readings because it can be displayed as a decimal e g 0 5 day further this parameter does not indicate that it is the average number of readings per day Additionally the user may have t
7. menu It is likely that users will become accustomed to this menu navigation but it is not initially intuitive how to navigate the user interface Scroll order Certain options within the meter s software are not presented in a manner that corresponds with accepted mental models When scrolling through the seven alarms a user must use the down arrow to view the alarms in increasing numerical order Users wishing to change the number Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 22 of days to count within an average view the options in a scattered numerical order 4 days 90 days and then 30 days when using the up arrow to scroll rather than the down arrow e Scrolling list wrapping The menu list on the meter wraps Specifically users can scroll to the bottom of a list and then press the down arrow again to bring themselves to the top of the list This list behavior can make it difficult for users to recognize where they are in a list and particularly when they are at the top and bottom of the list e No undo or escape function The meter does not provide users with a direct means to escape from a menu item or undo an action Therefore users who find themselves lost within a menu option are more likely to make unintended setting adjustments while pressing buttons to try to exit that option e Contrast On screen text dark gray contrasts relatively well against its backg
8. to 86 F and defines a different temperature range 50 F to 104 F under the heading Test Procedure e Binding The Owner s Guide s saddle stitch binding makes it hard to keep the document open to a particular page as compared to a document that has a ring binding that allows pages to lay flat on a table 8 Alternate Site Testing Cap An AST clear lancing device cap used for obtaining a blood sample on the palm at the base of 4 the thumb or forearm 9 Lancet Holder Cup Holds the lancet into place inside the lancing device e Material Typical of most leaflets i e inserts the Test Strip Leaflet is of relatively poor material quality The document appears to be optimized for economical reproduction rather than legibility readability and overall ease of use By comparison the Control Solution Leaflet has relatively high material quality e Index lack of The Owner s Guide lacks an index which some users are likely to value as a quick means to look up topics of interest in the 62 page document Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 24 Symbols The following symbols packages or in the pride ine On the equipment Manufacturer a In Vitro Diagnostic Medical Device Batch Code Cer S a e Es Const instructions For Use Ta t Reuse S Serial Number ZR Temperature Limitation at e Warnings and cautions The Owner s Guide neit
9. 75 2009 Human Factors Engineering Design of Medical Devices Draft and AAMI HE48 1993 Human Factors Guidelines and Preferred Practice for the Design of Medical Devices and other human factors engineering standards and textbooks Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 THE PRODUCT The WaveSense Jazz blood glucose system is an over the counter medical device that includes the following components OWNERS GUIDE Wavesense WaveSense Normal High Control Solution AgaMatrix WaveSense Jazz blood glucose system components Hardware e Meter WaveSense Jazz meter 4 5 cm wide x 8 3 cm high x 1 6 cm deep equipped with a dot matrix black and white display 3 8 cm wide x 2 9 cm high e Lancets Package of 10 transluscent WaveSense lancets e Case Zippered soft sided storage pouch 8 cm wide x 13 7 cm high x 2 5 cm deep e Lancet pen WaveSense lancing device with regular cap and alternative testing site cap e Test strips Vial of 50 WaveSense Jazz blood glucose test strips e Control solution 6mL vial of WaveSense Normal Control Solution Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 5 Documents Meter owner s guide WaveSense Jazz Owner s Guide 62 pages 2 color 10 3 cm wide x 14 cm high Control solution leaflet WaveSense Normal High Control Solution leaflet sided color 4 panels wide x 2 pa
10. aders throughout the document Preparing For a Tess WaveSense Jazz MEE 1 Insert a WaveSense Jazz Test Strip Insert a new WaveSense Jazz Test Strip into the meter Make sure you insert the test strip with the contact bars facing up into the strip port The meter will be activated automatically Note If you do not start the test within 5 minutes the meter will be deactivated To reactivate your meter press the CHECK Q button or remove the unused WaveSense Jazz Test Strip and reinsert it into the meter 2 Meter Ready for Test The meter now displays the blood drop symbol and the word Fill The WaveSense Jazz System is now ready for you to apply control solution or blood Use of text and graphics The Owner s Guide uses both text and informative graphics to effectively delineate operational steps mbol Inis means your Sense Jazz System window of the WaveSense Jazz eS gt r you to apply Test Strip will turn red Ba The entire y visual fill wn window will E H turn red e ately bring the z Test Strip to the lls from the tip lood on the top WARNING If the visual Reon est strip fill window does not window DONOT CR RY fill you mey AG d PUT BLOOD HERE getan inaccurate result A e Jazz Test Strip Retest and ensure that a Apply blood here 1ge and draws the the visual fill window is test strip through completely full a The visual fill WaveSense Jazz
11. bvious to users and might lead them to commit use errors For example a user viewing the Range screen might presume that pressing the Scroll button is enabling him to navigate among the available Range options and not realize that he is adjusting the meter s Range setting In most submenus i e Mem Stats AVG Meal Graph Tag Beep the user presses the scroll buttons to scroll through items in the submenu in other submenus i e Time Date Range Hypo Hyper the user presses the Check Button to scroll among editable items within the submenu Another example of inconsistent navigation is found on the Alarm screen The user presses the Scroll buttons to navigate among Alarms 7 and the Check button to enter an editing mode for the alarm parameters and then the user presses the Check button to advance to the next parameter and uses the scroll buttons to adjust the parameter Additionally in the Tag and Beep submenus the scroll buttons toggle between the On and Off position Lack of navigation context The meter s menu screens do not provide an indication of the number of menu options available Similarly the menu screens lack any indication of the user s relative position within the menu The lack of such indications might cause users to get lost in the menu Start up screen The meter s initial screen displays the word Mem but does not indicate scrolling or that this screen is the first of a list of items in the main
12. cissors to open them whereas a Ziplock type bag or one with a tear strip would offer greater convenience Wiklund R D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 18 METER SOFTWARE ASSESSMENT Strengths Stays on The meter is always on much like a digital watch equipped with an LCD display This eliminates the need for the user to turn the meter on and off Automatic transition into test mode When the user inserts a test strip into the test strip port the meter automatically transitions into testing mode indicating that the user should FILL the test strip with blood This automation is typical of many meters but nonetheless an important convenience Navigation Presenting users with a single menu containing all options makes navigation simple following a linear path as opposed to requiring branching which can lead to confusion As such users are enabled to develop a simple mental model of the meter s user interface structure Text size The blood glucose test results are quite large 17 5 mm 0 7 inches tall This character size suggests that people with normal vision will find the readings to be legible and appropriately attention getting at a distance of 238 cm nearly 8 feet which is well beyond the normal viewing distance of 46 cm 1 5 feet As such the readout seems properly over s
13. d graphs describing how their blood glucose level has varied at particular times of the day and over many days It displays test findings in particularly large numbers although their segmentation a function of using a relatively low resolution display gives them a somewhat odd and dated appearance The meter is attractive reflecting contemporary styling that gives it the appearance of a mobile phone is unlikely to draw undue attention to its use in public It has a pleasing soft feel owing to the use of plastics with a suede like texture Its small size enables it to sit comfortably in the hand Agamatrix Jazz meter compared to a standard cell phone and penny for size Noting the multiple positive characteristics listed above the WaveSense Jazz has what we consider to be serious user interface design shortcomings First the meter s display has poor legibility in some viewing conditions due to the arguably outdated LCD display that presents dark grayish characters on a somewhat lighter greenish gray background resulting in poor figure to ground contrast Turning on the meter s backlight makes the display much more legible in dark viewing conditions but not dramatically better in normal or slightly dim lighting conditions Legibility problems are compounded by the extensive use of small text to label data fields tag test values and present units of measure Even users with normal vision might have difficulty reading t
14. e of AgaMatrix WaveSense Jazz Released on 9 27 2010 9 Hardware keys e Arrow buttons The shape of the conjoined Arrow buttons implemented as a toggle which is intended for moving among displayed menu options e g MEM RANGE ALARM helps communicate the control s purpose Moreover its function is similar to that of buttons found on many consumer electronic devices thereby making its function potentially more familiar to users Button labels The iconic button labels are relatively conventional and likely to be correctly interpreted by meter users They are also language independent meaning they should be recognized and understood by non English speaking people as well as those with low literacy skills Rubber grips The rubber grips located on the sides and bottom of the device support a firm grasp and a stationary work environment respectively As such diabetics who are prone to have dry hands will be less likely to drop the meter due to their ability to maintain a more secure grip on it Those who prefer to place the device on a flat surface rather than hold it during use will find that it resists sliding Pa AT PA Se f Le Fo Le reci G ae te py G ey POST ao 7 On Darse HL Loc 7 Looy INGE Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 e Clear plastic strap The clear plastic strap intended to stabilize the meter in its carrying case
15. e port is a mini USB port meant for transferring data to another device but this is unclear due to the lack of information Additionally the protective black rubber tab might initially confuse users because it looks similar to a power button The engraved arrow is engraved in the same black color making it difficult to determine whether it s the power symbol Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 4 Clear plastic strap The material used for the clear plastic strap that s intended to stabilize the meter in its carrying case seems prone to smudging which may occlude the user s view of the screen Further the plastic strap s material often sticks to the meter s screen and can make inserting and removing the meter from the strap difficult Case The black zippered case provided with the meter is soft and flexible increasing the possibility that users could inadvertently actuate the meter s buttons when it is being stored in its case Accidental actuation could lead to improper settings such as changing the hyperglycemic and hypoglycemic ranges or deactivating an alarm Side rubber grips The rubber grips located on the meter s sides seem insufficiently affixed to the device In the device s first day removed from its packaging some of the rubber was protruding from its proper position Additionally glue was exposed on the rubber s exterior Wiklund R amp D Human Fact
16. electing the item the title at the top of the screen reads as bEEP O JAZZ Abbreviation Recognizing that small screen often require abbreviation the practice is still suboptimal 99 66 Certainly users would rather that terms such as hypr mem stats ctrl d and m were 99 66 99 66 replaced with hyperglycemic memory statistics 99 66 control day and month Unable to adjust volume The meter s alarm volume is fairly quiet approximately 58dB especially when contained in the carrying case approximately 54dB Users with hearing impairments may have difficulty hearing the alarm which could lead to missed blood glucose tests Users would likely appreciate the ability to increase or decrease the volume Date and time coding The coding used for the date is quite similar to the coding used for time making it somewhat difficult to distinguish between them This is especially true when the user has opted to display 24 hour military time because the only difference between the date and time is a dash versus a colon It may prove even more difficult to distinguish between time and date because the time is directly above the date Inconsistent categorization The option Night is listed under the MEAL menu item It is important to include the ability to tag a reading as Night but it seems inappropriate to categorize the option under
17. he small text due simply to its small size exacerbated by any smearing and glare on the screen Users with visual impairments stand little chance of being able to read the small text Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 7 JAZZ Agamatrix Jazz display Second the meter s display limitations it is not a dot matrix display that can present text and graphics in any location and limited number of buttons creates unwelcome interactive complexities as discussed further in the body of the report We expect that some users will struggle to master the pattern of Arrowkey and Checkmark button presses that are required to navigate the single main menu and make adjustments The challenge of making setup adjustments is compounded by the absence of an undo or escape function and the absence of confirmation dialogs that require the user to indicate if they want to accept a change Therefore we view the meter as vulnerable to unintended and potentially undetected adjustments made by users who are simply trying to find their way around within the device s menu system Third the meter and associated test strips seem to be particularly sensitive to slight variations in the amount of deposited blood During our inspections and use trials the meter repeatedly presented error messages indicating that the blood sample was not deposited properly As such we expect that some users will find the me
18. her places warnings and cautions in a particularly attention getting format nor distinguishes them in terms of priority ei NS hypoglycemia unaware 2 You are testing yc od glucose within 2 hours of 1 Setting eating taking insulin or diabetes pills exercising or Hypoglycemic Warning Alarms 3 Your blood glucose results obtained from the palm at the base of the thumb or forearm are not consistent with the way The Hypoglycemic Warning Alarm alerts you when your glucose you feel test results are below the hypoglycemic threshold that you have ue el as to a hypoglycemic threshold of 70 mg dl CAUTION Please read all the instructions provided in this Ela y Dae your healthcare professional for your recommend Owner s Guide and practice the testing procedures before arget ranges When your glucose test results are below your f WaveSense Jazz Blood Glucose Monitoring set hypoglycemic threshold the meter display wi yourte ito Id be done under results the abbreviation HYPO time anddete rene Ai a Ear profes i i WARNING Your healthcare professi m what your hypoglycemic limit is onal should recomm El 1 When your meter is deactivat ed E ton once to enter menu mode The Press the CHECK 0 but a he word MEM ic Aienlaved 28 e Numbered items Rather than using bullet points for example the Owner s Guide numbers items in a list This approach stands to reduce the effecti
19. ized accounting for the legibility degrading effects of on screen glare and the fact that some users might have visual impairments associated with diabetes e g retinopathy cataract macular degeneration 2 Human factors design principles suggest that the character heights of critical alphanumeric information should be the intended reading distance divided by 150 and that the character heights of important but secondary alphanumeric information should be the intended reading distance divided by 300 Note that the principles are typically applied to warnings signs rather than computer displays gt Normal viewing distance as cited in Humanscale 7a Standing at Work designed by Henry Dreyfuss Associated Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 19 e Control solution indicator The results derived from a test using the control solution are clearly marked as such with Ctrl on the primary results screen and in the results history Moreover the meter is able to recognize a control solution without requiring the user to take additional action e Time stamp Each reading is accompanied by a time stamp date and time e Backlight The backlight is readily activated by pressing the backlight button and makes the meter quite legible in dim and dark conditions Rather than timing out at a potentially inopportune time the meter s backlight stays on until the user presses the backligh
20. lp users with dexterity and hearing impairments receive confirmation of their actions with the lancing device Lancing device Weaknesses e Test strip The test strips visual fill window is quite small making it a challenge for users with even normal vision to see whether it is properly filled with blood Accordingly users with impaired vision e g blurred are likely to struggle to read the fill window Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 12 ya e ul i ele vatatatetes gt LARO SAL Fi IA i lt gt lt Pi E LEE E EDEN rat otter CA ets us AGUIE PAI EOT ETS TEER PE Par AE ARA ISR AS TE TORIO DRA CDA LE is ru Test strip with blood sample left and with simulated visual impairment right Small print on test strip bottle Some users with impaired vision are likely to have difficulty reading the small print on the test strip bottle e g control solution range expiry date 115 154 mg 303 431 mg dl Test strip vial label left and with simulated visual impairment right e Blood sample While the meter s test strips seems to require the same amount of blood sample as other strips see photo the meter often displays Er 1 and Er 2 message indicating a problem with the test strip or sample This may frustrate users who might have to use several test strips and re prick their fingers to test their blood gl
21. nels high 40 cm wide x 20 cm high Test strip leaflet WaveSense Jazz Glucose Test Strip Leaflet 2 sided color 2 panels wide x 8 panels high 21 6 cm wide x 20 cm high Packaging System box carton Overall system package with color graphics printed in it 15 5 cm high x 11 3 cm wide x 5 4 cm deep Test strips box A smaller box that contains a vial of 50 WaveSense Jazz blood glucose test strips 5 cm wide x 6 2 cm high x 3 cm deep Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 6 SUMMARY In terms of interactive quality the WaveSense Jazz has the positive attributes of many other blood glucose meters on the market The meter is impressively compact as compared to older models allowing it to fit easily in a small zippered pouch that also contains the essential supplies required to perform frequent blood tests It uses conventional test strips that require only a small blood sample from several alternative sites e g fingertip palm forearm to return a result in a matter of seconds The meter s four buttons including the conjoined arrow buttons are relatively large and provide good tactile feedback which should give users confidence that their control actions are recognized Again like many other meters the WaveSense Jazz offers users the option to review past test results indicate when the blood test occurred in relation to meals i e to tag a test result and view data an
22. o look in the Owner s Guide to determine the time period 14 days and to determine the other parameter meanings e Smile icon The meter s smiley face creates a somewhat juvenile connotation to blood glucose monitoring e Deactivated state When the meter is deactivated the date and time remain on the display It is unclear why users would want to have this information before turning on the meter This may drain the meter s battery more quickly and lead users to purchase the meter s uncommon batteries more often than desired e Tagging The tags are very small posing a reading challenge to people with normal vision and particularly for those with impaired vision Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 26 LEARNING TOOLS ASSESSMENT Strengths Table of contents The Owner s Guide has a useful table of contents which some users are likely to value as a quick means to look up topics of interest in the 62 page document Writing style The Owner s Guide is well written It speaks directly to the user by employing the pronoun you For example it states If you don t want to tag a reading scroll through the options by pressing the DOWN or UP arrow buttons It also uses relatively plain language as opposed to medical jargon Clarity The User Guide and Test Strip Leaflet are relatively well organized as reflected in the table of contents and reinforced by he
23. ors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 5 Battery type The meter requires two lithium CR2032 batteries Some users in the USA might find it inconvenient that the meter does not use more readily available batteries such as AA and AAA cells e a gt i 9500226 CV Test strip port Some users might struggle to insert the test strip into the port which is somewhat inconspicuous because it has the same silver coloring as the meter s encasement Moreover there is no integrated light as found on some meters to help users locate the port when using the meter in dim lighting conditions Lancet depth adjustment dial Some users might expect the numbers on the dial to increase as it is rotated clockwise but the numbers actually decrease The underlying problem is a natural uncertainty if one is moving the pointer or scale in this case the scale moves and the pointer is stationary The lancet s depth adjustment dial is imprecise permitting the window at times to be blank at times because the adjustment wheel can be fixed in intermediate positions although it does not click into such positions Also the lancet depth seems vulnerable to inadvertent adjustment during handling potentially causing the depth selector to move one increment clockwise from shallow to 8 deep In contrast to the existing design some users might expect that the depth selector would stop at and 8 rather than
24. round medium green affording reasonable text legibility for a monochromatic LCD display However the display s legibility is inferior to displays particularly color ones that enable the display of text in higher contrast e g black and dark blue on a white background lo JAZZ The meter s contrast is not ideal e Text flush with display bezel Many screens within the meter s software present text that is partially obscured by the display bezel Users sometimes have to tilt the device such that the outer casing s shadow doesn t interfere with reading the text e Text size Some screen text is very large i e BG results however much of the screen s text is very small Notably the BG result tagging items and measurement units e g per day mg dL etc These items may be difficult to read for users with visual impairments io Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 23 Mixed capitalization Several words in the meter s software are presented using mixed or inconsistent capitalization which is difficult to read When setting the pre and post meal ranges the word post is presented as POSt The T is lowercase and shows only the right half of the line cross making it appear similar to a capital E Users might be confused if they read post as pose The BEEP menu item is presented in all uppercase but upon s
25. stent behavior of some of the meter s controls In addition certain tasks such as adjusting Alarm settings require users to navigate three or four levels into the meter s menu which might cause users to get lost in the menu and potentially make programming errors After a period of use many users might become accustomed to the required button presses but some might never reach a reasonable level of competency and comfort interacting with the meter Rather they might find themselves making repeated keying mistakes and unintended changes that they would have difficulty correcting A sample task that might pose a problem to some users is Set the lower limit of the post meal glucose target range This task requires about ten button presses not including adjustments to the actual target range using the arrow buttons Moreover some users might not discern the need to switch from using the arrow buttons to scroll through main menu option to using the Check Button to switch among the secondary options Inconsistent navigation The Check and Scroll buttons function somewhat differently on various screens For example on the Stats screen users press the Scroll buttons to navigate among the recent blood glucose test results and press the Check button to return to the menu However on the Range screen users press the Scroll buttons to adjust the target range values and press the Check button to confirm the change Such differences might not be o
26. t button again e Screen density Generally the meter s screens have a pleasing information density In fact some screens e g time and date screens have ample room for larger text however this feature is hindered by the segmented display formatting e Tagging The meter provides a simple intuitive means for users to annotate a blood glucose reading with one of 7 meal labels Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 20 Tagging options for Agamatrix Jazz meter Alternate site testing The meter allows users to collect a blood sample from an alternate site e g palm or forearm Alarm The meter allows users to program up to seven reminder alarms JAZZ JAZZ Positive feedback The meter produces a smiley face when the BG reading falls within user s pre programmed target range This might be encouraging for some users Icon that displays when BG reading is in target range Weaknesses Interactive complexity At least new users are likely to struggle to decipher the means to navigate among the menu options versus select them select fields within the associated adjustment screens Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 21 make the adjustments and then escape the adjustment screen Such difficulties are likely to occur due to the lack of prompting provided by the meter as well as due to the inconsi
27. ter frustrating to use particularly because of the potentially frequent need to repeat blood tests due to a test strip related error In short test success seems somewhat technique dependent as opposed to foolproof pn LA A YE e ah Agamatrix Jazz test strip viewing window Summing up the device s positive though common features with its shortcomings we find the WaveSense Jazz to be inferior to others that we have critiqued on Roche s behalf Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 8 HARDWARE ASSESSMENT Strengths e Size The meter is compact compared to other glucose meters making it quite portable Meanwhile it is not so small that users with large hands and fingers are likely to experience a problem holding it and accurately pressing its buttons e Packaging The WaveSense Jazz is packaged in a paper carton that incorporates vivid graphics that might or might not be compatible with a given user s taste but certainly avoid looking overly medical One might assume on first glance that the package contains a mobile phone or comparable consumer electronic device Blood Glucose renitonng System i WaveSense Agamatrix Jazz meter compared to a consumer product e Buttons The four hardware buttons provide effective aural and tactile feedback thereby helping users recognize when they have pressed a button Wiklund R amp D Human Factors Critiqu
28. ucose Notably compared to other test strips the Jazz test strip does not allow the user to see the blood entering the strip there is a cover between the entry point and the sample viewing window that restricts the users ability to see if they have an adequate blood sample e Glare The meter s display with glossy surface seems particularly vulnerable to glare even when viewed away from direct light sources suggesting that it would have benefited from an anti glare coating As it is glare frequently interferes with display legibility and could potentially lead users to misread information presented in small text Wiklund R amp D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 JAZZ The Agamatrix Jazz s screen is susceptible to glare Case pocket The uppermost pocket located on the left flap is quite small making it difficult to remove the Alternative Testing Site lancet cap from within Button labels Users with impaired vision e g blurred vision due to cataracts might have difficulty reading the button labels because they are embossed in the same color affording very little contrast Hardware buttons left and with simulated visual impairment right Ambiguous port location The port located on top end of the device and covered by a protective black rubber tab is not mentioned in the Owner s Guide nor is there an accompanying cable with which to utilize the port Presumably th
29. veness of numbering the procedural steps eliminating an important visual distinction between lists and procedures About the WaveSense Lancing System 1 Cocking Handle C the device so itis ready to lance 2 Depth Adjustment Dial Adjusts how deep the lancet will lance the skin 3 Depth Indicator Window Displays the depth setting of the lancing device 4 Release Button Fires the lancet 5 Lancet Lances the skin to produce a drop of blood 6 Lancet Cap Covers the lancet for safety i 7 Lancing Device Cap Covers the lancet b when in lancing device Remove after inserting into the lancet holder cup
30. wrapping Wiklund R D Human Factors Critique of AgaMatrix WaveSense Jazz Released on 9 27 2010 16 e Lancet cap Once the lancet is loaded in the lancing device the cap is difficult to remove without unintentionally removing the entire lancet To remove the cap only the user must carefully loosen the connection and gently pull the cap off We expect that some users will resort to holding the lancet in its receptacle using a finger thumb from one hand while removing the cap using the other hand This type of fine motor action might be difficult for users with dexterity impairments e g neuropathy and or arthritis lt might also be a painful task because it requires the use of fingertips that might hurt from recent needle sticks e Lancing device cocking While the lancing device is relatively easy to cock i e pretention there is only a subtle indication that the device is ready to fire the lancet is withdrawn slightly 3 mm into the device s body e Display protection film We can envision some users not realizing that the screen has a protective film that should be removed prior to use Consequently some users might use the meter for some time with the film in place and causing the displayed information to be less legible e Alternate Site Testing Cap and Lancets bags Users with hand impairments might have difficulty opening the small plastic bags containing the lancets and alternate site testing cap resorting to using s
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