{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T21:02:17Z","timestamp":1777669337653,"version":"3.51.4"},"reference-count":47,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["R18HS024679"],"award-info":[{"award-number":["R18HS024679"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Hum Factors"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In this work, we systematically evaluated the reserved alarm sounds of the IEC 60601-1-8 international medical alarm standard to determine when and how they can be totally and partially masked.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>IEC 60601-1-8 gives engineers instruction for creating human-perceivable auditory medical alarms. This includes reserved alarm sounds: common types of alarms where each is a tonal melody. Even when this standard is honored, practitioners still fail to hear alarms, causing practitioner nonresponse and, thus, potential patient harm. Simultaneous masking, a condition where one or more alarms is imperceptible in the presence of other concurrently sounding alarms due to limitations of the human sensory system, is partially responsible for this.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this research, we use automated proof techniques to determine if masking can occur in a modeled configuration of medical alarms. This allows us to determine when and how reserved alarm sound can mask other reserved alarms and to explore parameters to address discovered problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We report the minimum number of other alarm sounds it takes to both totally and partially mask each of the high-, medium-, and low-priority alarm sounds from the standard.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Significant masking problems were found for both the total and partial masking of high-, medium-, and low-priority reserved alarm sounds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Application<\/jats:title>\n                    <jats:p>We show that discovered problems can be mitigated by setting alarm volumes to standard values based on priority level and by randomizing the timing of alarm tones.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0018720820967596","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T10:21:19Z","timestamp":1608632479000},"page":"835-851","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Masking Between Reserved Alarm Sounds of the IEC 60601-1-8 International Medical Alarm Standard: A Systematic, Formal Analysis"],"prefix":"10.1177","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7943-0497","authenticated-orcid":false,"given":"Matthew L.","family":"Bolton","sequence":"first","affiliation":[{"name":"University at Buffalo, The State University of New York, USA"}]},{"given":"Judy R.","family":"Edworthy","sequence":"additional","affiliation":[{"name":"University of Plymouth, United Kingdom"}]},{"given":"Andrew D.","family":"Boyd","sequence":"additional","affiliation":[{"name":"University of Illinois at Chicago, USA"}]}],"member":"179","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"bibr1-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1049\/ecej:19970403"},{"key":"bibr2-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003802"},{"key":"bibr11-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1177\/1541931213601664"},{"key":"bibr5-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1177\/154193120905301201"},{"key":"bibr6-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1007\/s11334-010-0129-9"},{"key":"bibr3-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijhcs.2012.05.010"},{"key":"bibr4-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1109\/TSMCA.2012.2210406"},{"key":"bibr8-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1177\/1541931218621119"},{"key":"bibr7-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1016\/j.apacoust.2018.06.012"},{"key":"bibr9-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1177\/1541931213601146"},{"key":"bibr10-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1177\/0018720819862911"},{"key":"bibr12-0018720820967596","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4615-0327-9"},{"key":"bibr13-0018720820967596","first-page":"780","volume":"42","author":"Brandenburg K.","year":"1994","journal-title":"Journal of the Audio Engineering Society"},{"key":"bibr14-0018720820967596","volume-title":"Model checking","author":"Clarke E. 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