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There are concerns that Artificial General Intelligence (AGI) could pose an existential threat to humanity; however, as AGI does not yet exist it is difficult to prospectively identify risks and develop requisite controls. We applied the Work Domain Analysis Broken Nodes (WDA-BN) and Event Analysis of Systemic Teamwork-Broken Links (EAST-BL) methods to identify potential risks in a future 'envisioned world' AGI-based uncrewed combat aerial vehicle system. The findings suggest five main categories of risk in this context: sub-optimal performance risks, goal alignment risks, super-intelligence risks, over-control risks, and enfeeblement risks. Two of these categories, goal alignment risks and super-intelligence risks, have not previously been encountered or dealt with in conventional safety management systems. Whereas most of the identified sub-optimal performance risks can be managed through existing defence design lifecycle processes, we propose that work is required to develop controls to manage the other risks identified. These include controls on AGI developers, controls within the AGI itself, and broader sociotechnical system controls.

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Introduction: Online community-based exercise (CBE) is a digital health intervention and rehabilitation strategy that promotes health among people living with HIV. Our aim was to describe the factors influencing initial implementation of a pilot online CBE intervention with adults living with HIV using a systems approach, as recommended by implementation science specialists. Methods: We piloted the implementation of a 6-month online CBE intervention and 6-month independent exercise follow up, in partnership with the YMCA in Toronto, Canada. We recruited adults living with HIV who identified themselves as safe to engage in exercise. The intervention phase included personalized exercise sessions online with a personal trainer; exercise equipment; access to online exercise classes; and a wireless physical activity monitor. Two researchers documented implementation factors articulated by participants and the implementation team during early implementation, defined as recruitment, screening, equipment distribution, technology orientation, and baseline assessments. Data sources included communication with participants; daily team communication; weekly team discussions; and in-person meetings. We documented implementation factors in meeting minutes, recruitment screening notes, and email communication; and analyzed the data using a qualitative descriptive approach using a systems engineering method called Cognitive Work Analysis. Results: Thirty-three adults living with HIV enrolled in the study (n = 33; median age: 52 years; cis-men: 22, cis-women: 10, non-binary: 1). Fifty-five factors influencing implementation, spanned five layers: (i) Natural, including weather and the COVID-19 virus; (ii) Societal, including COVID-19 impacts (e.g. public transit health risks impacting equipment pick-ups); (iii) Organizational, including information dissemination (e.g. tech support) and logistics (e.g. scheduling); (iv) Personal, including physical setting (e.g. space) and digital setting (e.g. device access); and (v) Human, including health (e.g. episodic illness) and disposition (e.g. motivation). The implementation team experienced heightened needs to respond rapidly; sustain engagement; and provide training and support. Additional organizational factors included a committed fitness training and research team with skills spanning administration and logistics, participant engagement, technology training, physical therapy, and research ethics. Conclusion: Fifty-five factors spanning multiple layers illustrate the complexities of online CBE with adults living with HIV. Initial implementation required a dedicated, rehabilitation-centred, multi-skilled, multi-stakeholder team to address a diverse set of factors.

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Live captioning is a challenging task that requires intense concentration to convert audio to text in real-time. Despite the importance of live captioning for accessibility, little is known about the subjective workload of captioners in this context. This study aimed to measure the subjective workload of live captioners using the NASA-TLX and to explore the factors that contribute to their mental workload. Thirty live captioners participated in the study, completing questionnaires and interviews. Results showed that the subjective mental workload of live captioners is high, similar to that of neurosurgeons. The mental workload was found to be associated with caption paraphrasing and employment status. The challenges of the job, such as the speed of speaking in live content, cognitive tasks involved in paraphrasing, the concern about poor performance, the impact on audiences, and the lack of control over job scheduling contribute to this high workload. These findings suggest the need for modulating the scheduling of the workers, having longer breaks, and working in teams rather than independently. Introducing paradigm changes for live captioning workflow, such as reducing the human effort of typing by adopting auto-generated captions, so that captioners become decision-makers or managers of generational AI systems should also be considered. By addressing these issues, we can help improve the well-being of live captioners and the quality of captions, ultimately enhancing accessibility for all.

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BACKGROUND: Implementing mass vaccination clinics for COVID-19 immunization has been a successful public health activity worldwide. However, this tightly coupled system has many logistical challenges, leading to increased workplace stress, as evidenced throughout the pandemic. The complexities of mass vaccination clinics that combine multidisciplinary teams working within nonclinical environments are yet to be understood through a human systems perspective. OBJECTIVE: This study aimed to holistically model mass COVID-19 vaccination clinics in the Region of Waterloo, Ontario, Canada, to understand the challenges centered around frontline workers and to inform clinic design and technological recommendations that can minimize the systemic inefficiencies that contribute to workplace stress. METHODS: An ethnographic approach was guided by contextual inquiry to gather data on work as done in these ad-hoc immunization settings. Observation data were clarified by speaking with clinic staff, and the research team discussed the observation data regularly throughout the data collection period. Data were analyzed by combining aspects of the contextual design framework and cognitive work analysis, and building workplace models that can identify the stress points and interconnections within mass vaccination clinic flow, developed artifacts, culture, physical layouts, and decision-making. RESULTS: Observations were conducted at 6 mass COVID-19 vaccination clinics over 4 weeks in 2021. The workflow model depicted challenges with maintaining situational awareness about client intake and vaccine preparation among decision-makers. The artifacts model visualized how separately developed tools for the vaccine lead and clinic lead may support cognitive tasks through data synthesis. However, their effectiveness depends on sharing accurate and timely data. The cultural model indicated that perspectives on how to effectively achieve mass immunization might impact workplace stress with changes to responsibilities. This depends on the aggressive or relaxed approach toward minimizing vaccine waste while adapting to changing policies, regulations, and vaccine scarcity. The physical model suggested that the co-location of workstations may influence decision-making coordination. Finally, the decision ladder described the decision-making steps for managing end-of-day doses, highlighting challenges with data uncertainty and ways to support expertise. CONCLUSIONS: Modeling mass COVID-19 vaccination clinics from a human systems perspective identified 2 high-level opportunities for improving the inefficiencies within this health care delivery system. First, clinics may become more resilient to unexpected changes in client intake or vaccine preparation using strategies and artifacts that standardize data gathering and synthesis, thereby reducing uncertainties for end-of-day dose decision-making. Second, improving data sharing among staff by co-locating their workstations and implementing collaborative artifacts that support a collective understanding of the state of the clinic may reduce system complexity by improving shared situational awareness. Future research should examine how the developed models apply to immunization settings beyond the Region of Waterloo and evaluate the impact of the recommendations on workflow coordination, stress, and decision-making.

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BACKGROUND: Patient mobility is an evidenced-based physical activity intervention initiated during intensive care unit (ICU) admission and continued throughout hospitalization to maintain functional status, yet mobility is a complex intervention and not consistently implemented. Cognitive work analysis (CWA) is a useful human factors framework for understanding complex systems and can inform future technology design to optimize outcomes. OBJECTIVE: The aim of this study is to understand the complexity and constraints of the ICU work environment as it relates to nurses carrying out patient mobility interventions, using CWA. METHODS: We conducted a work domain analysis and completed an abstraction hierarchy using the CWA framework. Data from documents, observation (32 hours), and interviews with nurses (N=20) from 2 hospitals were used to construct the abstraction hierarchy. RESULTS: Nurses seek information from a variety of sources and integrate patient and unit information to inform decision-making. The completed abstraction hierarchy depicts multiple high-level priorities that nurses balance, specifically, providing quality, safe care to patients while helping to manage unit-level throughput needs. Connections between levels on the abstraction hierarchy describe how and why nurses seek patient and hospital unit information to inform mobility decision-making. The analysis identifies several opportunities for technology design to support nurse decision-making about patient mobility. CONCLUSIONS: Future interventions need to consider the complexity of the ICU environment and types of information nurses need to make decisions about patient mobility. Considerations for future system redesign include developing and testing clinical decision support tools that integrate critical patient and unit-level information to support nurses in making patient mobility decisions.

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Passengers' travel behaviour is one of the significant factors affecting train overcrowding. Train occupancy information has been introduced as a tool to stimulate passengers' behaviour change to ease in-vehicle crowding. However, there are limitations to this strategy as it often fails to consider other elements in the complex rail system that influence behaviour. This research provides insights to service providers to promote passenger behaviour change by revealing the behavioural constraints in the environment. Cognitive Work Analysis (CWA) was applied to systematically analyse passengers' behaviour and related constraints in the environment. Specifically, Work Domain Analysis (WDA) and Social Organisation and Cooperation Analysis (SOCA) were conducted and presented in the forms of Abstraction Hierarchy (AH) and Contextual Activity Template (CAT). Results showed that a wide range of informational, navigational and physical support alongside provision of occupancy information could better encourage passengers to select and use less busy carriages and trains. Behaviour change goals are likely to be achieved more effectively when the constraints of the system are better understood.

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BACKGROUND: Cognitive skills and other non-technical skills are key for emergency medical services (EMS); however, there have been a limited number of their markers identified. This study aims to identify markers of cognitive skills-situation awareness and decision making-important for team leaders in EMS. The focus is on any markers of cognitive skills that are associated with quality and safety at EMS work. METHOD: In-depth semi-structured interviews were conducted with 20 EMS team leaders (10 EMS physician team leaders and 10 paramedic team leaders) and analysed by the structured approach utilising the known framework of cognitive skill elements. RESULTS: The data analysis revealed a set of 50 markers falling into elements of situation awareness (gathering information, interpreting information, anticipating states), elements of decision making (identifying options, implementing decisions, re-evaluating decisions), and an additional cognitive element (maintaining standards). These markers represented cognitive processes, acts, and communications, therefore, some of them can be observable and others rather unobservable. The identified markers were not too specific, applicable mostly in various challenging situations with patients' medical problems and in EMS team leaders working in ground ambulances in urban and rural/remote areas. CONCLUSION: The findings provide a better understanding of EMS team leaders' cognitive skills, and can aid in the development of assessment and training tools suited particularly to them.

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Besides radically altering work, advances in automation and intelligent technologies have the potential to bring significant societal transformation. These transitional periods require an approach to analysis and design that goes beyond human-machine interaction in the workplace to consider the wider sociotechnical needs of envisioned work systems. The Sociotechnical Influences Space, an analytical tool motivated by Rasmussen's risk management model, promotes a holistic approach to the design of future systems, attending to societal needs and challenges, while still recognising the bottom-up push from emerging technologies. A study explores the concept and practical potential of the tool when applied to the analysis of a large-scale, 'real-world' problem, specifically the societal, governmental, regulatory, organisational, human, and technological factors of significance in mixed human-artificial agent workforces. Further research is needed to establish the feasibility of the tool in a range of application domains, the details of the method, and the value of the tool in design. Practitioner summary: Emerging automation and intelligent technologies are not only transforming workplaces, but may be harbingers of major societal change. A new analytical tool, the Sociotechnical Influences Space, is proposed to support organisations in taking a holistic approach to the incorporation of advanced technologies into workplaces and function allocation in mixed human-artificial agent teams.

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Objectives. Earlier attempts to understand inspection work and improve inspection effectiveness are based on how controls are conducted and the interactions between the inspectors and inspection subjects. This study aimed to determine workplace occupational safety and health inspection effectiveness prerequisites using cognitive work analysis, an approach for design and evaluation of work domains, focusing on activities and work constraints. Methods. Data were collected through semi-structured interviews and a survey with labour inspection authority inspectors, and by reviewing inspection reports and earlier studies on workplace inspections. These were used in the first three cognitive work analysis phases to identify the prerequisites of effective workplace inspection and designing inspection strategies. Results. An abstraction hierarchy showing the affordances was prepared, with purpose-related functions identified as the inspection effectiveness prerequisites. A contextual activities template and a decision ladder for inspection work were prepared. Strategy maps for on-site control were created, allowing design of structured and organized workplace inspection strategies supporting the work domain's purposes. Conclusion. The analysis dimensions served the study sufficiently, providing the purpose-related functions with their respective subgoals and subsidiary functions that provided the prerequisite for effective workplace inspections and allowed for designing structured and organized strategies for on-site workplace inspection.

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BACKGROUND: Emergency departments (EDs) are complex socio-technical work systems that require staff to manage patients in an environment of fluctuating resources and demands. To better understand the purpose, and pressures and constraints for designing new ED facilities, we developed an abstraction hierarchy model as part of a work domain analysis (WDA) from the cognitive work analysis (CWA) framework. The abstraction hierarchy provides a model of the structure of the ED, encompassing the core objects, processes, and functions relating to key values and the ED's overall purpose. METHODS: Reviews of relevant national and state policy, guidelines, and protocol documents applicable to care delivery in the ED were used to construct a WDA. The model was validated through focus groups with ED clinicians and subsequently validated using a series of WDA prompts. RESULTS: The model shows that the ED system exhibits extremely interconnected and complex features. Heavily connected functions introduce vulnerability into the system with function performance determined by resource availability and prioritization, leading to a trade-off between time and safety priorities. CONCLUSIONS: While system processes (e.g., triage, fast-track) support care delivery in ED, this delivery manifests in complex ways due to the personal and disease characteristics of patients and the dynamic state of the ED system. The model identifies system constraints that create tension in care delivery processes (e.g., electronic data entry, computer availability) potentially compromising patient safety. APPLICATION: The model identified aspects of the ED system that could be leveraged to improve ED performance through innovative ED system design.

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While several competency frameworks have been proposed for Human Factors and Ergonomics (HFE) practitioners, these are not commonly based on structured analyses. The aim of this research was to develop a sociotechnical systems model of the HFE practitioner role in Australia and identify the competencies required to fulfil the role. Study One applied the Work Domain Analysis phase of cognitive work analysis (CWA) to model the HFE practitioner role. Model refinement was undertaken with seven subject matter experts. In Study Two, the model was used to elicit the competencies (knowledge, skills, abilities, other characteristics) required for successful performance, via a survey of 28 HFE practitioners. Most competencies related to skills (i.e. communication skills) and knowledge (i.e. domain knowledge). Gaps in competencies were also identified, linked to a lack of HFE education pathways in Australia. The findings have practical utility for designing HFE practitioner roles and educational programs. Practitioner summary: Cognitive work analysis provided a structured analysis of the role of the Human Factors and Ergonomics (HFE) practitioner and to support the identification of competencies. The results suggest that HFE practitioners are generalists rather than specialists and have implications for the job design and education of HFE practitioners. Abbreviations: BCPE: board of certification in professional ergonomics; CIEHF: chartered institute of ergonomics and human factors; CWA: cognitive work analysis; HFE: human factors and ergonomics; HFESA: human factors and ergonomics society of Australia; IEA: International Ergonomics Association; KSAO: knowledge, skills, abilities and other characteristics; O*NET: occupation information network; SME: subject matter expert; SRK: skills, rules, knowledge; UK: United Kingdom; USA: United States of America; WDA: work domain analysis.

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Following strict "lockdown" restrictions designed to control the spread of the COVID-19 virus, many jurisdictions are now engaged in a process of easing restrictions in an attempt to stimulate economic and social activity while continuing to suppress virus transmission. This is challenging and complex, and in several regions, new outbreaks have emerged. We argue that systems Human Factors and Ergonomics methods can assist in understanding and optimizing the return from lockdown. To demonstrate, we used work domain analysis to develop an abstraction hierarchy model of a generic "return from lockdown restrictions" system. The model was assessed to identify (a) issues preventing a successful return from lockdown; and (b) leverage points that could be exploited to optimize future processes. The findings show that the aim of continuing to suppress virus transmission conflicts with the aims of returning to pre-virus economic and social activity levels. As a result, many functions act against each other, ensuring that the system cannot optimally achieve all three of its primary aims. Potential leverage points include modifying the goals and rules of the system and enhancing communications and feedback. Specifically, it is argued that moderating economic aims and modifying how social and community activities are undertaken will result in longer term suppression of the virus.

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BACKGROUND: A telemedicine service enabling remote surgical consultation had shown promising results. When the service was to be scaled up, it was unclear how contextual variations among different clinical sites could affect the clinical outcomes and implementation of the service. It is generally recognized that contextual factors and work system complexities affect the implementation and outcomes of telemedicine. However, it is methodologically challenging to account for context in complex health care settings. We conducted a work domain analysis (WDA), an engineering method for modeling and analyzing complex work environments, to investigate and represent contextual influences when a telemedicine service was to be scaled up to multiple hospitals. OBJECTIVE: We wanted to systematically characterize the implementation contexts at the clinics participating in the scale-up process. Conducting a WDA would allow us to identify, in a systematic manner, the functional constraints that shape clinical work at the implementation sites and set the sites apart. The findings could then be valuable for informed implementation and assessment of the telemedicine service. METHODS: We conducted observations and semistructured interviews with a variety of stakeholders. Thematic analysis was guided by concepts derived from the WDA framework. We identified objects, functions, priorities, and values that shape clinical procedures. An iterative "discovery and modeling" approach allowed us to first focus on one clinic and then readjust the scope as our understanding of the work systems deepened. RESULTS: We characterized three sets of constraints (ie, facets) in the domain: the treatment facet, administrative facet (providing resources for procedures), and development facet (training, quality improvement, and research). The constraints included medical equipment affecting treatment options; administrative processes affecting access to staff and facilities; values and priorities affecting assessments during endoscopic retrograde cholangiopancreatography; and resources for conducting the procedure. CONCLUSIONS: The surgical work system is embedded in multiple sets of constraints that can be modeled as facets of the system. We found variations between the implementation sites that might interact negatively with the telemedicine service. However, there may be enough motivation and resources to overcome these initial disruptions given that values and priorities are shared across the sites. Contrasting the development facets at different sites highlighted the differences in resources for training and research. In some cases, this could indicate a risk that organizational demands for efficiency and effectiveness might be prioritized over the long-term outcomes provided by the telemedicine service, or a reduced willingness or ability to accept a service that is not yet fully developed or adapted. WDA proved effective in representing and analyzing these complex clinical contexts in the face of technological change. The models serve as examples of how to analyze and represent a complex sociotechnical context during telemedicine design, implementation, and assessment.

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Within the last decade, Para sport has experienced increased growth, global popularity, and scientific research. Likewise, there is increasing application of systems ergonomics methods to optimise sports performance. Despite this, few studies have attempted to analyse Para sport as a complex system. The aim of this study was to apply a systems ergonomics framework to redesign a current Para sport system via a multi staged approach. The Cognitive Work Analysis framework was used to model and redesign the Para sport system, via the insertion of design interventions. The findings offer insights into the complexity of the Para sport system via the multiple interacting factors that influence the performance of the system. In addition, the design interventions had substantial influence on the Para sport system by creating multiple new processes, functions, measures, and purposes, and enhanced multiple components of the existing system. This study provides a unique contribution to ergonomic science and extends system ergonomics theory and methods in sport. This study has practical implications for policy development by providing a template that can be used by others wanting to optimise able-bodied sport, Para sport, and non-sport systems.

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Operating a small carry-on unmanned aerial system (UAS) alone is challenging. Research on facilitating single-operator work has focused mainly on payload operation and health monitoring. Little focus has been given to mission-related aspects and how the command and control (C2) map display contributes to mission accomplishment. This study uses cognitive work analysis (CWA) to describe the operational work of the mission operator of a Skylark miniature UAS system. Three CWA phases were conducted - work domain analysis, control task analysis and strategy analysis - providing a rich framework of operational mission phases, task components, processes and the physical interface-objects in use. These representations highlight the operators' extensive use of the C2 map during all mission phases, for all object-related processes. To further enhance the outcomes of the CWA, and prior to outlining specific design requirements, an empirical investigation was conducted in which the eye movements of five experienced operators were obtained during a simulated mission. The empirical results confirm and further specify the work patterns that operators adopt. Quantitative analysis shows operators' extensive focus on the map, especially during mission-critical phases. These analyses led to the conclusion that a significant change in the way operators interact with the C2 map, or alternative designs to enhance map-based information utilization, should be applied. Insights drawn from this analysis can be applied to other aerial surveillance work domains, and adding empirical evaluations is helpful to further refine and reinforce the CWA outcomes.

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In this article, we analyse flight crew response to an in-flight powerplant system malfunction (PSM) using control task analysis. We demonstrate the application of the decision ladder template and the skills, rules, and knowledge (SRK) framework to this new area of inquiry. Despite the high reliability of turbofan engines, accidents and incidents involving PSM still occur. During these unusual events, flight crew have not always responded appropriately, leading to a reduction in safety margins or disruption of operations. This article proposes recommendations for technological and information system that can support flight crew in responding safely and appropriately to a PSM. These recommendations focus on new ways in which information from engine health monitoring system and other sources of data can be utilised and displayed. Firstly, we conducted knowledge elicitation using Critical Decision Method (CDM) interviews with airline pilots who have experienced real or simulated PSM events. We then developed generic decision ladders using the interview data, operations manual, training manual, and other guideline documents. The generic decision ladders characterise the different stages of responding to PSM identified as part of the research. These stages include: regaining and maintaining control of aircraft, identifying PSM and selecting appropriate checklists to secure the engine, and modifying the flight plan. Using the decision ladders and insights from the CDM interviews, we were able to identify cognitive processes and states that are more prone to errors and therefore more likely to generate an inappropriate response. Using the SRK framework, we propose design recommendations for technological and information systems to minimise the likelihood of such inappropriate response. We conclude that this combination of methods provides a structured and reliable approach to identifying system improvements in complex and dynamic work situations. Our specific contributions are the application of these techniques in the unrepresented area of flight operations, and the development of evidence-based design recommendations to improve flight crew response to in-flight powerplant system malfunctions.

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The suspension of major sporting competitions due to the global COVID-19 pandemic had a substantial negative impact on the sporting industry. As such, a successful and sustainable return to sport will require extensive modifications to the current operations of sporting organizations. In this article we argue that methods from the realm of sociotechnical systems (STS) theory are highly suited for this purpose. The aim of the study was to use such methods to develop a model of an Australian Football League (AFL) club's football department. The intention was to identify potential modifications to the club's operations to support a return to competition following the COVID-19 crisis. Subject Matter Experts from an AFL club participated in three online workshops to develop Work Domain Analysis and Social Organization and Cooperation Analysis models. The results demonstrated the inherent complexity of an AFL football department via numerous interacting values, functions and processes influencing the goals of the system. Conflicts within the system were captured via the modeling and included pursing goals that may not fully reflect the state of the system, a lack of formal assessment of core values, overlapping functions and objects, and an overemphasis on specialized roles. The current analysis has highlighted potential areas for modification in the football department, and sports performance departments in general.

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The design and evaluation of healthcare work systems requires an understanding of the cognitive work involved in healthcare tasks. Previous studies suggest that a formative approach would be particularly useful to examine healthcare activities for this purpose. In the present study, methods from cognitive work analysis and cognitive task analysis are combined in a formative examination of managing acute kidney injury, an activity that occurs across primary and secondary healthcare settings. The analyses are informed by interviews with healthcare practitioners and a review of practice guidelines. The findings highlight ways in which the task setting influenced practitioners' activity, and ways in which practitioners approached the activity (for example, how they used data to make decisions). The approach taken provided a rich understanding of the cognitive work involved, as well as generating suggestions for the design of work systems to support the clinical task. Practitioner summary: Healthcare tasks often require decision-making in complex and dynamic circumstances, potentially involving collaboration across different practitioner roles and locations. We demonstrate the use of a formative analysis to understand the cognitive work in managing a clinical syndrome across primary and secondary care settings, and consider the implications for work design.

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Work domain analysis (WDA) is used to model the functional structure of sociotechnical systems (STS) through the abstraction hierarchy (AH). By identifying objects, processes, functions and measures that support system purposes, WDA reveals constraints within the system. Traditionally, the AH describes system elements at the lowest level of abstraction as physical objects. Multiple analyses of complex systems reveal that many include objects that exist only at a conceptual level. This paper argues that, by extending the AH to include cognitive objects, the analytical power of WDA is extended, and novel areas of application are enabled. Three case studies are used to demonstrate the role that cognitive objects play within STS. It is concluded that cognitive objects are a valid construct that offer a significant enhancement of WDA and enable its application to some of the world's most pressing problems. Implications for future applications of WDA and the AH are discussed. Practitioner summary: Some sociotechnical systems include memes as part of their functional structure. Three case studies were used to evaluate the utility of introducing cognitive objects alongside physical ones in work domain analysis, the first phase of cognitive work analysis. Including cognitive objects increases the scope and accuracy of work domain analysis.

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In the information retrieval task, searching and choosing keywords to form the query is crucial. The present study analyzes and describes the keywords' search strategy into a thesaurus in the field of pharmacovigilance. Two ergonomics experts shadowed 22 pharmacovigilance specialists during their daily work. They focus on the strategies for searching and choosing MedDRA terms to build pharmacovigilance queries. Interviews of four pharmacovigilance specialists completed the observations. Results highlight that, for unusual or complex searches, pharmacovigilance specialists proceed iteratively in three main phases: (i) preparation of a list of terms and of evaluation criteria, (ii) exploration of the MedDRA hierarchy and choice of a term, and (iii) evaluation of the results against the criteria. Overall, the search and the choice of keywords within a thesaurus shares similarity with the information retrieval task and is closely interwoven with the query building process. Based on the results, the paper proposes design specifications for new interfaces supporting the identification of MedDRA terms so that pharmacovigilance reports searches achieve a good level of expressiveness.

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