Appl Clin Inform 2020; 11(01): 088-094
DOI: 10.1055/s-0039-1701003
Research Article
Georg Thieme Verlag KG Stuttgart · New York

Evaluating Usability of a Touchless Image Viewer in the Operating Room

1  Department of Orthopedic Surgery, Diakonissen Hospital, Mannheim, Germany
2  mbits imaging GmbH, Heidelberg, Germany
3  Department of Sports Surgery, ATOS Clinic, Heidelberg, Germany
Sebastian Schmitt
1  Department of Orthopedic Surgery, Diakonissen Hospital, Mannheim, Germany
Henning Roehl
1  Department of Orthopedic Surgery, Diakonissen Hospital, Mannheim, Germany
› Author Affiliations
Funding None.
Further Information

Publication History

30 September 2019

12 December 2019

Publication Date:
29 January 2020 (online)


Background Availability of patient-specific image data, gathered from preoperatively conducted studies, like computed tomography scans and magnetic resonance imaging studies, during a surgical procedure is a key factor for surgical success and patient safety. Several alternative input methods, including recognition of hand gestures, have been proposed for surgeons to interact with medical image viewers during an operation. Previous studies pointed out the need for usability evaluation of these systems.

Objectives We describe the accuracy and usability of a novel software system, which integrates gesture recognition via machine learning into an established image viewer.

Methods This pilot study is a prospective, observational trial, which asked surgeons to interact with software to perform two standardized tasks in a sterile environment, modeled closely to a real-life situation in an operating room. To assess usability, the validated “System Usability Scale” (SUS) was used. On a technical level, we also evaluated the accuracy of the underlying neural network.

Results The neural network reached 98.94% accuracy while predicting the gestures during validation. Eight surgeons with an average of 6.5 years of experience participated in the usability study. The system was rated on average with 80.25 points on the SUS.

Conclusion The system showed good overall usability; however, additional areas of potential improvement were identified and further usability studies are needed. Because the system uses standard PC hardware, it made for easy integration into the operating room.

Protection of Human and Animal Subjects

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study.