Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study

Fabiola Fernandez-Gutierrez, Santiago Martinez, Martin A. Rube, Benjamin F. Cox, Mahsa Fatahi, Kenneth C. Scott-Brown, J. Graeme Houston, Helen McLeod, Richard D. White, Karen French, Mariana Gueorguieva, Erwin Immel, Andreas Melzer

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Abstract

Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.
Original languageEnglish
Pages (from-to)1639-1650
Number of pages12
JournalInternational journal of computer assisted radiology and surgery
Volume10
Issue number10
Early online date21 Feb 2015
DOIs
Publication statusPublished - Oct 2015

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Human Engineering
Workflow
Fluoroscopy
Angioplasty
Blood Vessels
Back Injuries
Interviews
Education

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Fernandez-Gutierrez, Fabiola ; Martinez, Santiago ; Rube, Martin A. ; Cox, Benjamin F. ; Fatahi, Mahsa ; Scott-Brown, Kenneth C. ; Houston, J. Graeme ; McLeod, Helen ; White, Richard D. ; French, Karen ; Gueorguieva, Mariana ; Immel, Erwin ; Melzer, Andreas. / Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions : an iliac angioplasty exemplar case study. In: International journal of computer assisted radiology and surgery. 2015 ; Vol. 10, No. 10. pp. 1639-1650.
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title = "Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study",
abstract = "Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.",
author = "Fabiola Fernandez-Gutierrez and Santiago Martinez and Rube, {Martin A.} and Cox, {Benjamin F.} and Mahsa Fatahi and Scott-Brown, {Kenneth C.} and Houston, {J. Graeme} and Helen McLeod and White, {Richard D.} and Karen French and Mariana Gueorguieva and Erwin Immel and Andreas Melzer",
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Fernandez-Gutierrez, F, Martinez, S, Rube, MA, Cox, BF, Fatahi, M, Scott-Brown, KC, Houston, JG, McLeod, H, White, RD, French, K, Gueorguieva, M, Immel, E & Melzer, A 2015, 'Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study', International journal of computer assisted radiology and surgery, vol. 10, no. 10, pp. 1639-1650. https://doi.org/10.1007/s11548-015-1152-y

Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions : an iliac angioplasty exemplar case study. / Fernandez-Gutierrez, Fabiola; Martinez, Santiago; Rube, Martin A.; Cox, Benjamin F.; Fatahi, Mahsa; Scott-Brown, Kenneth C.; Houston, J. Graeme; McLeod, Helen; White, Richard D.; French, Karen; Gueorguieva, Mariana; Immel, Erwin; Melzer, Andreas.

In: International journal of computer assisted radiology and surgery, Vol. 10, No. 10, 10.2015, p. 1639-1650.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions

T2 - an iliac angioplasty exemplar case study

AU - Fernandez-Gutierrez, Fabiola

AU - Martinez, Santiago

AU - Rube, Martin A.

AU - Cox, Benjamin F.

AU - Fatahi, Mahsa

AU - Scott-Brown, Kenneth C.

AU - Houston, J. Graeme

AU - McLeod, Helen

AU - White, Richard D.

AU - French, Karen

AU - Gueorguieva, Mariana

AU - Immel, Erwin

AU - Melzer, Andreas

PY - 2015/10

Y1 - 2015/10

N2 - Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.

AB - Purpose A methodological framework is introduced to assess and compare a conventional fluoroscopy protocol for peripheral angioplasty with a new magnetic resonant imaging (MRI)-guided protocol. Different scenarios were considered during interventions on a perfused arterial phantom with regard to time-based and cognitive task analysis, user experience and ergonomics. Methods Three clinicians with different expertise performed a total of 43 simulated common iliac angioplasties (9 fluoroscopic, 34 MRI-guided) in two blocks of sessions. Six different configurations for MRI guidance were tested in the first block. Four of them were evaluated in the second block and compared to the fluoroscopy protocol. Relevant stages’ durations were collected, and interventions were audio-visually recorded from different perspectives. A cued retrospective protocol analysis (CRPA) was undertaken, including personal interviews. In addition, ergonomic constraints in the MRI suite were evaluated. Results Significant differences were found when comparing the performance between MRI configurations versus fluoroscopy. Two configurations [with times of 8.56 (0.64) and 9.48 (1.13) min] led to reduce procedure time for MRI guidance, comparable to fluoroscopy [8.49 (0.75) min]. The CRPA pointed out the main influential factors for clinical procedure performance. The ergonomic analysis quantified musculoskeletal risks for interventional radiologists when utilising MRI. Several alternatives were suggested to prevent potential low-back injuries. Conclusions This work presents a step towards the implementation of efficient operational protocols for MRI-guided procedures based on an integral and multidisciplinary framework, applicable to the assessment of current vascular protocols. The use of first-user perspective raises the possibility of establishing new forms of clinical training and education.

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