Comparative ergonomic workflow and user experience analysis of MRI versus fluoroscopy-guided vascular interventions: an iliac angioplasty exemplar case study
Tóm tắt
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. 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. 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. 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.
Tài liệu tham khảo
Saeed M, Wilson M (2012) Value of MR contrast media in image-guided body interventions. World J Radiol 4(1):1–12
Bock M, Wacker FK (2008) MR-guided intravascular interventions: techniques and applications. JMRI 27(2):326–338
Kos S, Huegli R, Bongartz GM, Jacob AL, Bilecen D (2008) MR-guided endovascular interventions: a comprehensive review on techniques and applications. Eur Radiol 18(4):645–657
Losey A, Lillaney P, Martin A, Cooke D (2014) Magnetically assisted remote-controlled endovascular catheter for interventional MR imaging. In vitro navigation at 1.5 T versus X-ray fluoroscopy. Radiology 271(3):862–869
Gentric J-C, Trelhu B, Jannin P, Riffaud L, Ferré J-C (2013) Development of workflow task analysis during cerebral diagnostic angiographies: time-based comparison of junior and senior tasks. J Neuroradiol 40(5):342–347
Flin R, Yule S, McKenzie L, Paterson-Brown S, Maran N (2006) Attitudes to teamwork and safety in the operating theatre. Surgeon 4(3):145–151
Johnson S, Healey a, Evans J, Murphy M, Crawshaw M, Gould D (2006) Physical and cognitive task analysis in interventional radiology. Clin Radiol 61(1):97–103
Van Herzeele I, Aggarwal R, Neequaye S, Darzi A, Vermassen F, Cheshire NJ (2008) Cognitive training improves clinically relevant outcomes during simulated endovascular procedures. J Vasc Surg 48(5):1223–1230
van Gog T, Paas F, van Merriënboer JJG, Witte P (2005) Uncovering the problem-solving process: cued retrospective reporting versus concurrent and retrospective reporting. J Exp Psychol Appl 11(4):237–244
Brusin JH (2011) Ergonomics in radiology. J Am Soc Radiol Technol 83(2):141–157
García-Lallana a, Viteri-Ramírez G, Saiz-Mendiguren R, Broncano J (2011) Ergonomics of the workplace in radiology. Radiol Engl Ed 53(6):507–515
Sikkink CJJM, Reijnen MMPJ, Zeebregts CJ (2008) The creation of the optimal dedicated endovascular suite. Eur J Vasc Endovasc Surg 35(2):198–204
Rostenberg B, Barach PR (2011) Design of cardiovascular operating rooms for tomorrow’s technology and clinical practice—part one. Prog Pediatr Cardiol 33(1):57–65
Rube MA, Fernandez-Gutierrez F, Cox BF, Holbrook AB, Houston JG, White RD, McLeod H, Fatahi M, Melzer A (2014) Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty. Int J CARS. doi:10.1007/s11548-014-1102-0
Chaffin D (2008) Digital human modeling for workspace design. Rev Hum Factors Ergon 4(1):41–74
Santos JM, Wright Ga, Pauly JM (2004) Flexible real-time magnetic resonance imaging framework. Conf Proc IEEE Eng Med Biol Soc 2:1048–1051
Ballinger Ga (2004) Using generalized estimating equations for longitudinal data analysis. Organ Res Methods 7(2):127–150
Law AM (2007) Simulation modeling and analysis, 4th edn. Mcgraw Hill Higher Education, New York
He Y (2010) Missing data analysis using multiple imputation: getting to the heart of the matter. Circul Cardiovasc Qual Outcomes 3(1):98–105
McAtamney L, Nigel Corlett E (1993) RULA: a survey method for the investigation of work-related upper limb disorders. Appl Ergon 24(2):91–99
Woodson WE, Tillman B, Tillman P (1992) Human factors design handbook, 2nd edn. McGraw Hill, New York
Fernandez-Gutierrez F, Ferut J, Smink J, Houston G, Melzer A (May 2013) Ergonomics for MRI guided procedures. Case of study: postural analysis for MRI scanners. In: Proceedings of the 27th international congress and exhibition. Int J Comput Assist Radiol Surg 8(S1):5–11
Takahara T, Kwee T, Kibune S, Ochiai R, Sakamoto T, Niwa T, Van Cauteren M, Luijten P (2010) Whole-body MRI using a sliding table and repositioning surface coil approach. Eur Radiol 20(6):1366–1373
Kettenbach J, Kacher DF, Kanan AR, Rostenberg B, Fairhurst J, Stadler A, Kienreich K, Jolesz Fa (2006) Intraoperative and interventional MRI: recommendations for a safe environment. MITAT 15(2):53–64
Buckingham G, Wong JD, Tang M, Gribble PL, Goodale MA (2014) Observing object lifting errors modulates cortico-spinal excitability and improves object lifting performance. Cortex 50:115–124
Duncan JR, Kline B, Glaiberman CB (2007) Analysis of simulated angiographic procedures. Part 2: extracting efficiency data from audio and video recordings. JVIR 18(4):535–544
Beta E, Parikh AS, Street M, Duncan JR (2009) Capture and analysis of data from image-guided procedures. JVIR 20(6):769–781
Klein LW, Miller DL, Balter S, Laskey W, Haines D, Norbash A, Mauro MA, Goldstein JA (2009) Occupational health hazards in time for a safer environment. Radiology 250(2):538–544
Mohseni-Bandpei Ma, Ahmad-Shirvani M, Golbabaei N, Behtash H, Shahinfar Z, Fernández-de-las-Peñas C (2011) Prevalence and risk factors associated with low back pain in Iranian surgeons. J Manip Physiol Therap 34(6):362–370
Pérez-Duarte FJ, Lucas-Hernández M, Matos-Azevedo a, Sánchez-Margallo Ja, Díaz-Güemes FM (2014) Objective analysis ofsurgeons’ ergonomy during laparoendoscopic single-site surgery through the use of surface electromyography and a motion capture data glove. Surg Endosc 28(4):1314–1320
Kramp KH, van Det MJ, Totte ER, Hoff C, Pierie J-PEN (2014) Ergonomic assessment of the French and American position for laparoscopic cholecystectomy in the MIS Suite. Surg Endosc 28(5):1571–1578
Neumuth T, Jannin P, Strauss G, Meixensberger J, Burgert O (2008) Validation of knowledge acquisition for surgical process models. J Am Med Inform Assoc 6(1):72–80