Designing Better User Interfaces for Radiology Interpretation

Since the 1980s, radiologists have started to interpret digital radiographs using modern computer systems, a process known as softcopy reading. For softcopy reading, Hanging Protocols are used to automatically arrange images for interpretation upon opening a case, thus minimizing the need for physicians to manipulate images. We have developed a strategy, called HP++, which extends current hanging protocols with support for 'scenario-based' interpretation, matching the radiologist's workflow and ensuring a chronological presentation of information. We hypothesized that HP++ significantly reduces off-image eye fixations, the interpretation time, and the frequency and complexity of user input. We validated our hypothesis with inexpensive usability studies based on an abstraction of the radiologist's task, transferred to novice subjects. For a radiology look-alike task, we compared the performance of 20 graduate students using our HP++ based interaction technique with their performance using a conventional interaction technique. We observed a 15% reduction in the average interpretation time using the staged approach, with one third fewer interpretation errors, two thirds fewer mouse clicks, and over 65% less eye gaze over the workstation controls. User satisfaction with the staged interface was significantly higher than with the traditional interface. Preliminary external validation of these results with physician subjects indicate our usability results transfer to radiology softcopy reading. We conclude that designing radiology workstations with support for HP++ can improve the performance of workstation users.