title: A usability evaluation of medical software at an expert conference setting.
abstract: BACKGROUND
  A usability test was employed to evaluate two medical software applications at an expert conference setting. One software application is a medical diagnostic tool (electrocardiogram [ECG] viewer) and the other is a medical research tool (electrode misplacement simulator [EMS]). These novel applications have yet to be adopted by the healthcare domain, thus, (1) we wanted to determine the potential user acceptance of these applications and (2) we wanted to determine the feasibility of evaluating medical diagnostic and medical research software at a conference setting as opposed to the conventional laboratory setting.
  
  
  METHODS
  The medical diagnostic tool (ECG viewer) was evaluated using seven delegates and the medical research tool (EMS) was evaluated using 17 delegates that were recruited at the 2010 International Conference on Computing in Cardiology. Each delegate/participant was required to use the software and undertake a set of predefined tasks during the session breaks at the conference. User interactions with the software were recorded using screen-recording software. The 'think-aloud' protocol was also used to elicit verbal feedback from the participants whilst they attempted the pre-defined tasks. Before and after each session, participants completed a pre-test and a post-test questionnaire respectively.
  
  
  RESULTS
  The average duration of a usability session at the conference was 34.69 min (SD=10.28). However, taking into account that 10 min was dedicated to the pre-test and post-test questionnaires, the average time dedication to user interaction of the medical software was 24.69 min (SD=10.28). Given we have shown that usability data can be collected at conferences, this paper details the advantages of conference-based usability studies over the laboratory-based approach. For example, given delegates gather at one geographical location, a conference-based usability evaluation facilitates recruitment of a convenient sample of international subject experts. This would otherwise be very expensive to arrange. A conference-based approach also allows for data to be collected over a few days as opposed to months by avoiding administration duties normally involved in laboratory based approach, e.g. mailing invitation letters as part of a recruitment campaign. Following analysis of the user video recordings, 41 (previously unknown) use errors were identified in the advanced ECG viewer and 29 were identified in the EMS application. All use errors were given a consensus severity rating from two independent usability experts. Out of a rating scale of 4 (where 1=cosmetic and 4=critical), the average severity rating for the ECG viewer was 2.24 (SD=1.09) and the average severity rating for the EMS application was 2.34 (SD=0.97). We were also able to extract task completion rates and times from the video recordings to determine the effectiveness of the software applications. For example, six out of seven tasks were completed by all participants when using both applications. This statistic alone suggests both applications already have a high degree of usability. As well as extracting data from the video recordings, we were also able to extract data from the questionnaires. Using a semantic differential scale (where 1=poor and 5=excellent), delegates highly rated the 'responsiveness', 'usefulness', 'learnability' and the 'look and feel' of both applications.
  
  
  CONCLUSIONS
  This study has shown the potential user acceptance and user-friendliness of the novel EMS and the ECG viewer applications within the healthcare domain. It has also shown that both medical diagnostic software and medical research software can be evaluated for their usability at an expert conference setting. The primary advantage of a conference-based usability evaluation over a laboratory-based evaluation is the high concentration of experts at one location, which is convenient, less time consuming and less expensive.
authors.affiliation: University of Ulster, Northern Ireland, UK. Electronic address: rb.bond@ulster.ac.uk.
authors.forename: Raymond Robert
authors.initials: RR
authors.lastname: Bond
authors.forename: Dewar D
authors.initials: DD
authors.lastname: Finlay
authors.forename: Chris D
authors.initials: CD
authors.lastname: Nugent
authors.forename: George
authors.initials: G
authors.lastname: Moore
authors.forename: Daniel
authors.initials: D
authors.lastname: Guldenring
mesh_terms: D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D004566:Electrodes; D012984:Software; D011795:Surveys and Questionnaires
keywords: ECG; HCI; Interaction design; Interfaces; Medical software; Usability