title: Less is sometimes more: a comparison of distance-control and navigated-control concepts of image-guided navigation support for surgeons.
abstract: Image-guided navigation (IGN) systems provide automation support of intra-operative information analysis and decision-making for surgeons. Previous research showed that navigated-control (NC) systems which represent high levels of decision-support and directly intervene in surgeons' workflow provide benefits with respect to patient safety and surgeons' physiological stress but also involve several cost effects (e.g. prolonged surgery duration, reduced secondary-task performance). It was hypothesised that less automated distance-control (DC) systems would provide a better solution in terms of human performance consequences. N = 18 surgeons performed a simulated mastoidectomy with NC, DC and without IGN assistance. Effects on surgical performance, physiological effort, workload and situation awareness (SA) were compared. As expected, DC technology had the same benefits as the NC system but also led to less unwanted side effects on surgery duration, subjective workload and SA. This suggests that IGN systems just providing information analysis support are overall more beneficial than higher automated decision-support.
  This study investigates human performance consequences of different concepts of IGN support for surgeons. Less automated DC systems turned out to provide advantages for patient safety and surgeons' stress similar to higher automated NC systems with, at the same time, reduced negative consequences on surgery time and subjective workload.
authors.affiliation: a Research Training Group prometei, Technische Universität Berlin , Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Luz
authors.forename: Dietrich
authors.initials: D
authors.lastname: Manzey
authors.forename: Susanne
authors.initials: S
authors.lastname: Modemann
authors.forename: Gero
authors.initials: G
authors.lastname: Strauss
mesh_terms: D000328:Adult; D001331:Automation; D001364:Awareness; D000066491:Clinical Decision-Making / Q000379:methods*; D003198:Computer Simulation; D020000:Decision Support Systems, Clinical; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery; D009784:Occupational Diseases / Q000209:etiology / Q000523:psychology; D061646:Operative Time; D013517:Otorhinolaryngologic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D013315:Stress, Psychological / Q000209:etiology; D066231:Surgeons / Q000523:psychology*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D013647:Task Performance and Analysis; D057188:Workflow; D016526:Workload / Q000523:psychology
keywords: healthcare ergonomics; human–automation interaction; image-guided navigation; stages and levels of automation