BACKGROUND: The complex user interface design of radiotherapy treatment delivery systems can lead to use error and patient harm. In this study, we present the results of a comparison of 3 radiotherapy treatment delivery systems now used in China.

MATERIAL AND METHODS: We conducted a comprehensive usability study of 3 radiotherapy treatment delivery systems. Expert evaluation was performed through heuristic evaluation with 3 human-factors experts and 1 experienced radiation therapist for each system. User experience was assessed through perceived system usability and workload, using the National Aeronautics and Space Administration Task Load Index and the Post-Study System Usability Questionnaire.

RESULTS: For the expert evaluation, 47 usability problems were identified for Varian Trilogy, 75 for Elekta Precise, and 37 for Shinva XHA600E. Most problems were classified as major and minor usability problems, and were found in the process of patient setup and setup verification. For the user experience, radiation therapists presented a lower workload for Varian Trilogy compared to Elekta Precise (P<0.01) and Shinva XHA600E (P<0.01), and a lower workload for Elekta Precise compared to Shinva XHA600E (P=0.020). Radiation therapists perceived a higher system usability for Varian Trilogy compared to Shinva XHA600E (P<0.01), and a higher system usability for Elekta Precise compared to Shinva XHA600E (P<0.01).

CONCLUSIONS: This research provides valuable data on how 3 radiotherapy treatment delivery systems compare. The results of this study may be useful for hospital equipment procurement decisions, and designing next-generation products to improve patient safety.

Keywords: Equipment Design, Equipment Failure Analysis, Equipment Safety, Radiotherapy, User-Computer Interface, Patient safety, Patient Satisfaction, Surveys and Questionnaires