Empirical studies of the reliability of surgical navigation systems

A number of studies demonstrate the clinical relevance of systems for computer assisted surgery (CAS systems). As however studies on human error in medicine indicate, reliability of the results strongly depends on aspects of usability and error tolerance of the system. This paper presents studies which aim to assess these aspects of reliability of CAS systems. In a clinical study, interaction with a CAS system by 16 expert and novice surgeons was observed and assessed. From 133 recorded incidents 41% were rated to have significant impact on the clinical result or to inhibit successful completion of the task, which indicates a low degree of error tolerance of the system. These findings are supported by the results obtained from questionnaire, were learnability and error tolerance were judged to be not sufficient.