Enabling reliable usability assessment and comparative analysis of medical software: a comprehensive framework for multimodal biomedical imaging platforms

Purpose. A literature review reveals that, at the moment, all usability tests for Software as a Medical Device (SaMD) are designed in compliance with international standards but it also reveals a lack of formalization in the implementa tion and administration of such usability tests, which prevents the comparison of results from different tests for the same class of SaMD. This study aims to provide a reproducible usability testing framework for SaMD to establish a standardized protocol which can ensure repeatability and comparisons of similar SaMD for the visualization of medi cal images and data. Methods. The devised protocol aligns with international standards and literature recommendations for usability and human factors engineering. It encompasses participant selection, testing environments, equipment setup for various testing methods (HDMI vs. wireless), and hardware interfaces (keyboard/mouse vs. touchscreen), as well as the roles of the required testers. The protocol consists of two distinct sections: exploratory tasks and specific scenarios, to assess software functions and real life tasks, respectively. Effectiveness and efficiency are evaluated using video analysis and a custom Stopwatch software, while user satisfaction is measured through post-test questionnaires. Results. The usability testing protocol was applied to a Multimodal Biomedical Imaging Platform All-in-One software developed by Imaginalis S.r.l. (Sesto Fiorentino, Italy) for validation. The results of the usability testing protocol applied to the case-study software demonstrate good values of software’s effectiveness and efficiency, along with user satisfaction supporting the prior heuristic evaluation. The outcomes confirm the robustness, applicability, and reproducibility of the usability testing protocol, aligning with best practices. Conclusions. The proposed usability testing framework enables reliable usability assessment and comparative analysis of medical software. Furthermore, the obtained results can serve as a reference for assessing other biomedical imaging platforms under development or ready for release.