Standardizing wrist x-rays: The human-centered design and evaluation of a wrist x-ray positioning tool
7 affiliations
- 1School of Biomedical Engineering, Western University, London, Ontario, Canada
- 2Roth McFarlane Hand and Upper Limb Centre, St. Joseph’s Health Care, London, Ontario, Canada
- 3School of Mechanical and Materials Engineering, Western University, London, Ontario, Canada
- 4Department of Diagnostic Imaging, St. Joseph’s Health Care, London, Ontario, Canada
- 5School of Health Sciences, Medical Radiation Technology Program, Fanshawe College, London, Ontario, Canada
- 6School of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
- 7Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
Abstract
Introduction/Background: Small amounts of malrotation can significantly decrease the diagnostic utility of a wrist radiograph. Poorly positioned wrist radiographs can result in repeat scans, additional imaging, and missed injuries. Tolerance for mistakes must be low. Radiographers, especially those with limited training, experience, or resources, may struggle to meet an acceptable standard, underscoring the need for an assistive positioning device that makes proper positioning more accessible. Methods: A human-centered design (HCD) process was used during the design of the Tru-Vu, a low-cost novel positioning aid, to assist radiographers with properly positioning of the wrist for x-rays. Initially, observations and preliminary interviews were conducted to understand the challenges faced by various end-users. The identified themes were used to guide the iterative design of the tool and training modules. To evaluate feasibility, the tool and training modules underwent testing using a cadaveric specimen. Results: Factors that affect x-ray positioning and shape device adoption were determined from the preliminary end-user interviews. Through post-intervention questionnaires, the Tru-Vu tool and training modules were found to be easy to use/understand and perceived as effective by radiographers. There was no significant difference observed in overall radiograph quality and visualization of the scapholunate (SL) interval during cadaveric feasibility testing. Discussion: This study provides insight into the HCD process used to create a novel radiographic positioning aid. The Tru-Vu tool was positively perceived by end-users; however, it did not demonstrate a significant effect on radiograph quality in cadaveric feasibility testing. Further research with live patients is required to demonstrate the clinical effectiveness of the Tru-Vu.
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BibTeX
@article{vancer2026standardizing,
title = {{Standardizing wrist x-rays: The human-centered design and evaluation of a wrist x-ray positioning tool}},
author = {Laura Vancer and Maxwell Campbell and Glenn Schurmans and John Henry and Jamie Kueneman and Joy MacDermid and Gregory Garvin and Emily Lalone},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0359437},
url = {https://doi.org/10.1371/journal.pone.0359437},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Standardizing wrist x-rays: The human-centered design and evaluation of a wrist x-ray positioning tool
AU - Laura Vancer
AU - Maxwell Campbell
AU - Glenn Schurmans
AU - John Henry
AU - Jamie Kueneman
AU - Joy MacDermid
AU - Gregory Garvin
AU - Emily Lalone
PY - 2026
DA - 2026/10/05
JO - PLOS One
DO - 10.1371/journal.pone.0359437
UR - https://doi.org/10.1371/journal.pone.0359437
AB - Introduction/Background: Small amounts of malrotation can significantly decrease the diagnostic utility of a wrist radiograph. Poorly positioned wrist radiographs can result in repeat scans, additional imaging, and missed injuries. Tolerance for mistakes must be low. Radiographers, especially those with limited training, experience, or resources, may struggle to meet an acceptable standard, underscoring the need for an assistive positioning device that makes proper positioning more accessible. Methods: A human-centered design (HCD) process was used during the design of the Tru-Vu, a low-cost novel positioning aid, to assist radiographers with properly positioning of the wrist for x-rays. Initially, observations and preliminary interviews were conducted to understand the challenges faced by various end-users. The identified themes were used to guide the iterative design of the tool and training modules. To evaluate feasibility, the tool and training modules underwent testing using a cadaveric specimen. Results: Factors that affect x-ray positioning and shape device adoption were determined from the preliminary end-user interviews. Through post-intervention questionnaires, the Tru-Vu tool and training modules were found to be easy to use/understand and perceived as effective by radiographers. There was no significant difference observed in overall radiograph quality and visualization of the scapholunate (SL) interval during cadaveric feasibility testing. Discussion: This study provides insight into the HCD process used to create a novel radiographic positioning aid. The Tru-Vu tool was positively perceived by end-users; however, it did not demonstrate a significant effect on radiograph quality in cadaveric feasibility testing. Further research with live patients is required to demonstrate the clinical effectiveness of the Tru-Vu.
SN - 1932-6203
ER -