Usability comparison scoring of video and direct laryngoscopes: a reply

Abstract

I would like to thank to Marshall for their response [1] on the topic of usability between videolaryngoscopy and direct laryngoscopy [2], as well as for an extended analysis of the system usability scale including its limitations when comparing medical devices. However, I would like to clarify that the focus on usability is not intended to question the complexity of the devices themselves. Rather, the emphasis is on the perceived complexity associated with using videolaryngoscopes as compared with direct laryngoscopes. The essence of usability studies lies in understanding the user's perspective – how they perceive the ease or difficulty of using a particular system. This approach does not challenge the established superiority of videolaryngoscopy but seeks to understand why this clearly superior device has not yet been universally adopted, despite overwhelming evidence and expert consensus supporting its use [3].

The analogy drawn between desk and cellular telephones and may also be apt in this regard. The rapid adoption of cellular telephones and shift from analogue devices was largely driven by substantial investments in communication infrastructure and network upgrades. Likewise, although we can continuously promote the use of videolaryngoscopy by emphasising its obvious clinical and procedural advantages, this approach appears to be inadequate. This is evident from the continued underuse of videolaryngoscopes even many years after their integration into clinical practice [4].

We already have good accounts on how strategic changes at the institutional level can facilitate this transition [5], including standardisation of device use or type locally. The challenge now is to scale such strategies to a broader, perhaps national or international level. Investing in the necessary infrastructure and simplifying the perceived complexity of using videolaryngoscopes can promote their broader adoption as a superior tool.