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Hands-free image retrieval in the operating room has taken another step forward. Engineers have taught the device to recognize the difference between intentional commands and random hand gestures.

Ever since Microsoft introduced the Kinect for Xbox 360, a 3-D infrared camera designed to control video games by means of gestures, tinkerers have been experimenting with medical uses, as we’ve reported.

Researchers at Purdue University have developed algorithms that recognize 10 specific hand gestures used in browsing and displaying medical images and electronic records during surgery. The gestures represent commands to rotate, zoom in or out, increase or decrease brightness, or browse left, right, up, or down.

However, said Juan Pablo Wachs, PhD, an assistant professor of industrial engineering at Purdue:

Surgeons will make many gestures during the course of a surgery to communicate with other doctors and nurses. The main challenge is to create algorithms capable of understanding the difference between these gestures and those specifically intended as commands to browse the image-viewing system.

Dr Wachs is lead author of an article about the research published online last month in the Journal of the American Medical Informatics Association. He was quoted in a Purdue news release.

To solve the problem, the researchers taught the device to consider context. “We can determine context by looking at the position of the torso and the orientation of the surgeon’s gaze,” Dr. Wachs said. “Based on the direction of the gaze and the torso position, we can assess whether the surgeon wants to access medical images.”

The algorithm can even determine the phase of the surgery. “By observing the progress of the surgery,” Dr. Wachs said, “we can tell what is the most likely image the surgeon will want to see next.”

Overall, he said, context recognition allowed the algorithms to reduce their rate of false positives from 20.8 percent to 2.3 percent.

But why bother with hands-free image retrieval in the first place? “Computers and their peripherals are difficult to sterilize, and keyboards and mice have been found to be a source of contamination,” Dr. Wachs said. “Also, when nurses or assistants operate the keyboard for the surgeons, the process of conveying information accurately has proven cumbersome and inefficient.”

Engineers will find other uses for hands-free control systems. But health-care applications are likely to remain limited. For many medical procedures, an error rate of even 2.3 percent is way, way too high.

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