Clinical Usability Evaluation of CT Work Systems: A Narrative Review and Socio-Technical Implementation Framework

Computed tomography (CT) services are commonly evaluated using image quality, radiation dose, and equipment uptime. These metrics, however, do not establish whether CT work systems can be used safely, efficiently, and consistently across clinical information flows. This review synthesizes usability standards, human factors concepts, and radiology informatics evidence to support clinical evaluation of CT work systems. The scope included scanner interfaces, RIS/PACS/EMR links, dose monitoring tools, protocol repositories, and workflow logs. We conducted a transparent narrative review using targeted PubMed/MEDLINE and IEEE Xplore searches, Crossref metadata checks, standards, guidance documents, and citation chaining. Evidence was organized by context of use, information system component, risk-relevant task, evaluation method, and implementation action. CT usability is a socio-technical property linking users, tasks, scanner interfaces, information systems, protocol governance, maintenance, and organizational context. No single method captures this system adequately. Digital timestamps and observation reveal workflow delays, while task-based testing and scales characterize interface performance and user burden. Protocol, dose monitoring, and maintenance audits identify lifecycle risks. The proposed framework maps five domains to evaluation methods, candidate indicators, mitigation strategies, and minimum reporting items. Comprehensive CT usability assessment should extend beyond global satisfaction and equipment performance. It should determine whether specified users can complete defined CT tasks within defined clinical and informatics contexts. Future research should validate CT-specific task libraries, usability scales, interoperable log definitions, and multi-site reporting standards.