In radiological screening, clinicians scan myriads of radiographs with the intent of recognizing and differentiating lesions. Even though they are trained experts, radiologists’ human search engines are not perfect: average daily error rates are estimated around 3–5%. A main underlying assumption in radiological screening is that visual search on a current radiograph occurs independently of previously seen radiographs. However, recent studies have shown that human perception is biased by previously seen stimuli; the bias in our visual system to misperceive current stimuli towards previous stimuli is called serial dependence. Here, we tested whether serial dependence impacts radiologists’ recognition of simulated lesions embedded in actual radiographs. We found that serial dependence affected radiologists’ recognition of simulated lesions; perception on an average trial was pulled 13% toward the 1-back stimulus. Simulated lesions were perceived as biased towards the those seen in the previous 1 or 2 radiographs. Similar results were found when testing lesion recognition in a group of untrained observers. Taken together, these results suggest that perceptual judgements of radiologists are affected by previous visual experience, and thus some of the diagnostic errors exhibited by radiologists may be caused by serial dependence from previously seen radiographs.

Humans perceive faces holistically rather than as a set of separate features. Previous work demonstrates that some individuals are better at this holistic type of processing than others. Here, we show that there are unique individual differences in holistic processing of specific Mooney faces. We operationalized the increased difficulty of recognizing a face when inverted compared to upright as a measure of the degree to which individual Mooney faces were processed holistically by individual observers. Our results show that Mooney faces vary considerably in the extent to which they tap into holistic processing; some Mooney faces require holistic processing more than others. Importantly, there is little between-subject agreement about which faces are processed holistically; specific faces that are processed holistically by one observer are not by other observers. Essentially, what counts as holistic for one person is unique to that particular observer. Interestingly, we found that the per-face, per-observer differences in face discrimination only occurred for harder Mooney faces that required relatively more holistic processing. These findings suggest that holistic processing of hard Mooney faces depends on a particular observer's experience whereas processing of easier, cartoon-like Mooney faces can proceed universally for everyone. Future work using Mooney faces in perception research should take these stimulus-specific individual differences into account to best isolate holistic processing.

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IntroductionRadiologists routinely make life-altering decisions. Optimizing these decisions has been an important goal for many years and has prompted a great deal of research on the basic perceptual mechanisms that underlie radiologists’ decisions. Previous studies have found that there are substantial individual differences in radiologists’ diagnostic performance (e.g., sensitivity) due to experience, training, or search strategies. In addition to variations in sensitivity, however, another possibility is that radiologists might have perceptual biases—systematic misperceptions of visual stimuli. Although a great deal of research has investigated radiologist sensitivity, very little has explored the presence of perceptual biases or the individual differences in these.MethodsHere, we test whether radiologists’ have perceptual biases using controlled artificial and Generative Adversarial Networks-generated realistic medical images. In Experiment 1, observers adjusted the appearance of simulated tumors to match the previously shown targets. In Experiment 2, observers were shown with a mix of real and GAN-generated CT lesion images and they rated the realness of each image.ResultsWe show that every tested individual radiologist was characterized by unique and systematic perceptual biases; these perceptual biases cannot be simply explained by attentional differences, and they can be observed in different imaging modalities and task settings, suggesting that idiosyncratic biases in medical image perception may widely exist.DiscussionCharacterizing and understanding these biases could be important for many practical settings such as training, pairing readers, and career selection for radiologists. These results may have consequential implications for many other fields as well, where individual observers are the linchpins for life-altering perceptual decisions.

Human face recognition is robust even under conditions of extreme lighting and in situations where there is high noise and uncertainty. Mooney faces are a canonical example of this: Mooney faces are two-tone shadow-defined images that are readily and holistically recognized despite lacking easily segmented face features. Face perception in such impoverished situations—and Mooney face perception in particular—is often thought to be supported by comparing encountered faces to stored templates. Here, we used a classification image approach to measure the templates that observers use to recognize Mooney faces. Visualizing these templates reveals the regions and structures of the image that best predict individual observer recognition, and they reflect the underlying internal representation of faces. Using this approach, we tested whether there are classification images that are consistent from session to session, whether the classification images are observer-specific, and whether they allow for pattern completion of holistic representations even in the absence of an underlying signal. We found that classification images of Mooney faces were indeed non-random (i.e., consistent session from session) within each observer, but they were different between observers. This result is in line with previously proposed existence of face templates that support face recognition, and further suggests that these templates may be unique to each observer and could drive idiosyncratic individual differences in holistic face recognition. Moreover, we found classification images that reflected information within the blank regions of the original Mooney faces, suggesting that observers may fill in missing information using idiosyncratic internal information about faces.