Do Long Radiology Workdays Affect Nodule Detection in Dynamic CT Interpretation?

Krupiński, Elizabeth A.; Berbaum, Kevin S.; Caldwell, Robert T.; Schartz, Kevin M.; Madsen, Mark T.; Kramer, David J.

doi:10.1016/j.jacr.2011.11.013

Cited by 91 publications

(70 citation statements)

References 38 publications

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“…We recently carried out two studies [11][12] examining the impact of fatigue on performance. In the first one [11] forty attending radiologists and radiology residents viewed 60 de-identified bone examinations, half with fractures, once before any clinical reading (Early) and once after a day of clinical reading (Late).…”

Section: Purposementioning

confidence: 99%

“…In the second study [12], twenty-two radiologists and 22 residents were given two tests searching CT chest sequences for a solitary pulmonary nodule before and after a day of clinical reading. To measure search time, ten lung CT sequences, each containing 20 consecutive sections and a single nodule, were inspected using free search and navigation.…”

Section: Purposementioning

confidence: 99%

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Potential method for relieving fatigue in radiologists

Krupiński

2013

Medical Imaging 2013: Image Perception, Observer Performance, and Technology Assessment

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Radiologists moved to an environment in which they read digital images off of computer displays instead of film images off of light boxes. With film and light boxes they typically would read for about an hour (seated) and then take a break while the film librarian changed the images on the view box. With digital viewing off computers they tend to sit all day in front of the computers with far fewer breaks and opportunity to stand up and move around than with film. There is concern that this lack of activity not only contributes to back, shoulder and neck discomfort, but also contributes to increased fatigue which has been shown to impact reader performance. The goal of this study was to determine if there are differences in physiologic vital signs (heart rate and blood pressure) of radiologists as a function of whether they read images while seated or while standing up. Five subjects had their blood pressure and heart rate measured while seated and while standing reading cases in the normal clinical setting. For all three measures there was a statistically significant (p < 0.0001) difference between seated and standing measures with seated being lower than standing. The higher heart rate and blood pressure with standing suggests that the radiologists are more active in this position and thus potentially more attentive than while seated. This study will be followed up to determine impact on diagnostic performance of standing vs seated as well as subjective ratings of wakefulness and mood. PURPOSERadiologists have moved from an environment in which they read digital images off computer displays instead of film images off light boxes. With film and light boxes they typically would read for about an hour (seated) and then take a break while the film librarian changed the images on the view box. During that time they would generally leave the viewing area, move to another alternator to resume work, or go to their offices to carry out other tasks. More often than not, they essentially got up and moved around a bit. With the transition to digital viewing off computers they tend to sit all day in front of the computers with far fewer breaks and opportunities to stand up and move around than with film. There is concern that this lack of activity not only contributes to back, shoulder and neck discomfort, but also contributes to lack of activity that could affect their physical well-being in general. One study of two large hospitals reported backache in 83% of technologists and neck pain in 59% of female radiologists. Mouse and keyboard use has also been associated with development of carpal and cubital tunnel syndrome in radiologists [1-3] Hedge et al. have documented that current patterns of information technology use in healthcare specifically pose an increased risk of work-related musculoskeletal disorders. [4] As a first step in our investigations into fatigue, we designed a survey to find out whether fatigue is a common and important problem in the radiology reading room that was given at different times during the d...

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Section: Purposementioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Potential method for relieving fatigue in radiologists

Krupiński

2013

Medical Imaging 2013: Image Perception, Observer Performance, and Technology Assessment

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“…After their usual workday, radiologists experience increased fatigue and decreased diagnostic accuracy for detecting pulmonary nodules on CT. Effects of fatigue may be mitigated by active interaction with the display [30].…”

Section: Visual Fatiguementioning

confidence: 99%

Real-Time Occupational Stress and Fatigue Measurement in Medical Imaging Practice

Krupiński

Reiner

2011

J Digit Imaging

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“…It has also been found that subjective feelings of physical, mental and emotional strain (11, 12) increase in radiologists who have spent as little as 8 hours interpreting clinical images. Both physical and subjective measures indicate that residents may actually be more vulnerable to effects of fatigue than attending radiologists.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Fatigue on Satisfaction of Search in Chest Radiography

et al. 2017

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Purpose To assess the nature of the satisfaction of search (SOS) effect in chest radiography when observers are fatigued; determine if we could replicate recent findings that have documented the nature of the SOS effect to be due to a threshold shift rather than a change in diagnostic accuracy as in earlier film-based studies. Materials and Methods Nearing or at the end of a clinical workday, 20 radiologists read 64 chest images twice, once with and once without the addition of a simulated pulmonary nodule. Half of the images had different types of “test” abnormalities. Decision thresholds were analyzed using the center of the range of false positive (FP) and true positive (TP) fractions associated with each Receiver Operating Characteristic (ROC) point for reporting test abnormalities. Detection accuracy was assessed with ROC technique and inspection time was recorded. Results The SOS effect was confirmed to be a reduction in willingness to respond (threshold shift). The center of the FP range was significantly reduced (FP = 0.10 without added nodules, FP = 0.05 with added nodules, F(1,18) = 19.85, p = 0.0003). The center of the TP range was significantly reduced (TP = 0.39 without added nodules, TP = 0.33 with added nodules, F(1,18) = 10.81, p = 0.004). Conclusion This study suggests that fatigue does not change the nature of the SOS effect, but rather may be additive with the SOS effect. SOS reduces both true and false positive responses, whereas fatigue reduces true positives more than false positives.

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Do Long Radiology Workdays Affect Nodule Detection in Dynamic CT Interpretation?

Cited by 91 publications

References 38 publications

Potential method for relieving fatigue in radiologists

Potential method for relieving fatigue in radiologists

Real-Time Occupational Stress and Fatigue Measurement in Medical Imaging Practice

The Impact of Fatigue on Satisfaction of Search in Chest Radiography

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