Eye-movement study and human performance using telepathology virtual slides. Implications for medical education and differences with experience

Krupiński, Elizabeth A.; Tillack, Allison A.; Richter, Lynne; Henderson, Jeffrey T.; Bhattacharyya, Achyut K.; Scott, Katherine; Graham, Anna R.; Descour, Michael R.; Davis, John R.; Weinstein, Ronald S.

doi:10.1016/j.humpath.2006.08.024

Cited by 249 publications

(231 citation statements)

References 29 publications

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“…These studies have identified different patterns, such as a 'scanning style' and a 'selective style' (Tiersma et al 2003), as well as highlighting differences in the behaviour of expert histopathologists and trainees (Krupinski et al 2006;Treanor et al 2009). …”

Section: Previous Studies Of Histopathologymentioning

confidence: 99%

Diagnosis at the microscope: a workplace study of histopathology

et al. 2011

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Histopathologists diagnose cancer and other diseases by using a microscope to examine glass slides containing thin sections of human tissue. Technological advances mean that it is now possible to digitise the slides so that they can be viewed on a computer, promising a number of benefits in terms of both efficiency and safety.Despite this, uptake of digital microscopy for diagnostic work has been slow and research suggests scepticism and uncertainty amongst histopathologists. In order to design a successful digital microscope, one which fits with the work practices of histopathologists and which they are happy to use within their daily work, we have undertaken a workplace study of a histopathology department. In this paper, we present the findings of that study and discuss the implications of these findings for the design of a digital microscope. The findings emphasise the way in which a diagnosis is built up as particular features on the glass slides are noticed and highlighted and the various information sources that are drawn on in the process of making a diagnosis.

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Section: Previous Studies Of Histopathologymentioning

confidence: 99%

Diagnosis at the microscope: a workplace study of histopathology

et al. 2011

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“…9,10 Digital WSI may provide opportunities to improve the way we train pathologists and how we evaluate histopathology skills, leading to improvements in overall diagnostic abilities and medical care. The inclusion of automated algorithms to highlight ROI may focus a practicing pathologist's attention on potentially diagnostic regions, particularly when non-diagnostic distracting features are present.…”

Section: Discussionmentioning

confidence: 99%

Region of interest identification and diagnostic agreement in breast pathology

et al. 2016

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A pathologist's accurate interpretation relies on identifying relevant histopathological features. Little is known about the precise relationship between feature identification and diagnostic decision making. We hypothesized that greater overlap between a pathologist's selected diagnostic region of interest (ROI) and a consensus derived ROI is associated with higher diagnostic accuracy. We developed breast biopsy test cases that included atypical ductal hyperplasia (n = 80); ductal carcinoma in situ (n = 78); and invasive breast cancer (n = 22). Benign cases were excluded due to the absence of specific abnormalities. Three experienced breast pathologists conducted an independent review of the 180 digital whole slide images, established a reference consensus diagnosis and marked one or more diagnostic ROIs for each case. Forty-four participating pathologists independently diagnosed and marked ROIs on the images. Participant diagnoses and ROI were compared with consensus reference diagnoses and ROI. Regression models tested whether percent overlap between participant ROI and consensus reference ROI predicted diagnostic accuracy. Each of the 44 participants interpreted 39-50 cases for a total of 1972 individual diagnoses. Percent ROI overlap with the expert reference ROI was higher in pathologists who self-reported academic affiliation (69 vs 65%, P = 0.002). Percent overlap between participants' ROI and consensus reference ROI was then classified into ordinal categories: 0, 1-33, 34-65, 66-99 and 100% overlap. For each incremental change in the ordinal percent ROI overlap, diagnostic agreement increased by 60% (OR 1.6, 95% CI (1.5-1.7), P o0.001) and the association remained significant even after adjustment for other covariates. The magnitude of the association between ROI overlap and diagnostic agreement increased with increasing diagnostic severity. The findings indicate that pathologists are more likely to converge with an expert reference diagnosis when they identify an overlapping diagnostic image region, suggesting that future computer-aided detection systems that highlight potential diagnostic regions could be a helpful tool to improve accuracy and education.

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“…Visual search characteristics often function as predictors of training and diagnostic accuracy [22][23][24][25][26][27][28][29][30][31][32][33][34][35] in other clinical specialties such as radiology and pathology; thus, one would expect to find differences in other specialties where images are utilized in the diagnostic process. The objective of this study was to evaluate the feasibility of extending the use of eyetracking methodology to the dermatology field, specifically to the evaluation of individual pigmented lesions through storedand-forward close-up and dermoscopy images.…”

Section: Introductionmentioning

confidence: 99%

Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training

et al. 2014

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The goal of this investigation was to explore the feasibility of characterizing the visual search characteristics of dermatologists evaluating images corresponding to single pigmented skin lesions (PSLs) (close-ups and dermoscopy) as a venue to improve training programs for dermoscopy. Two Board-certified dermatologists and two dermatology residents participated in a phased study. In phase I, they viewed a series of 20 PSL cases ranging from benign nevi to melanoma. The close-up and dermoscopy images of the PSL were evaluated sequentially and rated individually as benign or malignant, while eye position was recorded. Subsequently, the participating subjects completed an online dermoscopy training module that included a pre-and post-test assessing their dermoscopy skills (phase 2). Three months later, the subjects repeated their assessment on the 20 PSLs presented during phase I of the study. Significant differences in viewing time and eyeposition parameters were observed as a function of level of expertise. Dermatologists overall have more efficient search than residents generating fewer fixations with shorter dwells. Fixations and dwells associated with decisions changing from benign to malignant or vice versa from photo to dermatoscopic viewing were longer than any other decision, indicating increased visual processing for those decisions. These differences in visual search may have implications for developing tools to teach dermatologists and residents about how to better utilize dermoscopy in clinical practice.

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Eye-movement study and human performance using telepathology virtual slides. Implications for medical education and differences with experience

Cited by 249 publications

References 29 publications

Diagnosis at the microscope: a workplace study of histopathology

Diagnosis at the microscope: a workplace study of histopathology

Region of interest identification and diagnostic agreement in breast pathology

Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training

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