How do radiologists do it? The influence of experience and training on searching for chest nodules

Manning, David J.; Ethell, Susan C.; Donovan, Tim; Crawford, Trevor J.

doi:10.1016/j.radi.2005.02.003

Cited by 174 publications

(185 citation statements)

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“…Experienced radiographers frequently demonstrate comparable detection performance to experts in nodule detection tasks (Donovan & Litchfield, 2013;Litchfield et al, 2010;Manning, Barker-Mill, Donovan, & Crawford, 2005;Manning et al, 2006) and fracture detection tasks . As such, we do not believe this drop in accuracy was due to a lack of expertise, but instead due to increasing task demands.…”

Section: Discussionmentioning

confidence: 99%

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Litchfield¹,

Donovan²

2016

Journal of Experimental Psychology: Human Perception and Perfor

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Rapid scene recognition is a global visual process we can all exploit to guide search. This ability is thought to underpin expertise in medical image perception yet there is no direct evidence that isolates the expertise-specific contribution of processing scene previews on subsequent eye movement performance. We used the flash-preview moving window paradigm (Castelhano & Henderson, 2007) to investigate this issue. Expert radiologists and novice observers underwent 2 experiments whereby participants viewed a 250-ms scene preview or a mask before searching for a target. Observers looked for everyday objects from real-world scenes (Experiment 1), and searched for lung nodules from medical images (Experiment 2). Both expertise groups exploited the brief preview of the upcoming scene to more efficiently guide windowed search in Experiment 1, but there was only a weak effect of domain-specific expertise in Experiment 2, with experts showing small improvements in search metrics with scene previews. Expert diagnostic performance was better than novices in all conditions but was not contingent on seeing the scene preview, and scene preview actually impaired novice diagnostic performance. Experiment 3 required novice and experienced observers to search for a variety of abnormalities from different medical images. Rather than maximizing the expertise-specific advantage of processing scene previews, both novices and experienced radiographers were worse at detecting abnormalities with scene previews. We discuss how restricting access to the initial glimpse can be compensated for by subsequent search and discovery processing, but there can still be costs in integrating a fleeting glimpse of a medical scene.

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Section: Discussionmentioning

confidence: 99%

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Litchfield¹,

Donovan²

2016

Journal of Experimental Psychology: Human Perception and Perfor

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“…In previously reported studies we have investigated observer experience [1,2] and the effects of lesion conspicuity [3] on performance in nodule detection from plain chest radiology. Comparisons of diagnostic performance through alternate free response receiver operating characteristic (AFROC) [4] showed that after training and extensive caseload experience radiographers' detection rate improved to approach that of the experts.…”

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confidence: 99%

Time-dependent observer errors in pulmonary nodule detection

Manning¹,

S²,

Donovan³

et al. 2006

BJR

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ABSTRACT. The work was carried out to investigate differences in visual search characteristics between groups of observers with different levels of experience in the task of pulmonary nodule detection in chest radiology and we report here on these differences in respect of time related decisions. Volunteer observers were divided into three groups depending on their level of expertise. There were eight radiologists, eight radiographers and eight novices. Their task was to detect pulmonary nodules in a test bank of 120 digitized posteroanterior (PA) chest radiographs. Five of the eight radiographers were tested twice: once before and once after a 6-month training programme in interpretation of the adult chest radiograph. During each test session the observers' eye movements were tracked. Data on the observers' decisions through Alternate Free Response Operating Characteristic (AFROC) methodology were correlated to their eye-movement and fixation patterns. True negative decisions from all observers were associated with shorter fixation times than false negative decisions. No correct negative decisions were made after fixations exceeding 3 s.

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“…Accordingly, experts in a specific domain can draw on their acquired knowledge to be more selective in the information they use to make decisions and are less likely to look at conspicuous but non-informative areas of a scene (for a recent meta-analysis, see Gegenfurtner, Lehtinan, & Säljö, 2011). Indeed, experts in medical image perception are much more selective than novices in deciding where to look (Donovan & Litchfield, 2013;Krupinski, 1996;Kundel & La Follette, 1972;Manning, Ethell, & Crawford, 2003;Manning, Ethell, & Donovan, 2004;Manning, Ethell, Donovan, & Crawford, 2006), and exhibit efficient scanpaths that allow abnormalities to be detected quickly (Krupinski, 1996;Kundel, Nodine, Conant, & Weinstein, 2007;Kundel, Nodine, Krupinski, & Mello-Thoms, 2008), whilst minimizing unnecessary fixations (Manning et al, 2006). Consequently, this allows experts to inspect medical images faster than less experienced observers without compromising on decision accuracy (Nodine, Mello-Thoms, Kundel, & Weinstein, 2002), and there is much to learn from viewing how experts search these complex images (Litchfield, Ball, Donovan, Manning, & Crawford, 2010).…”

Section: Introductionmentioning

confidence: 99%

“…A recurring finding of expert/novice studies is that not only can experts correctly identify more abnormalities than novices, the time taken to first fixate abnormalities (search latency) is faster for experts compared to novices (Donovan & Litchfield, 2013;Krupinski, 1996;Kundel, et al, 2007;Kundel, Nodine, Krupinski, & Mello-Thoms 2008;Nodine & MelloThoms, 2010;Reingold & Sheridan, 2011). Related to this, experts tend to make longer saccades than novices and these larger eye movements across the image help experts reach targets faster (Krupinski, 1996;Kundel, et al, 2007;Kundel et al, 2008;Manning et al, 2006). According to the holistic model the initial global analysis of the image is thought to initiate and guide search and so this efficiency in expert search behaviour is attributed to experts exploiting global processing that less experienced observers cannot (Kundel et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

The Flash-Preview Moving Window Paradigm: Unpacking Visual Expertise One Glimpse at a Time

Litchfield¹,

Donovan²

2017

FLR

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How we make sense of what we see and where best to look is shaped by our experience, our current task goals and how we first perceive our environment. An established way of demonstrating these factors work together is to study how eye movement patterns change as a function of expertise and to observe how experts can solve complex tasks after only very brief glances at a domain-specific image. The primary focus of this paper is to introduce an innovative gaze-contingent method called the 'Flash-Preview Moving Window' (FPMW) paradigm (Castelhano & Henderson, 2007), which was recently developed to understand our shared expertise in scene perception and how our first glimpse of a scene is used to guide our eye movement behaviour. In keeping with this special issue on visual expertise and medicine, this paper will highlight how the FPMW paradigm has the potential to resolve long-standing theoretical issues as to how, right from the very first glance, experts are able to process domain-specific images and guide their eye movements better than novices. Since FPMW is a gaze-contingent eye-tracking method, the paper will first outline the current methodological and theoretical frontier, and how the FPMW paradigm bridges established methods used to investigate visual expertise. The paper will discuss a recent example in which the FPMW was employed to investigate medical image perception expertise for the first time (Litchfield & Donovan, 2016), and by discussing the insights and challenges this method offers, this should ultimately deepen our understanding of visual expertise.

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How do radiologists do it? The influence of experience and training on searching for chest nodules

Cited by 174 publications

References 10 publications

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Time-dependent observer errors in pulmonary nodule detection

The Flash-Preview Moving Window Paradigm: Unpacking Visual Expertise One Glimpse at a Time

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