Role of faulty visual search in the satisfaction of search effect in chest radiography

Berbaum, Kevin S.; Franken, Edmund A.; Dorfman, Donald D.; Miller, Eric M.; Caldwell, Robert T.; Kuehn, David M.; Berbaum, Michael L.

doi:10.1016/s1076-6332(98)80006-8

Cited by 66 publications

(44 citation statements)

References 16 publications

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“…There is also substantial evidence in favor of the phenomenon of satisfaction of search, whereby a reader stops looking for additional abnormalities once a certain number of findings have been reached. 21,22 Training and experience are essential for the development and maintenance of an accurate image interpreter. Eng et al 23 compared the interpretations of plain radiographs with known findings between radiology and emergency medicine physicians on staff and radiology and emergency medicine residents.…”

Section: Discussionmentioning

confidence: 99%

Quality Control in Neuroradiology: Discrepancies in Image Interpretation among Academic Neuroradiologists

Babiarz¹,

Yousem²

2011

AJNR Am J Neuroradiol

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SUMMARY:Prior studies have found a 3%-6% clinically significant error rate in radiology practice. We set out to assess discrepancy rates between subspecialty-trained university-based neuroradiologists. Over 17 months, university neuroradiologists randomly reviewed 1000 studies and reports of previously read examinations of patients in whom follow-up studies were read. The discrepancies between the original and "second opinion" reports were scored according to a 5-point scale: 1, no change; 2, clinically insignificant detection discrepancy; 3, clinically insignificant interpretation discrepancy; 4, clinically significant detection discrepancy; and 5, clinically significant interpretation discrepancy. Of the 1000 studies, 876 (87.6%) showed agreements with the original report. The neuroradiology division had a 2.0% (20/1000; 95% CI, 1.1%-2.9%) rate of clinically significant discrepancies involving 8 CTs and 12 MR images. Discrepancies were classified as vascular (n ϭ 7), neoplastic (n ϭ 9), congenital (n ϭ 2), and artifacts (n ϭ 2). Individual neuroradiologist's scores ranged from 0% to 7.7% Ϯ 2.3% (n ϭ 18). Both CT and MR imaging studies had a discrepancy rate of 2.0%. Our quality assessment study could serve as initial data before intervention as part of a PQI project.ABBREVIATIONS: ABR ϭ American Board of Radiology; ACGME ϭ Accreditation Council for Graduate Medical Education; CI ϭ confidence interval; PQI ϭ practice quality improvement R adiologic detection and interpretation errors will not be fully eliminated until the advent of "perfect diagnostic tests" and "perfect observers." 1,2 In the meantime, radiologists, similar to other physicians, struggle with assessing physician performance and reporting quality, to improve and deliver the best care possible.3 L. Henry Garland pioneered the work on radiologic errors more than 60 years ago. [4][5][6] He uncovered a 30% rate of missed radiologic findings in a series of radiographs with abnormal findings among expert reviewers. Subsequently Garland's results have been replicated by other researchers. [7][8][9] Most interesting, comparable rates of "mistakes" were discovered in other specialties. 10,11 In deriving the radiologic error rate, Garland used exclusively abnormal studies-that is, he tested radiologists in environments in which disease prevalence reached 100%. Because in the typical clinical setting, there are a substantial number of examinations with normal findings, Garland hypothesized that the expected radiologic error rate in everyday practice is closer to 5%.Subsequent studies confirmed the radiologic error rate in all-comers radiology practice to be in the 3%-6% range. 3,12-14Soffa et al 14 sampled approximately 7000 cases read by 26 radiologists and uncovered a 3% disagreement rate in general radiology, 3.6% in diagnostic mammography, 5.8% in screening mammography, and 4.1% in sonography, yielding the overall error rate of 3.5%. Robinson et al 13 compared reports for skeletal, chest, and abdominal radiographs completed by 3 radiologists and found ...

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Section: Discussionmentioning

confidence: 99%

Quality Control in Neuroradiology: Discrepancies in Image Interpretation among Academic Neuroradiologists

Babiarz¹,

Yousem²

2011

AJNR Am J Neuroradiol

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“…Prior to each procedure, the eyetracking apparatus was calibrated to the observer's eye position, using a previously reported method (Berbaum et al, 1998;Berbaum et aI., 1996).…”

Section: Efficacy Of the Correction Methodsmentioning

confidence: 99%

Correcting errors in eye-position data arising from the distortion of magnetic fields by display devices

Caldwell

Berbaum

Borah

2000

Behavior Research Methods, Instruments, & Computers

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Eye-position recordings have been used to produce detailed information about sampling and search behavior. The melding of magnetic head-tracking technology with eye-tracking systems has allowed for freer head movement, but not without problems. Although the requisite calibrations made before and after a reading might indicate good eye-tracking accuracy, point-of-gaze errors can occur if the reader leans toward a display, such as a film alternator. The error results from the characteristic that large metal masses can distort magnetic fields, leading to false magnetic sensor data. Corrections for this type of error have involved mapping the exact location and orientation of the magnetic sensor in the magnetic field by using a precision positioning device. We have devised a much cheaper method that relies on a fixture that holds the magnetic sensor in identical positions, with and without the distorting effect.

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“…Why else would clinical history affect the interpretation? [33][34][35][36][37][38][39][40]. If fatigue causes radiologists to take less time processing relevant information and preparing themselves cognitively to interpret a case, diagnostic errors will increase.…”

Section: Cognitive Fatiguementioning

confidence: 99%

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

Krupiński

Reiner

2011

J Digit Imaging

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Role of faulty visual search in the satisfaction of search effect in chest radiography

Cited by 66 publications

References 16 publications

Quality Control in Neuroradiology: Discrepancies in Image Interpretation among Academic Neuroradiologists

Quality Control in Neuroradiology: Discrepancies in Image Interpretation among Academic Neuroradiologists

Correcting errors in eye-position data arising from the distortion of magnetic fields by display devices

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

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