What can an echocardiographer see in briefly presented stimuli? Perceptual expertise in dynamic search

Abstract

Background: Experts in medical image perception are able to detect abnormalities rapidly from medical images. This ability is likely due to enhanced pattern recognition on a global scale. However, the bulk of research in this domain has focused on static rather than dynamic images, so it remains unclear what level of information that can be extracted from these displays. This study was designed to examine the visual capabilities of echocardiographers-practitioners who provide information regarding cardiac integrity and functionality. In three experiments, echocardiographers and naïve participants completed an abnormality detection task that comprised movies presented on a range of durations, where half were abnormal. This was followed by an abnormality categorization task. Results: Across all durations, the results showed that performance was high for detection, but less so for categorization, indicating that categorization was a more challenging task. Not surprisingly, echocardiographers outperformed naïve participants. Conclusions: Together, this suggests that echocardiographers have a finely tuned capability for cardiac dysfunction, and a great deal of visual information can be extracted during a global assessment, within a brief glance. No relationship was evident between experience and performance which suggests that other factors such as individual differences need to be considered for future studies.

Gaze patterns reflect and predict expertise in dynamic echocardiographic imaging

“…The same is expectedly true for diagnostic judgments, for which we obtained a d 0 (AUC) of 0.98 (0.76) for first-or second-year medical students and of 2.58 (0.97) for our expert cardiologists, who were basically at ceiling in the current task. Our experts' d 0 was very similar to the d 0 of 2.57 reported by Carrigan et al, 40 and our novices' performance was considerable better than theirs, most probably due to their use of a general student sample, whereas our medical students might have already acquired some relevant knowledge.…”

“…found that experts use a more flexible strategy of inspecting the images. More relevant for this study is the research by Carrigan et al., 40 who employed an SDT approach and had observers judge the patient status of dynamic apical four-chamber views presented for various durations ranging from 1 to 10 s. They used d′ as a measure of diagnostic quality and found that experts could achieve a diagnostic quality of d′=2.57, compared with d′=0.21 for complete novices. This study uses a similar approach, but it combines it with eye tracking.…”

Static versus dynamic medical images: The role of cue utilization in diagnostic performance

“…Combined, these results may reflect task demands, where retaining categorization information across both tasks was difficult. Further, the presentation time of 1500 ms meant that there were only 1–2 cardiac cycles observed, whereas, in clinical practice, more time can be taken to observe images (see Carrigan, Stoodley, Fernandez et al, 2020a). However, in the current study our goal was not to measure accuracy per se but to build upon our previous findings and investigate whether cue utilization could differentiate diagnostic performance as measured by accuracy.…”