title: Retrospective review of the drop in observer detection performance over time in lesion-enriched experimental studies.
abstract: The vigilance decrement describes a decrease in sensitivity or increase in specificity with time on task. It has been observed in a variety of repetitive visual tasks, but little is known about these patterns in radiologists. We investigated whether there is systematic variation in performance over the course of a radiology reading session. We re-analyzed data from six previous lesion-enriched radiology studies. Studies featured 8-22 participants assessing 27-100 cases (including mammograms, chest CT, chest x-ray, and bone x-ray) in a reading session. Changes in performance and speed as the reading session progressed were analyzed using mixed effects models. Time taken per case decreased 9-23% as the reading session progressed (p < 0.005 for every study). There was a sensitivity decrease or specificity increase over the course of reading 100 chest x-rays (p = 0.005), 60 bone fracture x-rays (p = 0.03), and 100 chest CT scans (p < 0.0001). This effect was not found in the shorter mammography sessions with 27 or 50 cases. We found evidence supporting the hypothesis that behavior and performance may change over the course of reading an enriched test set. Further research is required to ascertain whether this effect is present in radiological practice.
authors.affiliation: Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK, s.taylor-phillips@warwick.ac.uk.
authors.forename: Sian
authors.initials: S
authors.lastname: Taylor-Phillips
authors.forename: Markus C
authors.initials: MC
authors.lastname: Elze
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dennick
authors.forename: Alastair G
authors.initials: AG
authors.lastname: Gale
authors.forename: Aileen
authors.initials: A
authors.lastname: Clarke
authors.forename: Claudia
authors.initials: C
authors.lastname: Mello-Thoms
mesh_terms: D001143:Arousal; D005221:Fatigue; D006801:Humans; D008327:Mammography / Q000592:standards; D015588:Observer Variation; D011859:Radiography / Q000592:standards*; D013902:Radiography, Thoracic / Q000592:standards; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards