title: Satisfaction of Search in Chest Radiography 2015.
abstract: OBJECTIVE
  Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest.
  
  
  METHODS
  Sixty-four chest computed radiographs half demonstrating various "test" abnormalities were read twice by 20 radiologists, once with and once without the addition of a simulated pulmonary nodule. Receiver-operating characteristic detection accuracy and decision thresholds were analyzed to study the effects of adding the nodule on detecting the test abnormalities. Results of previous studies were reanalyzed using similar modern techniques.
  
  
  RESULTS
  In the present study, adding nodules did not influence detection accuracy for the other abnormalities (P = .93), but did induce a reluctance to report them (P < .001). Adding nodules did not affect inspection time (P = .58) so the reluctance to report was not associated with reduced search. Reanalysis revealed a similar decision threshold shift that had not been recognized in the early studies of SOS in chest radiography (P < .01) in addition to reduced detection accuracy (P < .01).
  
  
  CONCLUSIONS
  The nature of SOS in chest radiography has changed, but it is not clear why.
  
  
  CONCLUSIONS
  SOS may be changing as a function of changes in radiology education and practice.
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242. Electronic address: kevin-berbaum@uiowa.edu.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Berbaum
authors.affiliation: Department of Medical Imaging, The University of Arizona.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Schartz
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Caldwell
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Mark T
authors.initials: MT
authors.lastname: Madsen
authors.affiliation: Department of Medical Imaging, The University of Arizona.
authors.forename: Seung
authors.initials: S
authors.lastname: Hur
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Archana T
authors.initials: AT
authors.lastname: Laroia
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Brad H
authors.initials: BH
authors.lastname: Thompson
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Brian F
authors.initials: BF
authors.lastname: Mullan
authors.affiliation: Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 3170 Medical Laboratories, Iowa City, IA 52242.
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Franken
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D000066491:Clinical Decision-Making; D006801:Humans; D015588:Observer Variation; D012372:ROC Curve; D013902:Radiography, Thoracic / Q000379:methods / Q000592:standards*; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging
keywords: Diagnostic Radiology; images; interpretation; observer performance; quality assurance