title: Impact of Patient Photographs on Radiologists' Visual Search of Chest Radiographs.
abstract: To increase detection of mislabeled medical imaging studies, evidence shows it may be useful to include patient photographs during interpretation. This study examined how inclusion of photographs impacts visual search.
  
  
  
  Ten radiologists participated. Average age was 43.00 years and average years Board-certified was 9.70, with 2 residents, 1 general, 2 abdominal, 4 cardiothoracic, and 1 pediatric radiologist. They viewed 21 portable chest radiographs with and without a simultaneously acquired photograph of the patient while visual search was recorded. Their task was to note placement of lines and tubes.
  
  
  
  Presence of the photograph reduced the number of fixations (chest radiograph only mean 98.68; chest with photograph present 80.81; photograph 10.59; p < 0.0001) and total dwell (chest radiograph only mean 30.84 seconds; chest radiograph with photograph present 25.68; photograph 3.93; p < 0.0001) on the chest radiograph as a result of periodically looking at the photograph. Overall viewing time did not increase with addition of the photograph because time not spent on the radiograph was spent on the photograph. On average, readers scanned from the radiograph to the photographs about four times during search. Men and non-cardiothoracic radiologists spent significantly more time scanning all the images, including the photographs. Average preference for having photographs was 6.10 on a 0-10 scale, and neck and chest were preferred as areas to include in the photograph.
  
  
  
  Photographs may help with certain image interpretation tasks and may help personalize the reading experience for radiologists without increasing interpretation time.
authors.affiliation: Department of Medical Imaging, University of Arizona, 1609 N Warren Bldg 211 Tucson, AZ 85724; Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia. Electronic address: ekrupin@emory.edu.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Krupinski
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Alex
authors.initials: A
authors.lastname: Chung
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Applegate
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Ariadne K
authors.initials: AK
authors.lastname: DeSimone
authors.affiliation: Department of Radiology & Imaging Sciences, Emory University, Atlanta, Georgia; School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, Georgia.
authors.forename: Srini
authors.initials: S
authors.lastname: Tridandapani
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D008875:Middle Aged; D011173:Portraits as Topic; D013902:Radiography, Thoracic / Q000379:methods*; D000072177:Radiologists / Q000706:statistics & numerical data*; D017678:Sex Distribution; D014796:Visual Perception / Q000502:physiology*
keywords: Photographs; errors; patients; radiographs; safety; visual search; wrong-patient events