SATISFACTION OF SEARCH IN DIAGNOSTIC RADIOLOGY

误读错误，假否定的解释，是最常见的 和昂贵的类型的错误发生在诊断放射学。 的子集 这些误读被归因于“搜索满意度” 这发生在第二个病变在第二次手术后仍然未被检测到时。 在X光片中检测初始病变（图德纳姆，1961，1963; Smith，1967）。 我们以前的努力得到了NIH的支持， 第一次在实验室研究搜索满意度（SOS） （使用适当的控制条件）。 我们学习的总体目的 搜索的满意度是为了了解这种和其他类型的 错误，以减少其频率。 第一个实验表明，固有病变的检测精度降低 在胸片中严格添加人工结节后 证明SOS的存在，并建立一个范式来研究 现象 在刚刚完成的第二个实验中， 反应和终止搜索进行了测量，以确定是否SOS 是由搜索或感知捕捉的过早终止引起的。 这些 初步研究提供了一个框架， 解决遗留下来的复杂问题。 前两个提议 实验试图证实并将我们的发现扩展到其他类型的 图像和异常。 在第一个实验中， 出现在一系列X光片将被用来确定是否SOS 可以跨越一系列个人的X光照片， 干扰物和目标异常具有相同的性质。 第二 实验还将模拟一种已知的容易出错的条件， 胃肠道造影研究。 目的是确定是否 除了病变的初始检测之外，图像的其它方面可以 影响视觉注意力以产生SOS。 目标异常将是 在没有对比的情况下，对比材料将用作 干扰物 第三个实验测试临床病史的相互作用 和满意度的搜索，以解决文献中的争议 关于临床病史对放射学检测的影响。 许多研究的结果缺乏一致性可能是由于 在每个图像中是否包括单个或多个异常。 搜索的满意度，这发生在多个异常，可能 取消可能为建议的异常提供的改进 根据临床病史，X线片上仅存在一处异常。

Underreading errors, false-negative interpretations, are the most frequent and costly type of error occurring in diagnostic radiology. A subset of these underreading errors have been attributed to "satisfaction of search" which occurs when a second lesion remains undetected following the detection of an initial lesion in a radiograph (Tuddenham, 1961, 1963; Smith, 1967). Our previous endeavors supported by an NIH award were the first to study satisfaction of search (SOS) in the experimental laboratory (using an appropriate control condition). Our overall purpose in studying satisfaction of search is to gain understanding of this and other types of error necessary to reduce their frequency. The first experiment showed reduced detection accuracy of inherent lesions in chest radiographs after the addition of artificial nodules rigorously demonstrating the existence of SOS and establishing a paradigm to study the phenomenon. In a second experiment just completed, inspection times before responses and termination of search were measured to determine whether SOS is caused by premature termination of search or perceptual capture. These preliminary studies provide a framework in which definitive research can address the complex questions that remain. The first two proposed experiments attempt to confirm and extend our finding to other types of images and abnormalities. In the first experiment, multiple fractures appearing in a series of radiographs will be used to determine whether SOS can extend across a series of radiographs of an individual when both distractor and target abnormalities are of the same nature. The second experiment will also mimic a condition known to be error prone in gastrointestinal contrast studies. The purpose is to determine whether other aspects of images besides the initial detection of a lesion can influence visual attention to create SOS. The target abnormalities will be demonstrable without contrast, the contrast material will serve as the distractor. A third experiment tests the interaction of clinical history and satisfaction of search to resolve a controversy in the literature regarding the influence of clinical history upon radiographic detection. Lack of agreement in the findings of numerous studies may be explained by whether single or multiple abnormalities were included in each image. Satisfaction of search, which occurs with multiple abnormalities, might cancel the improvement that might be afforded for abnormalities suggested by clinical history were only one abnormality present on a radiograph.