SATISFACTION OF SEARCH IN DIAGNOSTIC RADIOLOGY

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The long-term objective of this proposal is to understand how the perception of multiple abnormalities in a radiology examination occurs and to develop strategies for improved diagnostic accuracy and patient outcome. Failure to detect an abnormality is the most common class of error in diagnostic imaging and generally considered the most serious by the medical community. Many of these errors have been attributed to 'satisfaction of search,' which occurs when a lesion is not reported because discovery of another abnormality has satisfied the goal of the search. The vast majority of technical research and clinical endeavor to reduce error is concentrated in improving image quality so that abnormalities are more visible. Another approach is to study, and thereby improve, the interpretive process itself. Interpretation is the most crucial, yet lease understood part of the diagnostic process. We are one of the few laboratories in the world pursuing the goal of reduce detection errors through a better understanding of the underlying perceptual processes involved. We propose six experiments to find out what causes radiologists to visually neglect some areas of images, to evaluate the error classification system currently used to study satisfaction of search (SOS) errors, and to test whether systematic self-promoting can reduce this type of error. The research methodologies will include receiver operating characteristic (ROC) curve analysis, eye-position recording and other psychophysical methods. The understanding gained from these studies could lead to a reduction in SOS error. This reduction in error could be most significant with increased image interpretation by non-radiologists, who, being principally driven by their clinical suspicion, are more susceptible to errors involving unanticipated abnormalities.