Satisfaction of Search in Diagnostic Radiology

描述(由申请人提供)：这项建议的长期目标是了解在影像检查中对多重异常的感知，并制定策略以提高诊断准确性和患者预后。我们是世界上为数不多的实验室之一，致力于通过更好地了解相关的潜在感知过程来减少检测错误。未能发现异常是诊断成像中最常见的错误类别，通常被医学界认为是最严重的错误。这些错误中的许多都被归因于“搜索的满足感”，即由于发现另一个异常已经“满足”了搜索的目标而没有报告一个病变。虽然我们已经对搜索满意度的机制有了一些了解，但仍然有一些重要的问题仍然存在。计算机断层扫描(CT)可能会取代射线照相成为最常见的放射学检查。CT产生大量的图像，这些图像可以以多种格式显示。要检查的数据量可能很快就会淹没放射科医生的感知资源，从而增加搜索错误的满意度风险。直到最近，还没有关于高级成像中SOS误差的实验研究。我们最初的CT研究表明SOS的影响有限，但在我们可以安全地得出SOS不是CT成像的主要问题之前，还需要进一步的实验。目前，很少有干预措施来纠正SOS错误。来自诊断问题的创新报告方法和方向可能会有希望。语音提示的核对表可以防止放射科医生忽略一些重要的结构，而不需要他们的眼睛离开图像。临床病史提示某些异常，保护放射科医生即使在出现其他异常时也不会错过它们。然而，提示可能会增加非提示异常的SOS错误。我们提出了四个决定性的实验来解决剩下的复杂问题。研究方法将包括分析接收器工作特性曲线、探测响应的时间过程以及观察者对CT图像数据阵列的导航和探索。从这项程序性研究中获得的知识将有助于减少观测者的误差。较新的成像方法，如计算机断层扫描，在诊断放射学中发挥着越来越重要的作用。尽管CT可以显示更小、更细微的病变，但要找到它们，需要检查更多的图像。在现代放射学研究中，图像的绝对数量可能会分散放射科医生的注意力，导致错误。这个项目寻求通过更好地理解潜在的感知过程来减少诊断错误的方法。

DESCRIPTION (provided by applicant): The long-term objective of this proposal is to understand the perception of multiple abnormalities in an imaging examination and to develop strategies for improved diagnostic accuracy and patient outcome. We are one of the few laboratories in the world pursuing the goal of reducing detection errors through a better understanding of the underlying perceptual processes involved. Failure to detect an abnormality is the most common class of error in diagnostic imaging and generally is 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. Although we have gained some understanding of the mechanisms of satisfaction of search (SOS), there are significant questions that remain. Computed tomography (CT) may replace radiography as the most common radiology examination. CT produces a large number of images that can be displayed in many formats. The volume of data to be inspected may quickly overwhelm the radiologists' perceptual resources, creating increased risk of satisfaction of search error. Until recently, there had been no experimental studies of SOS error in the advanced imaging. Our first studies in CT demonstrated limited SOS effects, but further experiments are needed before we can safely conclude that SOS is not a major problem for CT imaging. Currently, there are few interventions to remedy SOS error. Innovative reporting methods and direction from diagnostic questions may hold promise. A voice-prompted checklist may prevent the radiologist from neglecting some crucial structure without requiring them to take their eyes off of the image. Clinical history prompts certain abnormalities, protects the radiologist from missing them even when other abnormalities are present. However, the prompts may increase SOS errors for unprompted abnormalities. We propose four definitive experiments to approach the complex questions that remain. The research methods will include analysis of receiver operating characteristic curves, the time course of detection responses and the observer's navigation and exploration through the CT image data array. The knowledge gained from this programmatic research will lead to reduction of observer error. Newer imaging methods such as computed tomography play an increasingly prominent role in diagnostic radiology. Although CT makes smaller and subtler lesions visible, finding them requires inspection of many more images. The sheer number of images in a modern radiology study can stretch the attention of the radiologist and lead to errors. This project pursues methods to reduce diagnostic errors through a better understanding of the underlying perceptual processes.