SATISFACTION OF SEARCH IN DIAGNOSTIC RADIOLOGY

误读错误（假阴性解释）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 阅读不足的错误被归因于“搜索满意度”， 当第二个病变由于检测到 X线片上的初始病变（图德纳姆，1962，1963; Smith，1967）。 以前的研究得到了两个NIH奖项的支持， 搜索（SOS）在实验室获得一些了解， 这个错误，希望减少它的频率。 这些实验 结果表明，搜索的满意度可以在一个严格的 方法使用ROC方法与三种类型的X线检查 和异常。 在第一个实验程序中，检测 比较了胸片中各种细微病变的准确性 当肺结节 通过模拟将其添加到射线照片中。 检测减少， 添加人工结节。 另外两个实验程序 是为了代表更广泛的射线照相检查， 哪些SOS的临床案例比较常见 在第二个过程中， 在一系列X线照片中描述了多创伤患者。 当其他方法应用时， 骨折包括在每个系列的其他图像中。 第三 相比之下，过程模拟了一种已知的容易出错的情况 腹部的研究，其中造影剂本身可以作为 分心 报告肠外异常可见， 腹部X线片中的对比剂较少出现在对比剂中 考试作为一个显着增加的决定， 的搜索. 不幸的是，SOS的原因在很大程度上仍然未知。 但这些 初步研究提供了一个框架， 解决遗留下来的复杂问题。 ROC研究案例 将使用眼位置记录来研究表现出强SOS的动物。 SOS背后的过程可以反映在两个重要的衡量标准中 搜索、病灶上的凝视停留时间和凝视遇到的时间 病变，这些病变可从眼睛位置数据获得。 三个新 实验（每个SOS程序一个）将使用凝视停留时间， 确定搜索效果的满意度是否是由于 使用分类进行视觉扫描、识别或决策 Nodine & Kundel（1987）提出的方案。 SOS的因果模型， 将注视相遇时间和注视停留时间与检测相关联， 测试. 通过确定SOS的原因，干预的性质 可能减少SOS错误和有效的方法，以计算机辅助 诊断是可以确定的。

Underreading error (false-negative interpretation) is the most frequent and costly type of error occurring in diagnostic radiology. A subset of underreading error has been attributed to "satisfaction of search" which occurs when a second lesion goes unreported due to the detection of an initial lesion in a radiograph (Tuddenham, 1962,1963; Smith, 1967). Previous research supported by two NIH awards studied satisfaction of search (SOS) in the experimental laboratory to gain some understanding of this error in the hope of reducing its frequency. These experiments showed that satisfaction of search could be demonstrated in a rigorous way using ROC methodology with three types of radiographic examinations and abnormalities. In the first experimental procedure, detection accuracy for various subtle lesions in chest radiographs was compared with the accuracy for detecting the same lesions when a pulmonary nodule was added to the radiograph by simulation. Detection was reduced with the addition of artificial nodules. Two other experimental procedures were developed to represent a wider range of radiographic examinations in which clinical examples of SOS are common. In the second procedure, multi-trauma patients were depicted in a series of radiographs. Detection of subtle fractures was substantially reduced when other fractures were included in other images of each series. The third procedure mimicked a condition known to be error prone, on contrast studies of the abdomen where the contrast material itself may serve as a distraction. Reports of extra-intestinal abnormalities visible without contrast in abdominal radiographs were less frequent in contrast examinations as a consequence of significant increases in decision criteria. Unfortunately, the causes of SOS remain largely unknown. However, these preliminary studies provide a framework in which definitive research can address the complex questions that remain. Cases from the ROC studies that exhibited strong SOS will be studied using eye position recording. The processes underlying SOS may be reflected in two important measures of search, gaze dwell time on lesions and time for gaze to encounter lesions, that are available from eye position data. Three new experiments (one for each SOS procedure) will use gaze dwell time to determine whether satisfaction of search effects are due to errors in visual scanning, recognition, or decision making using a classification scheme developed by Nodine & Kundel (1987). A causal model of SOS that relates gaze encounter time and gaze dwell time to detection will be tested. By determining the causes of SOS, the nature of interventions likely to reduce SOS error and effective approaches to computer-aided diagnosis can be identified.