SATISFACTION OF SEARCH IN DIAGNOSTIC RADIOLOGY

误读错误(误译)是最常见的 以及在诊断放射学中发生的代价高昂的错误类型。的子集 阅读错误归因于“搜索的满足感” 当第二个病变由于检测到 放射照片中的初始损伤(Tuddenham，1962,1963；Smith，1967)。 之前由两个NIH奖项支持的研究表明， 在实验实验室搜索(SOS)以获得一些了解 这种错误希望能降低其发生的频率。这些实验 显示了搜索的满意度可以在一个严格的 使用ROC方法进行三种类型的放射检查 和异常情况。在第一个实验程序中，检测 比较胸部X线片中各种细微病变的准确性。 具有检测相同病变的准确性，当一个肺结节 通过模拟添加到X光片中。降低了检测率 人工结核的添加。另外两个实验程序 是为了代表更广泛的放射检查而开发的 哪些SOS的临床例子是常见的。在第二个程序中， 多发创伤患者在一系列的X线片中被描绘。 在其他情况下，隐蔽骨折的检测率大大降低 骨折包括在每个系列的其他图像中。第三 相比之下，过程模仿了一种已知容易出错的情况 对腹部的研究，在腹部，造影剂本身可以作为 让人分心。可见肠外异常的报告没有 腹部X线片中的对比较少出现在对比中 由于决策大幅增加而进行的考试 标准。 不幸的是，SOS的原因在很大程度上仍不清楚。然而，这些 初步研究提供了一个框架，在这个框架中，最终的研究可以 解决仍然存在的复杂问题。中华民国研究中的个案 那些表现出强烈SOS的人将通过眼位记录进行研究。 SOS背后的流程可能反映在两个重要的衡量标准中 在搜索中，凝视停留在病变上的时间和凝视遇到的时间 损伤，可从眼睛位置数据中获得。三个新的 实验(每个SOS程序一个)将使用凝视停留时间来 确定对搜索结果的满意是否源于 使用分类进行可视扫描、识别或决策 诺丁和昆德尔(1987)提出的方案。SOS的因果模型 将凝视相遇时间和凝视停留时间与检测相关联 测试过。通过确定SOS的原因、干预的性质 有可能减少SOS错误和有效的计算机辅助方法 诊断是可以识别的。

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.