SATISFACTION OF SEARCH IN DIAGNOSTIC RADIOLOGY

最常见的错误是阅读不足，即错误的否定解释 以及在诊断放射学中发生的代价高昂的错误类型。的子集 这些误读被归因于“搜索的满足感” 当第二个病变仍未被检测到时，就会发生这种情况 在X光片中检测初始病变(Tuddenham，1961,1963； Smith，1967)。我们之前的努力得到了NIH奖的支持， 首先在实验实验室中研究搜索满意度(SOS) (使用适当的控制条件)。我们学习的总目的 搜索的满足感是对这一类型和其他类型的理解 降低其频率所需的误差。 第一个实验表明，固有病变的检测准确率降低 在胸片中严格添加人工结节后 论证了SOS的存在，并建立了研究SOS的范式 现象。在刚刚完成的第二个实验中，检查次数之前 测量搜索的反应和终止以确定SOS是否 是由过早终止搜索或感知捕获引起的。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。前两项建议 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，多处骨折 出现在一系列X光片中将被用来确定SOS 可以延伸到个人的一系列X光照片，当两者都 分心物和靶点异常具有相同的性质。第二 实验还将模拟已知容易出错的情况 胃肠道对比研究。其目的是确定是否 除了病变的初始检测之外，图像的其他方面可以 影响视觉注意力以创造SOS。目标异常将是 无需对比即可显示，对比剂将用作 让人分心。第三个实验测试临床病史之间的相互作用 对解决文学争议的搜索和满足感 关于临床病史对放射学检查的影响。 许多研究结果的不一致可以用以下几点来解释 在每个图像中是否包括单个或多个异常。 搜索的满足感可能会出现多种异常 取消对所建议的异常情况可能提供的改进 根据临床病史，X线片上只有一种异常。

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.