Compromised Diagnostic Radiology Interpretation from Observer Fatigue

描述(申请人提供)：今天的先进成像设备正在获取越来越多的图像，这些图像必须在更短的时间内得到解释。有人担心，放射科医生的工作量如此之大，以至于疲惫和解释时间的减少正在对诊断的准确性产生负面影响。对差错的频率、原因和影响的了解不足，以及预防差错的有效方法是提高卫生保健质量的主要障碍。未报告异常的放射检查结果约占所犯错误的一半。避免假阴性错误是至关重要的--使用这种错误治疗不会发生。在上一个资助期，我们证明了在简单的检测任务中，疲劳显著降低了检测的准确性，而动眼疲劳是一个促成因素。这项拟议研究的目标是确定认知疲劳是否能更准确和全面地解释复杂放射决策任务中错误增加的原因。长期目标是通过研究一个明显但严重的问题疲劳来减少诊断错误，以确定它是否确实是错误的根本原因。这项研究将通过应用认知疲劳的综合测量来解决这个问题，并确定它们是否会产生诊断错误。在项目结束时，我们将了解认知疲劳对诊断准确性的影响，这将有助于我们实现减少诊断错误从而改善患者护理的总体目标。我们的总体假设是，目前的放射学实践会产生认知疲劳，从而降低诊断的准确性。通过对搜索满意度(SOS)等容易出错的情况的实验，已经在理解诊断放射学错误原因方面取得了进展，但到目前为止，疲劳在SOS中的作用尚未得到检验，因此第一个目标将找到通过测试认知疲劳是否加剧SOS现象来帮助放射科医生避免SOS错误的方法。我们的第二个和第三个目标是通过在长时间的图像解释工作之前和之后研究两种类型的复杂成像任务，将认知疲劳与放射学表现联系起来。放射科医生报告的准确性和效率将被分析，并与认知疲劳的测量相关联。

DESCRIPTION (provided by applicant): Today's advanced imaging modalities are acquiring more and more images that must be interpreted in less time. Concerns have been raised that radiologist workloads are so demanding that fatigue and reduced time for interpretation are negatively impacting diagnostic accuracy. Inadequate knowledge about the frequency, cause and impact of errors, as well as effective methods for error prevention is a major obstacle for improving health care quality. The failure to report abnormal radiographic findings accounts for about half the errors made. Avoiding false- negative errors is critical - with such errors treatmen does not occur. In the previous funding period we demonstrated that fatigue significantly reduces detection accuracy in simple detection tasks and that oculomotor strain is a contributing factor. The goal of the proposed research is to determine whether cognitive fatigue can more accurately and fully account for increases in errors in complex radiologic decision tasks. The long-term goal is to reduce diagnostic errors by studying an obvious but serious problem, fatigue, to determine whether it is indeed a root cause of error. This research will address the problem by applying comprehensive measures of cognitive fatigue and determining whether they generate diagnostic errors. At the end of the project, we will understand the influence of cognitive fatigue on diagnostic accuracy, which will help us in our general goal of reducing diagnostic errors thereby improving patient care. Our overall hypothesis is that the current practice of radiology produces cognitive fatigue that reduces diagnostic accuracy. Progress in understanding the causes of error in diagnostic radiology has been achieved by experiments focusing on error-prone situations such as Satisfaction of Search (SOS), but to date the role of fatigue in SOS has yet to be examined and thus the first aim will discover ways to help radiologists obviate SOS errors by testing whether cognitive fatigue exacerbates the SOS phenomenon. Our second and third aims relate cognitive fatigue to radiological performance using two types of complex imaging tasks studied before and after long hours of image interpretation work. The accuracy and efficiency of radiologist's reports will be analyzed and correlated with measures of cognitive fatigue.