Effect of fatigue on reading computed tomography examination of the multiply injured patient.

Our goal was to ascertain how fatigue affects performance in reading computed tomography (CT) examinations of patients with multiple injuries. CT images with multiple fractures from a previous study of satisfaction of search (SOS) were read by radiologists after a day of clinical work. Performance in this study with fatigued readers was compared to a previous study in which readers were not fatigued.

The Impact of Fatigue on Satisfaction of Search in Chest Radiography.

Rationale And Objectives: To assess the nature of the satisfaction of search (SOS) effect in chest radiography when observers are fatigued; determine if we could replicate recent findings that have documented the nature of the SOS effect to be due to a threshold shift rather than a change in diagnostic accuracy as in earlier film-based studies.

Materials And Methods: Nearing or at the end of a clinical workday, 20 radiologists read 64 chest images twice, once with and once without the addition of a simulated pulmonary nodule. Half of the images had different types of "test" abnormalities.

Calculating the Tumor Volumes in Vestibular Schwannomas: Are the ABC/2 and Volumetric Methods Comparable?

Purpose: To assess the efficacy of the ABC/2 method for calculating the volume of vestibular schwannomas as compared with 3-D planimetric method.

Study Design: Retrospective.

Methods: Fifty eight cases of pathologically confirmed sporadic vestibular schwannomas (VS) were analyzed.

Vestibular Schwannomas: Do Linear and Volumetric Parameters on MRI Correlate With Hearing Loss?

Purpose: To determine if two-dimensional and volumetric imaging parameters in vestibular schwannomas (VS) correlate with hearing loss at presentation.

Study Design: Retrospective.

Methods: Forty-one cases of pathologically confirmed sporadic VS were analyzed.

JOURNAL CLUB: Retrospective Evaluation of Ultrasound Features of Thyroid Nodules to Assess Malignancy Risk: A Step Toward TIRADS.

Objective: The aim of this retrospective study was to develop a thyroid nodule scoring system for malignancy potential to better select nodules for ultrasound (US)-guided fine needle aspiration (FNA).

Materials And Methods: US-guided FNA was performed on 2375 thyroid nodules in successive patients. Cytologic or histopathologic confirmation of disease state in 2002 lesions showed that 148 were malignant.

Trauma in CT: The Role of Severe Injury on Satisfaction of Search Revised.

Purpose: The satisfaction-of-search (SOS) effect occurs when an abnormality on an image is missed because another is found. The aim of this experiment was to test whether severe distracting fractures control the magnitude of SOS on other fractures when both appear in a single CT image.

Methods: The institutional review board approved this study.

The Influence of a Vocalized Checklist on Detection of Multiple Abnormalities in Chest Radiography.

Rationale And Objectives: Although a checklist has been recommended for preventing satisfaction of search (SOS) errors, a previous research study did not demonstrate that benefit. However, observers in that study had to turn away from the image display to use the checklist. The current study tested a vocalized checklist to avoid this constraint.

Satisfaction of Search in Chest Radiography 2015.

Rationale And Objectives: Two decades have passed since the publication of laboratory studies of satisfaction of search (SOS) in chest radiography. Those studies were performed using film. The current investigation tests for SOS effects in computed radiography of the chest.

Diagnostic accuracy of 3D color volume-rendered CT images for peroneal tendon dislocation in patients with acute calcaneal fractures.

Background: Use of three-dimensional (3D) color volume-rendered (VR) images has been reported to be more time-efficient compared to that of cross-sectional computed tomography (CT) images for the diagnosis of peroneal tendon dislocation. However, the diagnostic performance of this technique has not been studied.

Purpose: To test diagnostic accuracy of 3D color VR CT images of ankle for peroneal tendon dislocation in patients with acute calcaneal fractures.

Multiple diagnostic task performance in CT examination of the chest.

Objectives In three experiments, we studied the detection of multiple abnormality types using the satisfaction of search (SOS) paradigm, the provision of a computer-aided detection (CAD) of pulmonary nodules and a focused nodule detection task. Methods 51 chest CT examinations (24 that demonstrated subtle pulmonary nodules and 27 that demonstrated no pulmonary nodules) were read by 15 radiology residents and fellows under two experimental conditions: (1) when there were no other abnormalities present except test abnormalities in the exams (non-SOS condition), and (2) when other abnormalities were present in the exams (SOS condition). Trials from the two conditions were intermixed.

Satisfaction of search from detection of pulmonary nodules in computed tomography of the chest.

Rationale And Objectives: We tested whether satisfaction of search (SOS) effects that occur in computed tomography (CT) examination of the chest on detection of native abnormalities are produced by the addition of simulated pulmonary nodules.

Materials And Methods: Two experiments were conducted. In the first experiment, 70 CT examinations, half that demonstrated diverse, subtle abnormalities and half that demonstrated no native lesions, were read by 18 radiology residents and fellows under two experimental conditions: presented with and without pulmonary nodules.

Multiple diagnostic task performance in CT examination of the chest.

Objectives: In three experiments, we studied the detection of multiple abnormality types using the satisfaction of search (SOS) paradigm, the provision of a computer-aided detection (CAD) of pulmonary nodules and a focused nodule detection task.

Methods: 51 chest CT examinations (24 that demonstrated subtle pulmonary nodules and 27 that demonstrated no pulmonary nodules) were read by 15 radiology residents and fellows under two experimental conditions: (1) when there were no other abnormalities present except test abnormalities in the exams (non-SOS condition), and (2) when other abnormalities were present in the exams (SOS condition). Trials from the two conditions were intermixed.

Clinical role of radiography for thoracic spine fractures in daily practice in the MDCT era: a retrospective review of 255 trauma patients.

Purpose: To retrospectively assess the diagnostic efficacy of radiography in detecting vertebral body fractures of the thoracic spine compared with MDCT, to assess the confounding factors reducing the diagnostic efficacy, and to investigate the outcomes of radiographically overlooked patients.

Materials And Methods: Two hundred fifty-five patients suspected of thoracic spine fractures were enrolled. We assessed the diagnostic efficacy of radiography for the patients sub-grouped based on five confounding factors: chest abnormalities, head injuries, cervical spine fractures, upper extremity injuries, and age of 65 years or older.

Satisfaction of search for subtle skeletal fractures may not be induced by more serious skeletal injury.

Purpose: The aim of this experiment was to test whether radiographs of major injuries, those having serious consequences for life and limb, produce a satisfaction-of-search (SOS) effect on the detection of subtle, nondisplaced test fractures.

Methods: Institutional review board approval and informed consent from 24 participants were obtained. Seventy simulated patients with multiple trauma injuries were constructed from radiographs of 3 different anatomic areas demonstrated only skeletal injuries.

Do long radiology workdays affect nodule detection in dynamic CT interpretation?

Purpose: A previous study demonstrated decreased diagnostic accuracy for finding fractures and decreased ability to focus on skeletal radiographs after a long working day. Skeletal radiographic examinations commonly have images that are displayed statically. The aim of this study was to investigate whether diagnostic accuracy for detecting pulmonary nodules on CT of the chest displayed dynamically would be similarly affected by fatigue.

Synthetic positron emission tomography-computed tomography images for use in perceptual studies.

To better understand fundamental issues, perception studies of the fusion display would best be performed with a panel of lesions of variable location, size, intensity, and background. There are compelling reasons to use synthetic images that contain artificial lesions for perception research. A consideration of how to obtain this panel of lesions is the nucleus of the present review.

VFS interjudge reliability using a free and directed search.

Reports in the literature suggest that clinicians demonstrate poor reliability in rating videofluoroscopic swallow (VFS) variables. Contemporary perception theories suggest that the methods used in VFS reliability studies constrain subjects to make judgments in an abnormal way. The purpose of this study was to determine whether a directed search or a free search approach to rating swallow studies results in better interjudge reliability.

Using the mean-to-sigma ratio as a measure of the improperness of binormal ROC curves.

Rationale And Objectives: A basic assumption for a meaningful diagnostic decision variable is that there is a monotone relationship between the decision variable and the likelihood of disease. This relationship, however, generally does not hold for the binormal model. As a result, receiver operating characteristic (ROC)-curve estimation based on the binormal model produces improper ROC curves that are not concave over the entire domain and cross the chance line.

Power estimation for multireader ROC methods an updated and unified approach.

Rationale And Objectives: We describe a step-by-step procedure for estimating power and sample size for planned multireader receiver operating characteristic (ROC) studies that will be analyzed using either the Dorfman-Berbaum-Metz (DBM) or Obuchowski-Rockette (OR) method. This procedure updates previous approaches by incorporating recent methodological developments and unifies the approaches by allowing inputs to be conjectured parameter values or outputs from either a DBM or OR pilot-study analysis.

Materials And Methods: Power computations are described in a step-by-step procedure and the theoretical basis for the procedure is described.

Long radiology workdays reduce detection and accommodation accuracy.

Purpose: The aim of this study was to measure the diagnostic accuracy of fracture detection, visual accommodation, reading time, and subjective ratings of fatigue and visual strain before and after a day of clinical reading.

Methods: Forty attending radiologists and radiology residents viewed 60 deidentified, HIPAA-compliant bone examinations, half with fractures, once before any clinical reading (early) and once after a day of clinical reading (late). Reading time was recorded.

On the convexity of ROC curves estimated from radiological test results.

Rationale And Objectives: Although an ideal observer's receiver operating characteristic (ROC) curve must be convex-ie, its slope must decrease monotonically-published fits to empirical data often display "hooks." Such fits sometimes are accepted on the basis of an argument that experiments are done with real, rather than ideal, observers. However, the fact that ideal observers must produce convex curves does not imply that convex curves describe only ideal observers.

The Medical Image Perception Society update on key issues for image perception research.

To guide future investigations, the 2007 Medical Image Perception Society meeting held panel discussions to consider the current state of our knowledge of medical image perception and identify important questions to advance our understanding.

Measurement of visual strain in radiologists.

Rationale And Objectives: The authors hypothesized that the current practice of radiology produces oculomotor fatigue that reduces diagnostic accuracy.

Materials And Methods: Testing this hypothesis required an ability to measure eyestrain. This capability was developed by measuring the visual accommodation of radiologists before and after diagnostic viewing work using an autorefractor that was capable of making multiple measurements of accommodation per second.

Large-core breast biopsy: abnormal salivary cortisol profiles associated with uncertainty of diagnosis.

Purpose: To determine whether uncertainty of the diagnosis after large-core breast biopsy (LCBB) adversely affects biochemical stress levels.

Materials And Methods: This study was institutional review board approved and HIPAA compliant, and all patients gave written informed consent. One hundred fifty women aged 18-86 years collected four salivary cortisol samples per day for 5 days after LCBB.