womansurg

it's a hard life...
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The most talented radiologist I ever had the pleasure of working with told me about this study he'd seen...

Participants were stratified by their level of experience in radiographic interpretation. So, experienced radiologists were in one group, young radiologists another, staff physicians in another, medical students, and then I think surgery residents were down there at the bottom.

They took films with known pathology and presented them to the participants; they used some sort of optical tracking to follow the pupillary movement and recorded the times and patterns of what each person focused on.

Medical students would randomly look over the film, without any pattern or purpose.
Staff physicians would look over the film with a repetitive pattern: bones, then soft tissue, then lung windows, etc., finally focusing in on the pathology.
Young radiologists would scan about the entire film quickly, hitting most of the film, then find the pathology and spend the majority of their time on that area.
Experienced radiologists would focus for a long period of time on a midpoint of the film, sort of looking 'past' the picture, then would immediately hone in on pathology. No time was wasted scanning normal areas.

Surgery residents focused on their watches, then the TV set in the corner, then fell asleep. :p (JK.)

I thought it was a very cool depiction of the aquisition of skill in interpretation with experience.
 

snaggletooth

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any idea where I can find the study? (minus the surgical analaysis anyways) I thought I saw something pertaining to the optical tracker study on auntminnie or somewhere else on the web, but can't quite remember.
 

MustafaMond

K-Diddy M.D.
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Very interesting post.

I did a search and found this.

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Acad Radiol 1996 Feb;3(2):137-44 Related Articles, Links


Visual scanning patterns of radiologists searching mammograms.

Krupinski EA.

Department of Radiology, University of Arizona, Tucson 85724, USA.

RATIONALE AND OBJECTIVES: I examined whether the principles of search, detection, and decision making described for pulmonary nodule detection can be applied to lesion detection in mammographic images. METHODS: The eye position of six radiologists (three staff mammographers and three radiology residents) was recorded as they searched mammograms for masses and microcalcifications. RESULTS: True- and false-positive decisions were associated with prolonged gaze durations; false-negative decisions were associated with longer gaze durations than true-negatives. Readers with more experience tended to detect lesions earlier in the search than did readers with less experience, but those with less experience tended to spend more time overall searching the images and cover more image area than did those with more experience. CONCLUSION: Gaze duration is a useful predictor of missed lesions in mammography, making gaze duration a potential tool for perceptual feedback. Mammographic search for readers with different degrees of experience can be characterized by gaze durations, scan paths, and detection times.

PMID: 8796654 [PubMed - indexed for MEDLINE]
 
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