Impact of Patient Photographs on Radiologists’ Visual Search of Chest Radiographs

Elizabeth A. Krupinski, Alex Chung, Kimberly Applegate, Ariadne K. DeSimone, Srini Tridandapani

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Rationale and Objectives: To increase detection of mislabeled medical imaging studies, evidence shows it may be useful to include patient photographs during interpretation. This study examined how inclusion of photographs impacts visual search. Materials and Methods: Ten radiologists participated. Average age was 43.00 years and average years Board-certified was 9.70, with 2 residents, 1 general, 2 abdominal, 4 cardiothoracic, and 1 pediatric radiologist. They viewed 21 portable chest radiographs with and without a simultaneously acquired photograph of the patient while visual search was recorded. Their task was to note placement of lines and tubes. Results: Presence of the photograph reduced the number of fixations (chest radiograph only mean 98.68; chest with photograph present 80.81; photograph 10.59; p < 0.0001) and total dwell (chest radiograph only mean 30.84 seconds; chest radiograph with photograph present 25.68; photograph 3.93; p < 0.0001) on the chest radiograph as a result of periodically looking at the photograph. Overall viewing time did not increase with addition of the photograph because time not spent on the radiograph was spent on the photograph. On average, readers scanned from the radiograph to the photographs about four times during search. Men and non-cardiothoracic radiologists spent significantly more time scanning all the images, including the photographs. Average preference for having photographs was 6.10 on a 0–10 scale, and neck and chest were preferred as areas to include in the photograph. Conclusion: Photographs may help with certain image interpretation tasks and may help personalize the reading experience for radiologists without increasing interpretation time.

Original languageEnglish (US)
Pages (from-to)953-960
Number of pages8
JournalAcademic radiology
Issue number8
StatePublished - Aug 2016


  • Photographs
  • errors
  • patients
  • radiographs
  • safety
  • visual search
  • wrong-patient events

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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