TY - JOUR
T1 - Long radiology workdays reduce detection and accommodation accuracy
AU - Krupinski, Elizabeth A.
AU - Berbaum, Kevin S.
AU - Caldwell, Robert T.
AU - Schartz, Kevin M.
AU - Kim, John
N1 - Funding Information:
This work was supported in part by grant R01 EB004987 from the National Institute of Biomedical Imaging and Bioengineering (Bethesda, Md).
PY - 2010/9
Y1 - 2010/9
N2 - 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. Visual accommodation (the ability to maintain focus) was measured before and after each reading session. Subjective ratings of symptoms of fatigue and oculomotor strain were collected. The study was approved by local institutional review boards. Results: Diagnostic accuracy was reduced significantly after a day of clinical reading, with average areas under the receiver operating characteristic curves of 0.885 for early reading and 0.852 for late reading (P < .05). After a day of image interpretation, visual accommodation was no more variable, though error in visual accommodation was greater (P < .01), and subjective ratings of fatigue were higher. Conclusions: After a day of clinical reading, radiologists have reduced ability to focus, increased symptoms of fatigue and oculomotor strain, and reduced ability to detect fractures. Radiologists need to be aware of the effects of fatigue on diagnostic accuracy and take steps to mitigate these effects.
AB - 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. Visual accommodation (the ability to maintain focus) was measured before and after each reading session. Subjective ratings of symptoms of fatigue and oculomotor strain were collected. The study was approved by local institutional review boards. Results: Diagnostic accuracy was reduced significantly after a day of clinical reading, with average areas under the receiver operating characteristic curves of 0.885 for early reading and 0.852 for late reading (P < .05). After a day of image interpretation, visual accommodation was no more variable, though error in visual accommodation was greater (P < .01), and subjective ratings of fatigue were higher. Conclusions: After a day of clinical reading, radiologists have reduced ability to focus, increased symptoms of fatigue and oculomotor strain, and reduced ability to detect fractures. Radiologists need to be aware of the effects of fatigue on diagnostic accuracy and take steps to mitigate these effects.
KW - Reader fatigue
KW - observer performance
KW - visual accommodation
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U2 - 10.1016/j.jacr.2010.03.004
DO - 10.1016/j.jacr.2010.03.004
M3 - Article
AN - SCOPUS:84928096351
SN - 1546-1440
VL - 7
SP - 698
EP - 704
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 9
ER -