Exploring the effect of context and expertise on attention: is attention shifted by information in medical images?

Abstract

Radiologists make critical decisions based on searching and interpreting medical images. The probability of a lung nodule differs across anatomical regions within the chest, raising the possibility that radiologists might have a prior expectation that creates an attentional bias. The development of expertise is also thought to cause “tuning” to relevant features, allowing radiologists to become faster and more accurate at detecting potential masses within their domain of expertise. Here, we tested both radiologists and control participants with a novel attentional-cueing paradigm to investigate whether the deployment of attention was affected (1) by a context that might invoke prior knowledge for experts, (2) by a nodule localized either on the same or on opposite sides as a subsequent target, and (3) by inversion of the nodule-present chest radiographs, to assess the orientation specificity of any effects. The participants also performed a nodule detection task to verify that our presentation duration was sufficient to extract diagnostic information. We saw no evidence of priors triggered by a normal chest radiograph cue affecting attention. When the cue was an upright abnormal chest radiograph, radiologists were faster when the lateralised nodule and the subsequent target appeared at the same rather than at opposite locations, suggesting attention was captured by the nodule. The opposite pattern was present for inverted images. We saw no evidence of cueing for control participants in any condition, which suggests that radiologists are indeed more sensitive to visual features that are not perceived as salient by naïve observers. Electronic supplementary material The online version of this article (10.3758/s13414-019-01695-7) contains supplementary material, which is available to authorized users.

What can an echocardiographer see in briefly presented stimuli? Perceptual expertise in dynamic search

“…Although years of experience is often regarded as an indicator of expertise, this factor is difficult to measure as it represents overlapping variables that incorporate a number of dimensions which increase the variability in performance (Heilman and Stopeck 1985 ), such as individual differences. Studies in radiology have shown that experience bares little relationship with visual tasks such as spatial attention cueing (Carrigan et al 2019a , 2019b ), visual search strategies (Williams and Drew 2019 ), or nodule detection (Sunday et al 2018 ). Medical image perception researchers are finding that it is difficult to tease apart experience and learned strategies (Williams and Drew 2019 ), suggesting that there are other several other factors contributing to the development of expertise.…”

“…Those with expertise in a particular domain can also rapidly extract a large amount of relevant information from features in the environment (Abernethy 1987 ; Kundel and Nodine 1975 ; Nodine and Krupinski 1998 ), where a superior ability develops to encode large scale visual patterns (Drew et al 2013 ). In the context of medical imaging, radiologists, but not naïve participants, can detect abnormalities at above what is expected by chance after viewing the images for < 1 s (Brennan et al 2018 ; Carrigan et al 2019a ; Donovan and Litchfield 2013 ; Evans et al 2013 ; Evans et al 2016 ; Kundel and Nodine 1975 ; Kundel et al 2008 ). Eye-tracking studies indicate that expert radiologists fixate faster and more accurately on an abnormality in mammographic images than less-experienced radiologists and use fewer eye movements to do so (Kundel and La Follette Jr 1972 ; Kundel and Nodine 1975 ).…”

Individual differences in echocardiography: Visual object recognition ability predicts cue utilization

“…Decades of research in medical perceptual domains have demonstrated a domain specific, perceptual superiority for experts compared with novices. For example, radiologists adopt an efficient search strategy when interpreting medical images (e.g., Kundel & Nodine, 1975), and they can detect a lung nodule following a brief presentation of a chest X‐ray, whereas naïve participants cannot (Carrigan et al, 2019). Similar findings have been shown in the non‐medical domain with car experts (e.g., Curby et al, 2009).…”

“…In the medical imaging domain, radiology experts have the remarkable capacity to rapidly and accurately detect abnormalities in chest X-Rays (Carrigan, Curby, Moerel, & Rich, 2019;Kundel & Nodine, 1975) and mammograms (Brennan et al, 2018;Carrigan, Wardle, & Rich, 2018;Evans, Georgian-Smith, Tambouret, Birdwell, & Wolfe, 2013). Nodine and Krupinski (1998) and Charness, Krampe, and Mayr (1996) proposed that, with exposure and deliberate practice, a perceptual fine-tuning develops for relevant features and patterns.…”

Visual Search Performance and Strategy for Three-Dimensional Visualization Systems: Impact of Radiologist Experience

“…Medical images contain a high variability of physical properties and image artifacts, which altogether lead to distracted visual attention [47]. Moreover, the semantic context of medical images may mask the effect of the physical properties of the display and visual stimulus [25].…”