Measuring Observer Performance in Chest Radiology: Some Experiences

Potchen, E. James

doi:10.1016/j.jacr.2006.02.020

Cited by 48 publications

(37 citation statements)

References 24 publications

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“…Different doctors have different ways of managing uncertainty and may be unaware of how they compare with others; poor performers often have misplaced confidence in their performance. 11 Giving doctors educational feedback on their performance compared to the optimal can change the clinical performance of some doctors, 11 and may have an impact on referral rates OOH.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Risk taking in general practice: GP out-of-hours referrals to hospital

Ingram

Calnan²,

Greenwood³

et al. 2009

Br J Gen Pract

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Emergency admissions to hospital at night and weekends are distressing for patients and disruptive for hospitals. Many of these admissions result from referrals from GP out-of-hours (OOH) providers. AimTo compare rates of referral to hospital for doctors working OOH before and after the new general medical services contract was introduced in Bristol in 2005; to explore the attitudes of GPs to referral to hospital OOH; and to develop an understanding of the factors that influence GPs when they refer patients to hospital. Design of studyCross-sectional comparison of admission rates; postal survey. SettingThree OOH providers in south-west England. MethodReferral rates were compared for 234 GPs working OOH, and questionnaires explored their attitudes to risk.

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Section: Comparison With Existing Literaturementioning

confidence: 99%

Risk taking in general practice: GP out-of-hours referrals to hospital

Ingram

Calnan²,

Greenwood³

et al. 2009

Br J Gen Pract

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“…There is evidence that confidence and accuracy are at odds in medicine. For example, radiologists who performed less well were highly confident that they were accurate [20]; a survey of 100 internal medicine physicians found only a very small difference in confidence in diagnostic accuracy between very difficult and simple clinical cases, whereas there was a large difference in actual diagnostic accuracy [16], and surgical residents were confident they would recognize different distal radius fractures 68% of the time while actually identifying only 33% correctly [18]. Overconfidence bias can lead to other biases such as the availability heuristic (considering only the first thing that comes to mind) and confirmation bias, where a person notices only the things that agree with his or her point of view and is less attentive to support for alternative viewpoints [15].…”

Section: Discussionmentioning

confidence: 99%

“…Sixty percent (146) were politically liberal or moderately liberal, and 32% (76) were conservative or very conservative. Sixty percent (146) believed in God, 8% (20) had no opinion, 17% (40) were agnostic, and 15% (36) were atheists. Only 8% (17) thought their confidence had decreased since graduate training (Table 2).…”

Section: Study Populationmentioning

confidence: 99%

Do Orthopaedic Surgeons Acknowledge Uncertainty?

Teunis

Janssen

Guitton

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decisionmaking. Questions/purposes We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? Methods We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents One of the authors (DR) certifies that he, or a member of his immediate family, has or may receive payments or benefits, an amount of less than USD 10,000 during the study period from Wright Medical (Memphis, TN, USA); an amount less than USD 10,000 from Skeletal Dynamics (Miami, FL, USA); an amount less than USD 10,000 from Biomet (Warsaw, IN, USA); an amount less than USD 10,000 from AO North America (Paoli, PA, USA); and an amount less than USD 10,000 from AO International (Dubendorf, Switzerland Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years of experience. Two hundred forty-two (34%) members completed the survey. We found no differences between responders and nonresponders. Each survey item measured its own trait better than any of the other traits. Recognition of uncertainty (0.70) and confidence bias (0.75) had relatively high Cronbach alpha levels, meaning that the questions making up these traits are closely related and probably measure the ...

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“…When historical cues were added (e.g. chest X-ray for metastatic survey) the detection rate increased to 83% [22] (Figure 4).…”

Section: Contributing Factors To Perceptual Errormentioning

confidence: 99%

Perceptual errors in pediatric radiology

Taylor

2017

Diagnosis

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Perceptual errors are common contributors to missed diagnoses in the clinical practice of radiology. While the physical attributes of an image such as image resolution, signal-to-noise characteristics, and anatomic complexity are major causes of poor conspicuity of pathologic lesions, there are major interrelated cognitive contributors to visual errors. The first is satisfaction of search (SOS), where the detection of an abnormality results in premature termination of further search. Another form of incomplete search pattern is visual isolation, where a radiologist's search pattern is truncated to the main areas of an image, while little or no attention is given to peripheral areas. A second cognitive error is inattentional blindness, defined as the failure to notice a fully visible, but unexpected object because attention was otherwise engaged. Strategies for error mitigation have centered around the use of check lists, self prompting routines, and structured reporting within an institutional culture of safety and vigilance.

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Measuring Observer Performance in Chest Radiology: Some Experiences

Cited by 48 publications

References 24 publications

Risk taking in general practice: GP out-of-hours referrals to hospital

Risk taking in general practice: GP out-of-hours referrals to hospital

Do Orthopaedic Surgeons Acknowledge Uncertainty?

Perceptual errors in pediatric radiology

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