Visual Scanning, Pattern Recognition and Decision-making in Pulmonary Nodule Detection

Kundel, Harold L.; Nodine, Calvin F.; Carmody, Dennis P.

doi:10.1097/00004424-197805000-00001

Cited by 409 publications

(277 citation statements)

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“…The ability to exploit the initial glimpse of the scene is at the core of the holistic model (Kundel et al, 2007) but is also a key component of scene perception research (Castelhano & Henderson, 2007;Torralba et al, 2006;Wolfe et al, 2011). By using the FPMW paradigm to control the contribution of the initial glimpse on subsequent search as a function of expertise, the present study extends previous eye-tracking research that has until now only been able to indirectly investigate these issues, either via tachistoscopic studies (Carmody et al, 1981;Kundel et al, 1975;Evans et al, 2013) or free viewing studies (Donovan & Litchfield, 2013;Kundel et al, 1978;Kundel et al, 2008;Manning et al, 2004).…”

Section: Discussionmentioning

confidence: 80%

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Litchfield¹,

Donovan²

2016

Journal of Experimental Psychology: Human Perception and Perfor

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Rapid scene recognition is a global visual process we can all exploit to guide search. This ability is thought to underpin expertise in medical image perception yet there is no direct evidence that isolates the expertise-specific contribution of processing scene previews on subsequent eye movement performance. We used the flash-preview moving window paradigm (Castelhano & Henderson, 2007) to investigate this issue. Expert radiologists and novice observers underwent 2 experiments whereby participants viewed a 250-ms scene preview or a mask before searching for a target. Observers looked for everyday objects from real-world scenes (Experiment 1), and searched for lung nodules from medical images (Experiment 2). Both expertise groups exploited the brief preview of the upcoming scene to more efficiently guide windowed search in Experiment 1, but there was only a weak effect of domain-specific expertise in Experiment 2, with experts showing small improvements in search metrics with scene previews. Expert diagnostic performance was better than novices in all conditions but was not contingent on seeing the scene preview, and scene preview actually impaired novice diagnostic performance. Experiment 3 required novice and experienced observers to search for a variety of abnormalities from different medical images. Rather than maximizing the expertise-specific advantage of processing scene previews, both novices and experienced radiographers were worse at detecting abnormalities with scene previews. We discuss how restricting access to the initial glimpse can be compensated for by subsequent search and discovery processing, but there can still be costs in integrating a fleeting glimpse of a medical scene.

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Section: Discussionmentioning

confidence: 80%

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Litchfield¹,

Donovan²

2016

Journal of Experimental Psychology: Human Perception and Perfor

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“…A consistent finding was that the dermatologists overall had more efficient search than residents generating fewer fixations with lower dwells. This has been observed in radiology and pathology and is considered one of the hallmarks of expertise [22][23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…Visual search characteristics often function as predictors of training and diagnostic accuracy [22][23][24][25][26][27][28][29][30][31][32][33][34][35] in other clinical specialties such as radiology and pathology; thus, one would expect to find differences in other specialties where images are utilized in the diagnostic process. The objective of this study was to evaluate the feasibility of extending the use of eyetracking methodology to the dermatology field, specifically to the evaluation of individual pigmented lesions through storedand-forward close-up and dermoscopy images.…”

Section: Introductionmentioning

confidence: 99%

Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training

et al. 2014

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The goal of this investigation was to explore the feasibility of characterizing the visual search characteristics of dermatologists evaluating images corresponding to single pigmented skin lesions (PSLs) (close-ups and dermoscopy) as a venue to improve training programs for dermoscopy. Two Board-certified dermatologists and two dermatology residents participated in a phased study. In phase I, they viewed a series of 20 PSL cases ranging from benign nevi to melanoma. The close-up and dermoscopy images of the PSL were evaluated sequentially and rated individually as benign or malignant, while eye position was recorded. Subsequently, the participating subjects completed an online dermoscopy training module that included a pre-and post-test assessing their dermoscopy skills (phase 2). Three months later, the subjects repeated their assessment on the 20 PSLs presented during phase I of the study. Significant differences in viewing time and eyeposition parameters were observed as a function of level of expertise. Dermatologists overall have more efficient search than residents generating fewer fixations with shorter dwells. Fixations and dwells associated with decisions changing from benign to malignant or vice versa from photo to dermatoscopic viewing were longer than any other decision, indicating increased visual processing for those decisions. These differences in visual search may have implications for developing tools to teach dermatologists and residents about how to better utilize dermoscopy in clinical practice.

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“…This can tell us something about why abnormalities are missed, for example. In a classic early study of the eye movements of radiologists, in this case looking at chest X-rays, Kundel, Nodine and Carmody (1978) classified missed cancers according to whether the radiologists' gaze completely missed the abnormality (errors of search), passed over it without dwelling on it long enough for an object to be recognised (errors of detection) or dwelt on it but did not correctly identify it (errors of decision); 30% of missed nodules correspond to errors of search, 25% to errors of detection and 45% to errors of decision [38]. Patterns of search show a clear evolution in the course of a radiologist's training, becoming much more efficient, with the most dramatic changes occurring in medical school, apparently more affected by improvements in knowledge of radiographic anatomy and clinical medicine than by formal training in radiology [39].…”

Section: Studies Of Radiologists' Perceptual Processesmentioning

confidence: 99%

A Review of Research Into the Development of Radiologic Expertise: Implications for Computer-Based Training

Taylor

2007

Academic Radiology

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Studies of radiological error reveal high levels of variation between radiologists.Although it is known that experts outperform novices, we have only limited knowledge about radiological expertise and how it is acquired. This review identifies three areas of research: studies of the impact of experience and related factors on the accuracy of decision-making; studies of the organisation of expert knowledge; and studies of radiologists' perceptual processes.Interpreting evidence from these three paradigms in the light of recent research into perceptual learning and studies of the visual pathway has a number of conclusions for the training of radiologists, particularly for the design of computer-based learning programs which are able to illustrate the similarities and differences between diagnoses, to give access to large numbers of cases and to help identify weaknesses in the way trainees build up a global representation from fixated regions.

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Visual Scanning, Pattern Recognition and Decision-making in Pulmonary Nodule Detection

Cited by 409 publications

References 0 publications

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Worth a quick look? Initial scene previews can guide eye movements as a function of domain-specific expertise but can also have unforeseen costs.

Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training

A Review of Research Into the Development of Radiologic Expertise: Implications for Computer-Based Training

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