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      The Development of Expertise in Radiology: In Chest Radiograph Interpretation, “Expert” Search Pattern May Predate “Expert” Levels of Diagnostic Accuracy for Pneumothorax Identification

      , , , ,
      Radiology
      Radiological Society of North America (RSNA)

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          Expert performance: Its structure and acquisition.

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            Receiver operating characteristic curves and their use in radiology.

            Sensitivity and specificity are the basic measures of accuracy of a diagnostic test; however, they depend on the cut point used to define "positive" and "negative" test results. As the cut point shifts, sensitivity and specificity shift. The receiver operating characteristic (ROC) curve is a plot of the sensitivity of a test versus its false-positive rate for all possible cut points. The advantages of the ROC curve as a means of defining the accuracy of a test, construction of the ROC, and identification of the optimal cut point on the ROC curve are discussed. Several summary measures of the accuracy of a test, including the commonly used percentage of correct diagnoses and area under the ROC curve, are described and compared. Two examples of ROC curve application in radiologic research are presented. Copyright RSNA, 2003
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              Holistic component of image perception in mammogram interpretation: gaze-tracking study.

              To test the hypothesis that rapid and accurate performance of the proficient observer in mammogram interpretation involves a shift in the mechanism of image perception from a relatively slow search-to-find mode to a relatively fast holistic mode. This HIPAA-compliant study had institutional review board approval, and participant informed consent was obtained; patient informed consent was not required. The eye positions of three full-time mammographers, one attending radiologist, two mammography fellows, and three radiology residents were recorded during the interpretation of 20 normal and 20 subtly abnormal mammograms. The search time required to first locate a cancer, as well as the initial eye scan path, was determined and compared with diagnostic performance as measured with receiver operating characteristic (ROC) analysis. The median time for all observers to fixate a cancer, regardless of the decision outcome, was 1.13 seconds, with a range of 0.68 second to 3.06 seconds. Even though most of the lesions were fixated, recognition of them as cancerous ranged from 85% (17 of 20) to 10% (two of 20), with corresponding areas under the ROC curve of 0.87-0.40. The ROC index of detectability, d(a), was linearly related to the time to first fixate a cancer with a correlation (r(2)) of 0.81. The rapid initial fixation of a true abnormality is evidence for a global perceptual process capable of analyzing the visual input of the entire retinal image and pinpointing the spatial location of an abnormality. It appears to be more highly developed in the most proficient observers, replacing the less efficient initial search-to-find strategies. (c) RSNA, 2007.
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                Author and article information

                Journal
                Radiology
                Radiology
                Radiological Society of North America (RSNA)
                0033-8419
                1527-1315
                July 2016
                July 2016
                : 280
                : 1
                : 252-260
                Article
                10.1148/radiol.2016150409
                27322975
                bcba2d8b-218a-4f24-96ce-8d0280be555f
                © 2016
                History

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