Underreading errors, false-negative interpretations, are the most frequent and costly type of error occurring in diagnostic radiology. A subset of these underreading errors have been attributed to """"""""satisfaction of search"""""""" which occurs when a second lesion remains undetected following the detection of an initial lesion in a radiograph (Tuddenham, 1961, 1963; Smith, 1967). Our previous endeavors supported by an NIH award were the first to study satisfaction of search (SOS) in the experimental laboratory (using an appropriate control condition). Our overall purpose in studying satisfaction of search is to gain understanding of this and other types of error necessary to reduce their frequency. The first experiment showed reduced detection accuracy of inherent lesions in chest radiographs after the addition of artificial nodules rigorously demonstrating the existence of SOS and establishing a paradigm to study the phenomenon. In a second experiment just completed, inspection times before responses and termination of search were measured to determine whether SOS is caused by premature termination of search or perceptual capture. These preliminary studies provide a framework in which definitive research can address the complex questions that remain. The first two proposed experiments attempt to confirm and extend our finding to other types of images and abnormalities. In the first experiment, multiple fractures appearing in a series of radiographs will be used to determine whether SOS can extend across a series of radiographs of an individual when both distractor and target abnormalities are of the same nature. The second experiment will also mimic a condition known to be error prone in gastrointestinal contrast studies. The purpose is to determine whether other aspects of images besides the initial detection of a lesion can influence visual attention to create SOS. The target abnormalities will be demonstrable without contrast, the contrast material will serve as the distractor. A third experiment tests the interaction of clinical history and satisfaction of search to resolve a controversy in the literature regarding the influence of clinical history upon radiographic detection. Lack of agreement in the findings of numerous studies may be explained by whether single or multiple abnormalities were included in each image. Satisfaction of search, which occurs with multiple abnormalities, might cancel the improvement that might be afforded for abnormalities suggested by clinical history were only one abnormality present on a radiograph.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA042453-04
Application #
3183804
Study Section
Diagnostic Radiology Study Section (RNM)
Project Start
1986-05-01
Project End
1992-05-31
Budget Start
1990-06-01
Budget End
1991-05-31
Support Year
4
Fiscal Year
1990
Total Cost
Indirect Cost
Name
University of Iowa
Department
Type
Schools of Medicine
DUNS #
041294109
City
Iowa City
State
IA
Country
United States
Zip Code
52242
Berbaum, Kevin S; Franken Jr, Edmund A (2011) Satisfaction of search in radiographic modalities. Radiology 261:1000-1; author reply 1001-2
Berbaum, Kevin S; Franken Jr, E A (2006) Commentary does clinical history affect perception? Acad Radiol 13:402-3
Berbaum, Kevin; Franken Jr, Edmund A; Caldwell, Robert T et al. (2006) Can a checklist reduce SOS errors in chest radiography? Acad Radiol 13:296-304
Berbaum, Kevin S; Franken Jr, E A; Dorfman, Donald D et al. (2005) Can order of report prevent satisfaction of search in abdominal contrast studies? Acad Radiol 12:74-84
Berbaum, Kevin S; Dorfman, Donald D; Franken Jr, E A et al. (2002) An empirical comparison of discrete ratings and subjective probability ratings. Acad Radiol 9:756-63
Berbaum, K S; Brandser, E A; Franken, E A et al. (2001) Gaze dwell times on acute trauma injuries missed because of satisfaction of search. Acad Radiol 8:304-14
Berbaum, K S; Franken Jr, E A; Dorfman, D D et al. (2000) Role of faulty decision making in the satisfaction of search effect in chest radiography. Acad Radiol 7:1098-106
Berbaum, K S; Dorfman, D D; Franken, E A et al. (2000) Proper ROC analysis and joint ROC analysis of the satisfaction of search effect in chest radiology. Acad Radiol 7:945-58
Caldwell, R T; Berbaum, K S; Borah, J (2000) Correcting errors in eye-position data arising from the distortion of magnetic fields by display devices. Behav Res Methods Instrum Comput 32:572-8
Dorfman, D D; Berbaum, K S (2000) A contaminated binormal model for ROC data: Part III. Initial evaluation with detection ROC data. Acad Radiol 7:438-47

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