Effect of fatigue on reading computed tomography examination of the multiply injured patient.

• Type of Material: Article
• Authors: Elizabeth Krupinski, Emory University; Kevin M. Schartz, University of Iowa; Mark S. Van Tassell, University of Iowa; Mark T. Madsen, University of Iowa; Robert T. Caldwell, University of Iowa; Kevin S. Berbaum, University of Iowa
• Language: English
• Date: 2017-07
• Publisher: Society of Photo-optical Instrumentation Engineers (SPIE)
• Publication Version: Final Published Version
• Copyright Statement: © 2017 Society of Photo-Optical Instrumentation Engineers (SPIE)
• Final Published Version (URL): http://dx.doi.org/10.1117/1.JMI.4.3.035504
• Title of Journal or Parent Work: Journal of Medical Imaging
• ISSN: 2329-4302
• Volume: 4
• Issue: 3
• Start Page: 035504
• End Page: 035504
• Grant/Funding Information: This work was supported by Grant No. R01 EB004987 from the National Institute of Biomedical Imaging and Bioengineering, Bethesda, Maryland.
• Keywords: satisfaction of search; errors; interpretation time; fatigue
• Research Categories: Health Sciences, Health Care Management; Engineering, Biomedical

Abstract

Our goal was to ascertain how fatigue affects performance in reading computed tomography (CT) examinations of patients with multiple injuries. CT images with multiple fractures from a previous study of satisfaction of search (SOS) were read by radiologists after a day of clinical work. Performance in this study with fatigued readers was compared to a previous study in which readers were not fatigued. Detection accuracy for obvious injuries was not affected by fatigue, but accuracy for subtle fractures was reduced ([Formula: see text]). An SOS effect on decision thresholds was evident mirroring recent studies. Without fatigue, readers spent more time interpreting and reporting findings as the number of the injuries increased. When fatigued, readers did not increase reading time as fracture number increased. Without fractures, reading time for not-fatigued and fatigued readers was the same ([Formula: see text]) but was significant ([Formula: see text]) with an added subtle fracture. The difference increased with a major injury ([Formula: see text]) and increased further with both a major injury and subtle fracture ([Formula: see text]). Fatigue and multiple abnormalities have independent effects on detection performance but do interact in determining search time.