Rationale and Objectives
To assess the nature of the satisfaction of search (SOS) effect in chest radiography
when observers are fatigued; determine if we could replicate recent findings that
have documented the nature of the SOS effect to be due to a threshold shift rather
than a change in diagnostic accuracy as in earlier film-based studies.
Materials and Methods
Nearing or at the end of a clinical workday, 20 radiologists read 64 chest images
twice, once with and once without the addition of a simulated pulmonary nodule. Half
of the images had different types of “test” abnormalities. Decision thresholds were
analyzed using the center of the range of false-positive (FP) and true-positive (TP)
fractions associated with each receiver operating characteristic (ROC) point for reporting
test abnormalities. Detection accuracy was assessed with ROC technique and inspection
time was recorded.
Results
The SOS effect was confirmed to be a reduction in willingness to respond (threshold
shift). The center of the FP range was significantly reduced (FP = 0.10 without added
nodules, FP = 0.05 with added nodules, F(1,18) = 19.85, P = 0.0003). The center of the TP range was significantly reduced (TP = 0.39 without
added nodules, TP = 0.33 with added nodules, F(1,18) = 10.81, P = 0.004).
Conclusions
This study suggests that fatigue does not change the nature of the SOS effect, but
rather may be additive with the SOS effect. SOS reduces both TP and FP responses,
whereas fatigue reduces TPs more than FPs.
Key Words
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Article info
Publication history
Published online: May 23, 2017
Accepted:
March 29,
2017
Received in revised form:
March 28,
2017
Received:
January 16,
2017
Footnotes
Support: This work was supported in part by grant 5R01EB004987-07 from the NIBIB.
Identification
Copyright
© 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
