The Impact of Fatigue on Complex CT Case Interpretation by Radiology Residents

      Rationale and Objectives

      To examine the effect of fatigue on diagnostic performance and interpretation of complex CT trauma studies by radiology residents.

      Materials and Methods

      Ten 2nd, 3rd, and 4th year radiology residents were given 1 hour to review as many complex CT cases as they could, once when they were fresh and once when they were fatigued (after a full day or night of diagnostic reading activity). Number of cases completed, interpretation accuracy and time per case were analyzed.

      Results

      On average readers completed 7.5 cases when fresh and 7.3 when fatigued, with 4th and 3rd year residents spending more time per case when fresh than fatigued and 2nd year residents spending more time when fatigued. The total number of true positives for major (fresh mean = 29.4 vs fatigued mean = 24.1) and minor (fresh mean = 23.30 vs fatigued mean = 18.90) findings decreased for fresh vs fatigued; and there was a significant difference as a function of year of residency (F = 4.72, p = 0.027). The 4th year residents had the most TPS in both conditions, followed by 3rd then 2nd year residents. There were more false positives when fatigued than fresh.

      Conclusion

      Fatigue significantly impacts radiologic diagnostic efficiency and efficacy, and differs as a function of year of residency.

      Key Words

      Abbreviations:

      AIS (Abbreviated Injury Scale), ANOVA (Analysis of Variance), CT (Computed Tomography), FP (False Positive), ISS (Injury Severity Score), MAIS (Maximum Abbreviated Injury Scale), NISS (New Injury Severity Score), ROC (Receiver Operating Characteristic), SD (Standard Deviation), SOFI (Swedish Occupational Fatigue Inventory), SSQ (Simulator Sickness Questionnaire), TP (True Positive)
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