Long radiology workdays reduce detection and accommodation accuracy

Elizabeth A. Krupinski, Kevin S. Berbaum, Robert T. Caldwell, Kevin M. Schartz, John Kim

Research output: Contribution to journalArticle

113 Scopus citations

Abstract

Purpose: The aim of this study was to measure the diagnostic accuracy of fracture detection, visual accommodation, reading time, and subjective ratings of fatigue and visual strain before and after a day of clinical reading. Methods: Forty attending radiologists and radiology residents viewed 60 deidentified, HIPAA-compliant bone examinations, half with fractures, once before any clinical reading (early) and once after a day of clinical reading (late). Reading time was recorded. Visual accommodation (the ability to maintain focus) was measured before and after each reading session. Subjective ratings of symptoms of fatigue and oculomotor strain were collected. The study was approved by local institutional review boards. Results: Diagnostic accuracy was reduced significantly after a day of clinical reading, with average areas under the receiver operating characteristic curves of 0.885 for early reading and 0.852 for late reading (P < .05). After a day of image interpretation, visual accommodation was no more variable, though error in visual accommodation was greater (P < .01), and subjective ratings of fatigue were higher. Conclusions: After a day of clinical reading, radiologists have reduced ability to focus, increased symptoms of fatigue and oculomotor strain, and reduced ability to detect fractures. Radiologists need to be aware of the effects of fatigue on diagnostic accuracy and take steps to mitigate these effects.

Original languageEnglish (US)
Pages (from-to)698-704
Number of pages7
JournalJournal of the American College of Radiology
Volume7
Issue number9
DOIs
StatePublished - Sep 2010

Keywords

  • Reader fatigue
  • observer performance
  • visual accommodation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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