Abstract

To examine whether radiologists' mammogram reading performance varies according to how long they have been awake ("hours awake") and the number of hours they slept ("hours slept") the night before a reading session. Retrospective data were retrieved from the BreastScreen Reader Assessment Strategy database. Malignancy-enriched mammographic readings were performed by 133 radiologists. Information on their hours awake and hours slept was collected. Analysis of covariance was performed to determine whether these two variables influenced radiologists' sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) curve, and jackknife alternative free-response ROC. Radiologists were divided into a more experienced and a less experienced groups (based on reading ≥2,000 and <2,000 mammogram readings per year, respectively). The hours awake significantly influenced less experienced radiologists' lesion sensitivity (F6,63= 2.51; P= .03). Those awake for <2 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P= .01), and those awake for 4 to 6 hours had significantly lower lesion sensitivity than those awake for 8 to 10 hours (P= .002) and 10 to 12 hours (P= .02). The hours slept also influenced the ROC values of less experienced radiologists (F1,68= 4.96; P= .02). Radiologists with up to 6 hours of sleep had a significantly lower value (0.72) than those who had slept more than 6 hours (0.77). No statistically significant findings were noted for more experienced radiologists. Inexperienced radiologists' performance may be influenced by the hours awake and hours slept before reading sessions.

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