Abstract

A hallmark of a perceptual expert is the ability to detect and categorize stimuli in their domain of expertise after brief exposure. For example, expert radiologists can differentiate between “abnormal” and “normal” mammograms after a 250 ms exposure. It has been speculated that rapid detection depends on a global analysis referred to as holistic perception. Holistic processing in radiology seems similar to holistic perception in which a stimulus like a face is perceived as an integrated whole, not in terms of its individual features. Holistic processing is typically subject to inversion effects in which the inverted image is harder to process/recognize. Is radiological perception similarly subject to inversion effects? Eleven experienced radiologists (> 5 years of radiological experience) and ten resident radiologists (< 5 years of radiological experience) judged upright and inverted bilateral mammograms as “normal” or “abnormal”. For comparison, the same participants judged whether upright and inverted faces were “happy” or “neutral”. We obtained the expected inversion effect for faces. Expression discrimination was superior for upright faces. For mammograms, experienced radiologists exhibited a similar inversion effect, showing higher accuracy for upright than for inverted mammograms. Less experienced radiology residents performed more poorly than experienced radiologists and demonstrated no inversion effect with mammograms. These results suggest that the ability to discriminate normal from abnormal mammograms is a form of learned, holistic processing.

Highlights

  • A hallmark of the human visual system is our ability to make rapid visual categorizations in fractions of a second, whether we are interpreting the meaning of a picture (Potter, Wyble, Hagmann, & McCourt, 2013), classifying a scene (Schyns & Oliva, 1994) or recognizing a familiar face (Grill-Spector & Kanwisher, 2005).Chin et al Cognitive Research: Principles and Implications (2018) 3:31In a medical evaluation, diagnosis of chest radiographs and mammograms requires the detection and localization of the radiological abnormality (Kundel, Nodine, Conant, & Weinstein, 2007)

  • A main effect of Orientation was statistically significant (F(1, 19) = 36.73, p < 0.0002, ηp2 = 0.53), displaying the classic face inversion effect where expression classification was impaired in the inverted orientation relative to the upright orientation

  • These results are consistent with previous studies of perceptual expertise showing that, with extensive domain-specific experience, experts access holistic information in an upright stimulus, but holistic information is impaired when the stimulus is inversion impaired mammogram detection for the experienced radiologists, it did not completely abolish the expertise advantage

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Summary

Introduction

Diagnosis of chest radiographs and mammograms requires the detection and localization of the radiological abnormality (Kundel, Nodine, Conant, & Weinstein, 2007). In searching for signs of lung cancer, Kundel and Nodine (1975) found that radiologists could achieve a d’ of about 1.0 after a just 200 ms glimpse of a chest X-ray. This level of performance was nowhere near the level of d’ of 2.5 obtained during free-viewing conditions of these stimuli but, comfortably above chance performance. The rapid global analysis of the radiological image has been referred to as holistic processing and is the precursor to the subsequent stage involved in the localization of abnormalities (Carrigan et al, 2018)

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