Abstract
Brain tumour detection and diagnosis requires clinicians to inspect and analyse brain magnetic resonance images. Eye-tracking is commonly used to examine observers’ gaze behaviour during such medical image interpretation tasks, but analysis of eye movement sequences is limited. We therefore used ScanMatch, a novel technique that compares saccadic eye movement sequences, to examine the effect of expertise and diagnosis on the similarity of scanning patterns. Diagnostic accuracy was also recorded. Thirty-five participants were classified as Novices, Medics and Experts based on their level of expertise. Participants completed two brain tumour detection tasks. The first was a whole-brain task, which consisted of 60 consecutively presented slices from one patient; the second was an independent-slice detection task, which consisted of 32 independent slices from five different patients. Experts displayed the highest accuracy and sensitivity followed by Medics and then Novices in the independent-slice task. Experts showed the highest level of scanning pattern similarity, with medics engaging in the least similar scanning patterns, for both the whole-brain and independent-slice task. In the independent-slice task, scanning patterns were the least similar for false negatives across all expertise levels and most similar for experts when they responded correctly. These results demonstrate the value of using ScanMatch in the medical image perception literature. Future research adopting this tool could, for example, identify cases that yield low scanning similarity and so provide insight into why diagnostic errors occur and ultimately help in training radiologists.
Highlights
Medical imaging is a crucial tool when making diagnostic and treatment decisions
Experiment 1b: independent-slices Since most existing research uses 2D viewing modalities, we examined the effect of expertise and diagnosis on eye-gaze behaviour and diagnostic accuracy in an independent-slice brain tumour detection task
This study examined the effect of expertise and diagnosis on performance and gaze behaviour in a brain tumour detection task using Magnetic resonance imaging (MRI) scans
Summary
Medical imaging is a crucial tool when making diagnostic and treatment decisions. Clinicians inspect an image to first detect and interpret any abnormalities in the context of a given medical problem. Crowe et al Cognitive Research: Principles and Implications (2018) 3:12 aided detection (CAD), final medical decision-making resides with clinicians and so is constrained by their perceptual and cognitive abilities. A large body of eye-tracking research has been conducted to better understand how clinicians engage in these interrelated processes and so provide insight into the relationship between visual search and diagnostic decision-making (Reingold & Sheridan, 2011). Novice-expert studies, which examine the effect of expertise on gaze behaviour, have revealed that experts have faster overall search times to detect and confirm the presence of an abnormality (Krupinski, 1996; Krupinski et al, 2006). Such research demonstrates that gaze behaviour changes as a function of expertise and hints at the possibility that we may be able to identify what characterises expertise and how knowledge of this can be used to improve training practices, and efficiency, for future clinicians
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