Less experienced radiologists are more susceptible to fatigue when reading DBT exams

A radiologist's career experience, level of fatigue and time of day during which they read digital breast tomosynthesis (DBT) images all impact patient recall rates, according to research published Tuesday.

With DBT becoming more widely available, the modality positioned to become the gold standard for routine breast screening. In contrast to the four views obtained during 2D digital mammography, DBT requires radiologists to review hundreds more images. Consequently, reading DBT exams presents a more arduous task for readers, which could affect accuracy. 

To assess how these factors may impact exam recalls, researchers at the Brown Radiology Human Factors Lab evaluated false positive and call- back rates for digital mammography and DBT. They then compared those figures to the time of day when the read was completed. 

More than 40,000 DBT and 57,000 digital mammograms were evaluated for the study. Although DM yielded higher false positives (9.8%) and recalls (10.2%) compared to DBT (8.6% and 9%), the recall rates for DBT increased when reads were completed later in the day. 

The experience level of the radiologist also appeared to impact the recall rates for DBT. This rate increased by 11.5% every hour among radiologists with less than five years of experience.  

“It’s useful to know that fatigue is a factor that impacts performance metrics. As we’re trying to do the best job for our patients and handle increased imaging volumes, these results suggest that regular breaks may have tangible benefits for outcome measures,” explained co-author Ana P. Lourenco, MD, with the Warren Alpert Medical School at Brown University. 

Lourenco continued by suggesting that the increase in recall rates for less experienced radiologists could be due to different ways of thinking—indicating they might be more deliberate in their processes than more seasoned radiologists who do not require as much time or focus to interpret exams. She does, however, note that more research is necessary. 

“I hope this study spurs additional research to look at more of the details of what it is that goes on in humans who interpret these images,” Lourenco said. 

You can view the detailed research in Radiology.  

 


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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.

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