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Biomedical subjects

D D Dorfman

Publications and source records attributed to D D Dorfman.

15 recordsLinked to original sources
PubMed1991

Time course of satisfaction of search.

"Satisfaction of search" (SOS) refers to the effect in which a second lesion remains undetected after detection of another lesion on the same radiograph. The objective of this study was to clarify our understanding of SOS by relating it to total time of inspection and time intervals before, between, and after discovery of lesions. Detection accuracy of native lesions in chest radiographs, before and after the addition of a simulated nodular lesion, was measured for ten observers. Analysis of data from this and a previous experiment showed that average perceptual accuracy of individual receiver operating characteristic curves was significantly reduced with the addition of the nodules. Plots and analyses of search time revealed that, on average, during a typical 46-second inspection of a case, simulated nodules were found at 18 seconds, native abnormalities at 25 seconds, and false positives occurred at 33 seconds. Time needed to find nodules did not depend on whether native lesions were present; time to find native lesions did not change with addition of nodules; and total search time was the same for images with one, two, or no lesions. The detection results show that the SOS effect was obtained, but that interrupting search in order to measure it also diminishes accuracy. Analysis of the time course data relates SOS to perceptual capture and strategic halting of search.

Diagnostic Errors↗
PubMed1990

Satisfaction of search in diagnostic radiology.

A subset of underreading errors (false-negative responses) in radiology has been attributed to "satisfaction of search," which occurs when lesions remain undetected after detection of an initial lesion. This phenomenon has not been studied in the experimental laboratory. A primary goal of this study was to develop a procedure or paradigm to study satisfaction of search. The authors measured detection accuracy for native lesions in images before and after the addition of a simulated nodular lesion. Simulated and native lesions were not spatially superimposed and the native abnormalities were physically identical with and without the nodules. Only responses related to the native lesion were analyzed. Accuracy parameters of receiver operating characteristic (ROC) curves were estimated by the method of maximum likelihood and jackknife. The average perceptual accuracy of the individual ROC curves as measured by Az and de' was significantly reduced with addition of the nodules (t = 2.364, p = 0.025, t = 2.648, p = 0.017, respectively). Az and de' parameters of the pooled ROC curve showed a similar effect (t = 1.573, p = 0.080; t = 1.934, p = 0.047, respectively). The results indicated a substantial satisfaction-of-search effect, with diminished accuracy in perception of native lesions.

Adolescent↗
PubMed1988

Influence of clinical history upon detection of nodules and other lesions.

The authors reexamined a suspected difference in the effects of clinical information upon detection of nodules vs. more diverse lesions by directly incorporating classification specificity into detection ROC analysis. Categorical prompts, correct for specific abnormalities, led to detection superior to unprompted reading when non-nodule trials (various lesion types) were analyzed. Trials that contained pulmonary nodules, or contained no lesions but had been preceded by "possible tuberculosis" or "rule out metastatic disease" prompts, failed to demonstrate the diagnostic prompt superiority. Perceptual responses may differ when nodules are compared with more complex lesions.

Diagnostic Errors↗
PubMed1986

Tentative diagnoses facilitate the detection of diverse lesions in chest radiographs.

The influence of clinical history upon detection has been frequently studied. In a unique investigation, detection of diverse abnormalities commonly encountered in practice was tested, and the influence of clinical history was conceptualized as suggesting a tentative diagnosis. Categorical prompts that were correct for specific abnormalities resulted in detection superior to that with unprompted reading. Prompts that were plausible but incorrect for abnormal and normal cases led to very few false-positive responses, and subsequent reports of specific abnormalities were as accurate as in unprompted reading. It is concluded that appropriate clinical history results in improved perceptual performance rather than simply improved decision-making.

Adult↗