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Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT)

Chen, Yan; Sudin, Ellhia S; Partridge, George J W; Taib, Adnan G; Darker, Iain T; Phillips, Peter; James, Jonathan J; Satchithananda, Keshthra; Sharma, Nisha; Michell, Michael J

Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT) Thumbnail


Authors

YAN CHEN Yan.Chen@nottingham.ac.uk
Professor of Digital Health

Ellhia S Sudin

George J W Partridge

ADNAN TAIB ADNAN.TAIB@NOTTINGHAM.AC.UK
Clinical Research Fellow

Iain T Darker

Peter Phillips

Jonathan J James

Keshthra Satchithananda

Nisha Sharma

Michael J Michell



Abstract

Objectives: The interpretation of digital breast tomosynthesis (DBT) screening examinations is a complex task for an already overstretched workforce which has the potential to increase pressure on readers leading to fatigue and patient safety issues. Studies in non-medical and medical settings have suggested that changes in blink characteristics can reflect fatigue. The purpose of this study is to investigate the use of blink characteristics as an objective marker of fatigue in readers interpreting DBT breast screening examinations. Methods: Twenty-six DBT readers involved in the UK PROSPECTS trial interpreted a test set of 40 DBT cases while being observed by an eye tracking device from November 2019 to February 2021. Raw data from the eye tracker were collected and automated processing software was used to produce eye blinking characteristics data which were analysed using multiple linear regression statistical models. Results: Of the 26 DBT readers recruited, eye tracking data from 23 participants were analysed due to missing data rendering 3 participants’ data uninterpretable. The mean reading time per DBT case was 2.81 min. There was a statistically significant increase in blinking duration of 0.38 ms/case as the reading session progressed (p < 0.0001). This was the result of a significant decrease in the number of ultra-short blinks lasting ≤50 ms (p = 0.0005) and a significant increase in longer blinks lasting 51–100 ms (p = 0.008). Conclusion Changes in blinking characteristics could serve as objective measures of reader fatigue and may prove useful in the development of DBT reading protocols. Advances in knowledge: Blink characteristics can be used as an objective measure of fatigue; however there is limited evidence of their use in radiological settings. Our study suggests that changes in blink duration and frequency could be used to monitor fatigue in DBT reading sessions.

Citation

Chen, Y., Sudin, E. S., Partridge, G. J. W., Taib, A. G., Darker, I. T., Phillips, P., …Michell, M. J. (2023). Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT). British Journal of Radiology, 96(1143), Article 20220629. https://doi.org/10.1259/bjr.20220629

Journal Article Type Article
Acceptance Date Nov 6, 2022
Online Publication Date Jan 12, 2023
Publication Date Feb 1, 2023
Deposit Date Jan 13, 2023
Publicly Available Date Jan 20, 2023
Journal British Journal of Radiology
Print ISSN 0007-1285
Electronic ISSN 1748-880X
Publisher British Institute of Radiology
Peer Reviewed Peer Reviewed
Volume 96
Issue 1143
Article Number 20220629
DOI https://doi.org/10.1259/bjr.20220629
Keywords Radiology, Nuclear Medicine and imaging; General Medicine
Public URL https://nottingham-repository.worktribe.com/output/15939015
Publisher URL https://www.birpublications.org/doi/10.1259/bjr.20220629
Additional Information This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited

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https://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2022 The Authors. Published by the British Institute of Radiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.




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