Readers' diagnostic accuracy drops as the day goes on

Now there’s proof after a day of interpreting images radiologists are less accurate, more tired, unable to focus, and experience eyestrain compared with earlier in the day. A study in the Journal of the American College of Radiology compared the ability of radiologists and residents to read bone exams early in the day with later.

Later in the work day radiologists experienced higher levels of fatigue. Increased visual strain rendered them less able to focus on images which made the radiologists less accurate when interpreting images.

The study, conducted at the University of Arizona and the University of Iowa, required attending radiologists and residents to view 60 bone exams, half of which had fractures. Study participants looked at the exams before any diagnostic reading activity in the morning and then again after diagnostic reading activity in the afternoon. They had to determine if a fracture was present and then locate it with their cursor.

“Our study demonstrated reduced diagnostic accuracy after the radiology workday, but the difference between accuracy before and after work was small, on the order of 4%,” said Elizabeth Krupinski, Ph.D., from the department of radiology at the University of Arizona in Tucson. “It seems that our sample of 40 readers reading 60 multiview examinations was just sufficient to detect this difference at the .05 significance level.”

However, only radiographic images were viewed and not CT or MR scans, which contain hundreds of images that must be scrolled through. Reading CT and MR images is potentially more fatiguing than reading x-rays, according to the authors.