Alberdi E, Povyakalo A A, Strigini L, Ayton P, Hartswood M, Procter R, Slack R
Centre for Software Reliability and Psychology Department, City University, Northampton Square, London EC1V 0HB.
Br J Radiol. 2005;78 Spec No 1:S31-40. doi: 10.1259/bjr/37646417.
We summarise a set of analyses and studies conducted to assess the effects of the use of a computer-aided detection (CAD) tool in breast screening. We have used an interdisciplinary approach that combines: (a) statistical analyses inspired by reliability modelling in engineering; (b) experimental studies of decisions of mammography experts using the tool, interpreted in the light of human factors psychology; and (c) ethnographic observations of the use of the tool both in trial conditions and in everyday screening practice. Our investigations have shown patterns of human behaviour and effects of computer-based advice that would not have been revealed by a standard clinical trial approach. For example, we found that the negligible measured effect of CAD could be explained by a range of effects on experts' decisions, beneficial in some cases and detrimental in others. There is some evidence of the latter effects being due to the experts using the computer tool differently from the intentions of the developers. We integrate insights from the different pieces of evidence and highlight their implications for the design, evaluation and deployment of this sort of computer tool.
我们总结了一系列为评估计算机辅助检测（CAD）工具在乳腺筛查中的使用效果而开展的分析和研究。我们采用了一种跨学科方法，该方法结合了：（a）受工程可靠性建模启发的统计分析；（b）运用该工具的乳腺造影专家决策的实验研究，并根据人因心理学进行解读；（c）在试验条件和日常筛查实践中对该工具使用情况的人种志观察。我们的调查揭示了人类行为模式以及基于计算机的建议所产生的影响，而这些是标准临床试验方法所无法揭示的。例如，我们发现CAD测量出的可忽略不计的效果可以通过一系列对专家决策的影响来解释，这些影响在某些情况下是有益的，而在其他情况下则是有害的。有证据表明，后一种影响是由于专家使用计算机工具的方式与开发者的意图不同所致。我们整合了来自不同证据的见解，并强调了它们对这类计算机工具的设计、评估和部署的影响。
