Department of Radiology, University of Arizona, 1609 N Warren, Tucson, AZ 85724, USA.
J Am Coll Radiol. 2010 Sep;7(9):698-704. doi: 10.1016/j.jacr.2010.03.004.
The aim of this study was to measure the diagnostic accuracy of fracture detection, visual accommodation, reading time, and subjective ratings of fatigue and visual strain before and after a day of clinical reading.
Forty attending radiologists and radiology residents viewed 60 deidentified, HIPAA-compliant bone examinations, half with fractures, once before any clinical reading (early) and once after a day of clinical reading (late). Reading time was recorded. Visual accommodation (the ability to maintain focus) was measured before and after each reading session. Subjective ratings of symptoms of fatigue and oculomotor strain were collected. The study was approved by local institutional review boards.
Diagnostic accuracy was reduced significantly after a day of clinical reading, with average areas under the receiver operating characteristic curves of 0.885 for early reading and 0.852 for late reading (P < .05). After a day of image interpretation, visual accommodation was no more variable, though error in visual accommodation was greater (P < .01), and subjective ratings of fatigue were higher.
After a day of clinical reading, radiologists have reduced ability to focus, increased symptoms of fatigue and oculomotor strain, and reduced ability to detect fractures. Radiologists need to be aware of the effects of fatigue on diagnostic accuracy and take steps to mitigate these effects.
本研究旨在测量骨折检测、视觉调节、阅读时间的诊断准确性，以及在一天的临床阅读前后疲劳和视觉紧张的主观评分。
40 名主治放射科医师和住院医师观看了 60 份经 HIPAA 认证的匿名骨骼检查，其中一半有骨折，一次是在任何临床阅读之前（早期），一次是在一天的临床阅读之后（晚期）。记录阅读时间。在每次阅读前后测量视觉调节（保持焦点的能力）。收集疲劳和眼动紧张症状的主观评分。该研究得到了当地机构审查委员会的批准。
一天的临床阅读后，诊断准确性显著降低，早期阅读的平均受试者工作特征曲线下面积为 0.885，晚期阅读为 0.852（P<0.05）。经过一天的图像解释后，视觉调节的变化不再明显，尽管视觉调节的误差更大（P<0.01），而且疲劳的主观评分更高。
经过一天的临床阅读后，放射科医生的聚焦能力下降，疲劳和眼动紧张症状增加，骨折检测能力下降。放射科医生需要意识到疲劳对诊断准确性的影响，并采取措施减轻这些影响。
