Park Hyung-Bum, Azer Lilian, Ahn Shinhae, Dinh Tam-Dan, Macias Gabriela, Zhang Gavin, Chen Bihong Beth, Ma Huiyan, Botejue Mahesh, Choi Eric H, Zhang Weiwei
The University of Chicago, Institute for Mind and Biology, Chicago, Illinois, United States.
University of California, Riverside, Department of Psychology, Riverside, California, United States.
J Med Imaging (Bellingham). 2023 Feb;10(Suppl 1):S11911. doi: 10.1117/1.JMI.10.S1.S11911. Epub 2023 May 8.
The influential holistic processing hypothesis attributes expertise in medical image perception to cognitive processing of global gist information. However, it has remained unclear whether or how experts use rapid global impression of images for their subsequent diagnostic decisions based on the focal sign of cancer. We hypothesized that continuous-global and discrete-local processes jointly attribute to radiological experts' detection of mammogram, with different weights and temporal dynamics.
We examined experienced versus inexperienced observers' performance at first (500 ms) versus second (2500 ms) mammogram image presentation in an abnormality detection task. We applied a dual-trace signal detection (DTSD) model of receiver operating characteristic (ROC) to assess the time-varying contributions of global and focal cancer signals on mammogram reading and medical expertise.
The hierarchical Bayesian DTSD modeling of empirical ROCs revealed that mammogram expertise (experienced versus inexperienced observers) manifests largely in a continuous-global component for the detection of the gist of abnormality at the early phase of mammogram reading. For the second presentation of the same mammogram images, the experienced participants showed increased task performance that was largely driven by better processing of discrete-local information, whereas the global processing of abnormality remained saturated from the first exposure. Modeling of the mouse trajectory of the confidence rating responses further revealed the temporal dynamics of global and focal processing.
These results suggest a joint contribution of continuous-global and discrete-local processes on medical expertise, and these processes could be analytically dissociated.
有影响力的整体加工假说将医学图像感知方面的专业能力归因于对整体主旨信息的认知加工。然而，专家是否以及如何基于癌症的重点体征利用图像的快速整体印象进行后续诊断决策仍不明确。我们假设连续的整体过程和离散的局部过程共同作用于放射科专家对乳房X光片的检测，且权重和时间动态各不相同。
我们在一项异常检测任务中，考察了经验丰富和缺乏经验的观察者在首次（500毫秒）和第二次（2500毫秒）呈现乳房X光片图像时的表现。我们应用了一种接收器操作特征（ROC）的双轨迹信号检测（DTSD）模型，以评估整体和重点癌症信号在乳房X光片解读和医学专业能力方面随时间变化的作用。
对经验证的ROC进行分层贝叶斯DTSD建模显示，乳房X光片专业能力（经验丰富与缺乏经验的观察者）在很大程度上体现在乳房X光片解读早期对异常主旨的检测的连续整体成分中。对于同一乳房X光片图像的第二次呈现，经验丰富的参与者表现出任务绩效的提高，这在很大程度上是由对离散局部信息的更好加工驱动的，而对异常的整体加工从首次接触起就保持饱和。对信心评级反应的鼠标轨迹建模进一步揭示了整体和重点加工的时间动态。
这些结果表明连续的整体过程和离散的局部过程对医学专业能力有共同作用，并且这些过程可以进行分析性区分。
