Translational Medical Sciences, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, UK.
Health and Medical Sciences Group, University of Cumbria, Lancaster, UK.
Eur Radiol. 2024 Feb;34(2):1388-1398. doi: 10.1007/s00330-023-10086-4. Epub 2023 Aug 17.
Digital breast tomosynthesis (DBT) can improve diagnostic accuracy compared to 2D mammography, but DBT reporting is time-consuming and potentially more fatiguing. Changes in diagnostic accuracy and subjective and objective fatigue were evaluated over a DBT reporting session, and the impact of taking a reporting break was assessed.
Forty-five National Health Service (NHS) mammography readers from 6 hospitals read a cancer-enriched set of 40 DBT cases whilst eye tracked in this prospective cohort study, from December 2020 to April 2022. Eye-blink metrics were assessed as objective fatigue measures. Twenty-one readers had a reporting break, 24 did not. Subjective fatigue questionnaires were completed before and after the session. Diagnostic accuracy and subjective and objective fatigue measures were compared between the cohorts using parametric and non-parametric significance testing.
Readers had on average 10 years post-training breast screening experience and took just under 2 h (105.8 min) to report all cases. Readers without a break reported greater levels of subjective fatigue (44% vs. 33%, p = 0.04), which related to greater objective fatigue: an increased average blink duration (296 ms vs. 286 ms, p < 0.001) and a reduced eye-opening velocity (76 mm/s vs. 82 mm/s, p < 0.001). Objective fatigue increased as the trial progressed for the no break cohort only (ps < 0.001). No difference was identified in diagnostic accuracy between the groups (accuracy: 87% vs. 87%, p = 0.92).
Implementing a break during a 2-h DBT reporting session resulted in lower levels of subjective and objective fatigue. Breaks did not impact diagnostic accuracy, which may be related to the extensive experience of the readers.
DBT is being incorporated into many mammography screening programmes. Recognising that reporting breaks are required when reading large volumes of DBT studies ensures this can be factored in when setting up reading sessions.
Clinical trials registration number: NCT03733106 KEY POINTS: • Use of digital breast tomosynthesis (DBT) in breast screening programmes can cause significant reader fatigue. • The effectiveness of incorporating reading breaks into DBT reporting sessions, to reduce mammography reader fatigue, was investigated using eye tracking. • Integrating breaks into DBT reporting sessions reduced reader fatigue; however, diagnostic accuracy was unaffected.
与二维乳房 X 光相比，数字乳房断层合成术（DBT）可以提高诊断准确性，但 DBT 报告耗时且潜在地更容易疲劳。本前瞻性队列研究评估了 DBT 报告过程中的诊断准确性以及主观和客观疲劳的变化，并评估了休息对报告的影响。
2020 年 12 月至 2022 年 4 月，来自 6 家医院的 45 名英国国家医疗服务体系（NHS）乳腺摄影读者在这项研究中使用眼部追踪进行了一项癌症富集的 40 例 DBT 病例的前瞻性队列研究。眨眼指标被评估为客观疲劳的测量指标。21 名读者有报告休息，24 名没有。在会议前后完成了主观疲劳问卷。使用参数和非参数显著性检验比较了两组之间的诊断准确性以及主观和客观疲劳指标。
读者在接受培训后平均有 10 年的乳腺筛查经验，平均花费近 2 小时（105.8 分钟）报告所有病例。没有休息的读者报告的主观疲劳程度更高（44%比 33%，p=0.04），这与更高的客观疲劳有关：平均眨眼持续时间增加（296 毫秒比 286 毫秒，p<0.001）和睁眼速度降低（76 毫米/秒比 82 毫米/秒，p<0.001）。仅在没有休息的队列中，随着试验的进行，客观疲劳会增加（ps<0.001）。两组之间的诊断准确性没有差异（准确性：87%比 87%，p=0.92）。
在 2 小时的 DBT 报告过程中实施休息可以降低主观和客观疲劳的程度。休息并不影响诊断准确性，这可能与读者的丰富经验有关。
DBT 正在被纳入许多乳腺 X 光筛查计划中。认识到在阅读大量 DBT 研究时需要报告休息，这可以在设置阅读会议时加以考虑。
NCT03733106
在乳房筛查计划中使用数字乳房断层合成术（DBT）会导致显著的读者疲劳。
使用眼部追踪来调查在 DBT 报告过程中纳入阅读休息以减少乳腺摄影读者疲劳的效果。
将休息纳入 DBT 报告过程可减轻读者疲劳；然而，诊断准确性不受影响。
