Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT)

Chen, Yan, Sudin, Ellhia, Partridge, George, Taib, Adnan, Darker, Iain, Phillips, Peter, James, Jonathan, Satchithananda, Keshthra, Sharma, Nisha and Michell, Michael (2023) Measuring reader fatigue in the interpretation of screening digital breast tomosynthesis (DBT). The British Journal of Radiology .

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Official URL: https://doi.org/10.1259/bjr.20220629

Abstract

Objectives: The interpretation of digital breast tomosynthesis (DBT) screening examinations is a complex task for an already overstretched workforce which has the potential to increase pressure on readers leading to fatigue and patient safety issues. Studies in non-medical and medical settings have suggested that changes in blink characteristics can reflect fatigue. The purpose of this study is to investigate the use of blink characteristics as an objective marker of fatigue in readers interpreting DBT breast screening examinations.

Methods: Twenty-six DBT readers involved in the UK PROSPECTS trial interpreted a test set of 40 DBT cases while being observed by an eye tracking device from November 2019 to February 2021. Raw data from the eye tracker were collected and automated processing software was used to produce eye blinking characteristics data which were analysed using multiple linear regression statistical models.

Results: Of the 26 DBT readers recruited, eye tracking data from 23 participants were analysed due to missing data rendering 3 participants’ data uninterpretable. The mean reading time per DBT case was 2.81 min. There was a statistically significant increase in blinking duration of 0.38 ms/case as the reading session progressed (p < 0.0001). This was the result of a significant decrease in the number of ultra-short blinks lasting ≤50 ms (p = 0.0005) and a significant increase in longer blinks lasting 51–100 ms (p = 0.008).

Conclusion: Changes in blinking characteristics could serve as objective measures of reader fatigue and may prove useful in the development of DBT reading protocols.

Advances in knowledge: Blink characteristics can be used as an objective measure of fatigue; however there is limited evidence of their use in radiological settings. Our study suggests that changes in blink duration and frequency could be used to monitor fatigue in DBT reading sessions.

Item Type: Article
Journal / Publication Title: The British Journal of Radiology
Publisher: British Institute of Radiology
ISSN: 1748-880X
Departments: Institute of Health > Medical Sciences
Additional Information: This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License http://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Depositing User: Insight Administrator
SWORD Depositor: Insight Administrator
Date Deposited: 23 Jan 2023 09:33
Last Modified: 23 Jan 2023 09:45
URI: https://insight.cumbria.ac.uk/id/eprint/6823

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