Reporting instructions significantly impact false positive rates when reading chest radiographs

John W Robinson; Patrick C Brennan; Claudia Mello-Thoms; Sarah J Lewis

doi:10.1007/s00330-015-4194-1

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Reporting instructions significantly impact false positive rates when reading chest radiographs

Journal article

Peer reviewed

Reporting instructions significantly impact false positive rates when reading chest radiographs

John W Robinson, Patrick C Brennan, Claudia Mello-Thoms and Sarah J Lewis

European radiology, Vol.26(10), pp.3654-3659

10/2016

DOI: 10.1007/s00330-015-4194-1

PMID: 26780639

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Abstract

To determine the impact of specific reporting tasks on the performance of radiologists when reading chest radiographs. Ten experienced radiologists read a set of 40 postero-anterior (PA) chest radiographs: 21 nodule free and 19 with a proven solitary nodule. There were two reporting conditions: an unframed task (UFT) to report any abnormality and a framed task (FT) reporting only lung nodule/s. Jackknife free-response operating characteristic (JAFROC) figure of merit (FOM), specificity, location sensitivity and number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) decisions were used for analysis. JAFROC FOM for tasks showed a significant reduction in performance for framed tasks (P = 0.006) and an associated decrease in specificity (P = 0.011) but no alteration to the location sensitivity score. There was a significant increase in number of FP decisions made during framed versus unframed tasks for nodule-containing (P = 0.005) and nodule-free (P = 0.011) chest radiographs. No significant differences in TP were recorded. Radiologists report more FP decisions when given specific reporting instructions to search for nodules on chest radiographs. The relevance of clinical history supplied to radiologists is called into question and may induce a negative effect. • Framed reporting tasks increases false positive rates when searching for pulmonary nodules • False positive results were observed in both nodule-containing and nodule-free cases • Radiologist's decision-making may be influenced by clinical history in thoracic imaging.

Clinical Competence

Reproducibility of Results

Humans

Tomography, X-Ray Computed - methods

Lung Neoplasms - pathology

Male

False Positive Reactions

Solitary Pulmonary Nodule - diagnostic imaging

Clinical Decision-Making

Sensitivity and Specificity

Female

Lung Neoplasms - diagnostic imaging

Radiography, Thoracic - methods

Radiographic Image Interpretation, Computer-Assisted

Observer Variation

Solitary Pulmonary Nodule - pathology

Details

Title: Subtitle: Reporting instructions significantly impact false positive rates when reading chest radiographs
Creators: John W Robinson - Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, 2141, NSW, Australia. john.robinsonmrs@sydney.edu.au
Patrick C Brennan - Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, 2141, NSW, Australia
Claudia Mello-Thoms - Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, 2141, NSW, Australia
Sarah J Lewis - Medical Image Optimisation and Perception Group, Discipline of Medical Radiation Sciences, Faculty of Health Sciences, The University of Sydney, 75 East Street, Lidcombe, 2141, NSW, Australia
Resource Type: Journal article
Publication Details: European radiology, Vol.26(10), pp.3654-3659
Publisher: Germany
DOI: 10.1007/s00330-015-4194-1
PMID: 26780639
ISSN: 0938-7994
eISSN: 1432-1084
Language: English
Date published: 10/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984051586602771

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