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  1. Context bias : A problem in diagnostic radiology.

    Article - En anglais

    Objective

    - To determine whether radiologists'interpretations of images are biased by their context and by prevalence of disease in other recently observed cases.

    Methods

    - A test set of 24 right pulmonary arteriograms with a 33% prevalence of pulmonary emboli (PE) was assembled and embedded in 2 larger groups of films.

    Group A contained 16 additional arteriograms, all showing PE involving the right lung, so that total prevalence was 60%. Group B contained 16 additional arteriograms without PE so that total prevalence was 20%. Six radiologists were randomly assigned to see either group first and then « cross over » to review the other group after a hiatus of at least 8 weeks.

    The direction of changes in a 5-point rating scale for the 2 readings of each film in the test set was compared with the sign test ; mean sensitivity, specificity, and areas under receiver operating characteristic (ROC) curves were compared with the paired t test.

    Results

    - In the context of group A's higher disease prevalence, radiologists shifted more of their diagnoses toward higher suspicion than expected by chance (P=03, sign test).

    In group A, mean sensitivity for diagnosing PE was significantly higher (75% vs 60% ; P=04), and area under the ROC curve was significantly larger (0.88 vs 0.82 ; P=02).

    Conclusions

    - Radiologists'diagnoses are significantly influenced by the context of interpretation, even when spectrum and verification bias are avoided. (...)

    Mots-clés Pascal : Radiodiagnostic, Interprétation, Diagnostic, Evaluation performance, Homme, Exploration radiologique, Biais "contexte"

    Mots-clés Pascal anglais : Radiodiagnosis, Interpretation, Diagnosis, Performance evaluation, Human, Radiologic investigation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0073740

    Code Inist : 002B24A10. Création : 21/05/1997.