Diagnostic performance on briefly presented digital pathology images

Background: Identifying new and more robust assessments of proficiency/expertise (finding new "biomarkers of expertise") in histopathology is desirable for many reasons. Advances in digital pathology permit new and innovative tests such as flash viewing tests and eye tracking and slide nav...

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Main Authors: Joseph P Houghton, Bruce R Smoller, Niamh Leonard, Michael R Stevenson, Tim Dornan
Format: Article
Language:English
Published: Elsevier 2015-01-01
Series:Journal of Pathology Informatics
Subjects:
Online Access:http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=56;epage=56;aulast=Houghton
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author Joseph P Houghton
Bruce R Smoller
Niamh Leonard
Michael R Stevenson
Tim Dornan
author_facet Joseph P Houghton
Bruce R Smoller
Niamh Leonard
Michael R Stevenson
Tim Dornan
author_sort Joseph P Houghton
collection DOAJ
description Background: Identifying new and more robust assessments of proficiency/expertise (finding new "biomarkers of expertise") in histopathology is desirable for many reasons. Advances in digital pathology permit new and innovative tests such as flash viewing tests and eye tracking and slide navigation analyses that would not be possible with a traditional microscope. The main purpose of this study was to examine the usefulness of time-restricted testing of expertise in histopathology using digital images. Methods: 19 novices (undergraduate medical students), 18 intermediates (trainees), and 19 experts (consultants) were invited to give their opinion on 20 general histopathology cases after 1 s and 10 s viewing times. Differences in performance between groups were measured and the internal reliability of the test was calculated. Results: There were highly significant differences in performance between the groups using the Fisher′s least significant difference method for multiple comparisons. Differences between groups were consistently greater in the 10-s than the 1-s test. The Kuder-Richardson 20 internal reliability coefficients were very high for both tests: 0.905 for the 1-s test and 0.926 for the 10-s test. Consultants had levels of diagnostic accuracy of 72% at 1 s and 83% at 10 s. Conclusions: Time-restricted tests using digital images have the potential to be extremely reliable tests of diagnostic proficiency in histopathology. A 10-s viewing test may be more reliable than a 1-s test. Over-reliance on "at a glance" diagnoses in histopathology is a potential source of medical error due to over-confidence bias and premature closure.
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spelling doaj.art-ce4b84142a094fa1abf529f5688062222022-12-22T03:35:36ZengElsevierJournal of Pathology Informatics2153-35392015-01-0161565610.4103/2153-3539.168517Diagnostic performance on briefly presented digital pathology imagesJoseph P HoughtonBruce R SmollerNiamh LeonardMichael R StevensonTim DornanBackground: Identifying new and more robust assessments of proficiency/expertise (finding new "biomarkers of expertise") in histopathology is desirable for many reasons. Advances in digital pathology permit new and innovative tests such as flash viewing tests and eye tracking and slide navigation analyses that would not be possible with a traditional microscope. The main purpose of this study was to examine the usefulness of time-restricted testing of expertise in histopathology using digital images. Methods: 19 novices (undergraduate medical students), 18 intermediates (trainees), and 19 experts (consultants) were invited to give their opinion on 20 general histopathology cases after 1 s and 10 s viewing times. Differences in performance between groups were measured and the internal reliability of the test was calculated. Results: There were highly significant differences in performance between the groups using the Fisher′s least significant difference method for multiple comparisons. Differences between groups were consistently greater in the 10-s than the 1-s test. The Kuder-Richardson 20 internal reliability coefficients were very high for both tests: 0.905 for the 1-s test and 0.926 for the 10-s test. Consultants had levels of diagnostic accuracy of 72% at 1 s and 83% at 10 s. Conclusions: Time-restricted tests using digital images have the potential to be extremely reliable tests of diagnostic proficiency in histopathology. A 10-s viewing test may be more reliable than a 1-s test. Over-reliance on "at a glance" diagnoses in histopathology is a potential source of medical error due to over-confidence bias and premature closure.http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=56;epage=56;aulast=HoughtonDigital pathology, expertise, overconfidence bias, premature closure, time-restricted test
spellingShingle Joseph P Houghton
Bruce R Smoller
Niamh Leonard
Michael R Stevenson
Tim Dornan
Diagnostic performance on briefly presented digital pathology images
Journal of Pathology Informatics
Digital pathology, expertise, overconfidence bias, premature closure, time-restricted test
title Diagnostic performance on briefly presented digital pathology images
title_full Diagnostic performance on briefly presented digital pathology images
title_fullStr Diagnostic performance on briefly presented digital pathology images
title_full_unstemmed Diagnostic performance on briefly presented digital pathology images
title_short Diagnostic performance on briefly presented digital pathology images
title_sort diagnostic performance on briefly presented digital pathology images
topic Digital pathology, expertise, overconfidence bias, premature closure, time-restricted test
url http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=56;epage=56;aulast=Houghton
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AT niamhleonard diagnosticperformanceonbrieflypresenteddigitalpathologyimages
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AT timdornan diagnosticperformanceonbrieflypresenteddigitalpathologyimages