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Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training

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Abstract

The goal of this investigation was to explore the feasibility of characterizing the visual search characteristics of dermatologists evaluating images corresponding to single pigmented skin lesions (PSLs) (close-ups and dermoscopy) as a venue to improve training programs for dermoscopy. Two Board-certified dermatologists and two dermatology residents participated in a phased study. In phase I, they viewed a series of 20 PSL cases ranging from benign nevi to melanoma. The close-up and dermoscopy images of the PSL were evaluated sequentially and rated individually as benign or malignant, while eye position was recorded. Subsequently, the participating subjects completed an online dermoscopy training module that included a pre- and post-test assessing their dermoscopy skills (phase 2). Three months later, the subjects repeated their assessment on the 20 PSLs presented during phase I of the study. Significant differences in viewing time and eye-position parameters were observed as a function of level of expertise. Dermatologists overall have more efficient search than residents generating fewer fixations with shorter dwells. Fixations and dwells associated with decisions changing from benign to malignant or vice versa from photo to dermatoscopic viewing were longer than any other decision, indicating increased visual processing for those decisions. These differences in visual search may have implications for developing tools to teach dermatologists and residents about how to better utilize dermoscopy in clinical practice.

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Acknowledgments

This study was supported by a seed grant from the University of Arizona Cancer Center Skin Cancer Institute.

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Authors and Affiliations

  1. Department of Medical Imaging, University of Arizona Tucson, 1609 N Warren Bldg 211 Rm 112, Tucson, AZ, 85724, USA

    Elizabeth A. Krupinski

  2. College of Medicine, University of Arizona Tucson, Tucson, AZ, USA

    Joseph Chao

  3. Department Dermatology, University Graz, Graz, Austria

    Rainer Hofmann-Wellenhof

  4. Section Dermatology & Skin Cancer Institute, University of Arizona Tucson, Tucson, AZ, USA

    Lynne Morrison & Clara Curiel-Lewandrowski

Authors
  1. Elizabeth A. Krupinski
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  2. Joseph Chao
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  3. Rainer Hofmann-Wellenhof
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  4. Lynne Morrison
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  5. Clara Curiel-Lewandrowski
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Correspondence to Elizabeth A. Krupinski.

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Krupinski, E.A., Chao, J., Hofmann-Wellenhof, R. et al. Understanding Visual Search Patterns of Dermatologists Assessing Pigmented Skin Lesions Before and After Online Training. J Digit Imaging 27, 779–785 (2014). https://doi.org/10.1007/s10278-014-9712-1

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  • DOI: https://doi.org/10.1007/s10278-014-9712-1

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