Abstract
Expert and novice radiologists were given films accompanied-by-clinical histories that supported a diagnosis either of bronchiolitis or of normal. To provide a plausible task context, some films were radiologically unambiguous and were accompanied by histories consistent with them. For a set of radiologically difficult films from confirmed normal or bronchiolitis patients, fictitious normal or abnormal histories were counterbalanced with the films. The clinical histories affected ratings both of diagnosis and of features present on the difficult films. Thus, uncertainty about individual features evidently was affected by history, and features did not act as an independent source of information. The dependence of feature calls on an overall judgment was also suggested by intra-observer agreement in another study in which an explicit diagnosis was not requested. It is unclear whether the history increased discrimination between normal and -abnormal films, or indiscriminately added evidence for or against the disease. Factors are discussed that make it appropriate for feature identification to be partially dependent on category identification.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Barrows, H. S., Norman, G. R., Neufeld, V. R., &Feightner, J. W. (1982). The clinical reasoning process of randomly selected physicians in general medical practice.Clinical & Investigative Medicine,5, 49–56.
Berraum, K. S., El-Khoury, G. Y., Franken, E. A., Kathol.M., Montgomery, W. J., &Hesson, W. (1988). Impact of clinical history on fracture detection with radiography.Radiology,168, 507–511.
Berbaum, K. S., Franken, E. A., Dorfman, D. D., Barloon, T., Ell, S. R., Lu, C. H., Smith, W., &Abu-Yousef, M. M. (1986). Tentative diagnoses facilitate the detection of diverse lesions in chest radiographs.Investigative Radiology,21, 532–553.
Berbaum, K. S., Franken, E. A., Dorfman, D. D., Rooholamini, S. A., Kathol, M. H., Barloon, T. J., Behike, F. M., Sato, Y., Lu, C. H., El-Khoury, G. Y., Fuckinger, F. W., &Montgomery, W. J. (1990). Satisfaction of search in diagnostic radiology.Investigative Radiology,25, 133–140.
Brooks, L. R., Norman, G. R., &Allen, S. W. (1991). The role of specific similarity in a medical diagnostic task.Journal of Experimental Psychology: General,120, 278–287,
Coblentz, C. L., Babcook, C. J., Alton, D., Rilev, B. J., &Norman, G. R. (1991). Observer variation in detecting the radiologic features associated with bronchiolitis.Investigative Radiology,26, 115–118.
Cohen, I. (1968). Weighted kappa: Nominal scale agreement with provision for scaled disagreement or partial credit.Psychological Bulletin,70, 213–220.
Doubilet, P., &Herman, P. G. (1981). Interpretation of radiographs: Effect of clinical history.American Journal of Radiology,137, 1055- 1058.
Fischhoff, B., &Beyth-Marom, R. (1983). Hypothesis evaluation from a Bayesian perspective.Psychological Review,90, 239–260.
Good, B. C., Cooperstein, L. A., DeMarino, G. B, Miketic, L. M., Gennari, R. C., Rockette, H. E., &Gur, D. (1990). Does knowledge of the clinical history affect the accuracy of chest radiograph interpretation?American Journal of Radiology,154, 709–712.
Guppy, K. H., Detrano, R., Abbassi, N., Janosi, A., Sandhu, S., &Froelicher, V. (1989). The reliability of probability analysis in the prediction of coronary artery disease in two hospitals.Medical Decision Making,9, 181–189.
Holdaway, D., Rome, A. C., &Gardner, P. S. (1967). The diagnosis and management of bronchiolitis.Pediatrics,39, 924–928.
Lesgold, A. M., Rubinson, H., Feltovich, P., Glaser, R., Klopfer, D., &Wang, Y. (1988). Expertise in a complex skill: Diagnosing X-ray pictures. In M. T. H. Chi, R. Glaser, & M. Farr (Eds.),The nature of expertise (pp. 322–351). Hillsdale, NJ: Erlbaum.
Lusted, L. B. (1968).Introduction to medical decision making. Springfield, IL: C. C. Thomas.
Markus, J. B., Somers, S., O’Malley, B. P., &Stephenson, G. W. (1989). Double-contrast barium enema studies: Effect of multiple readings on perception error.Radiology,175, 155–156.
McClelland, J. L., &Rumelhart, D. E. (1981). An interactive activation model of context effects in letter perception: Part I. An account of basic findings.Psychological Review,88, 375–407.
Myles-Worsley, M., Johnston, W., &Simons, M. (1988). The influence of expertise on X-ray image processing.Journal of Experimental Psychology: Learning, Memory, & Cognition,14, 553–557.
Norman, G. R., Brooks, L. R., &Allen, S. W. (1989). Recall by expert medical practitioners as a record of processing attention.Journal of Experimental Psychology: Learning, Memory, & Cognition,15, 1166–1174.
Schreiber, M. H. (1963). The clinical history as a factor in roentgenographic interpretation.Journal of the American Medical Association,185, 137–139.
Slovic, P., Rorer, L. G., &Hoffman, P. J. (1971). Analyzing use of diagnostic signs.Investigative Radiology,6, 18–26.
Swanson, D. B., Feltovich, P. J. &Johnson, P. E. (1977). Psychological analysis of physician expertise: Implications for design of decision support systems. In D. B. Shires & H. L. Wolf, (Eds.),Proceedings of the Second World Conference on Medical Informatics (pp. 161–164). Amsterdam, North-Holland.
Swensson, R. G. (1980). A two-stage detection model applied to skilled visual search by radiologists.Perception & Psychophysics,27, 11–16.
Wigton, R. S. (1988). Use of linear models to analyze physicians decisions.Medical Decision Making,8, 241–252.
Author information
Authors and Affiliations
Additional information
This research was carried out under the support of the Natural Sciences and Engineering Research Council of Canada through a grant to the first and second authors.
Rights and permissions
About this article
Cite this article
Norman, G.R., Brooks, L.R., Coblentz, C.L. et al. The correlation of feature identification and category judgments in diagnostic radiology. Memory & Cognition 20, 344–355 (1992). https://doi.org/10.3758/BF03210919
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.3758/BF03210919