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Fatigue and vigilance in medical experts detecting breast cancer

Taylor-Phillips, Sian; Jenkinson, David; Stinton, Chris; Kunar, Melina A.; Watson, Derrick G.; Freeman, Karoline; Mansbridge, Alice; Wallis, Matthew G.; Kearins, Olive; Hudson, Sue; Clarke, Aileen

Authors

Sian Taylor-Phillips

Chris Stinton

Melina A. Kunar

Derrick G. Watson

Karoline Freeman

Alice Mansbridge

Matthew G. Wallis

Olive Kearins

Sue Hudson

Aileen Clarke



Abstract

An abundance of laboratory-based experiments has described a vigilance decrement of reducing accuracy to detect targets with time on task, but there are few real-world studies, none of which have previously controlled the environment to control for bias. We describe accuracy in clinical practice for 360 experts who examined >1 million women’s mammograms for signs of cancer, whilst controlling for potential biases. The vigilance decrement pattern was not observed. Instead, test accuracy improved over time, through a reduction in false alarms and an increase in speed, with no significant change in sensitivity. The multiple-decision model explains why experts miss targets in low prevalence settings through a change in decision threshold and search quit threshold and propose it should be adapted to explain these observed patterns of accuracy with time on task. What is typically thought of as standard and robust research findings in controlled laboratory settings may not directly apply to real-world environments and instead large, controlled studies in relevant environments are needed.

Citation

Taylor-Phillips, S., Jenkinson, D., Stinton, C., Kunar, M. A., Watson, D. G., Freeman, K., …Clarke, A. (2024). Fatigue and vigilance in medical experts detecting breast cancer. Proceedings of the National Academy of Sciences of the United States of America, 121(11), https://doi.org/10.1073/pnas.2309576121

Journal Article Type Article
Acceptance Date Dec 19, 2023
Online Publication Date Mar 4, 2024
Publication Date Mar 12, 2024
Deposit Date Mar 7, 2024
Publicly Available Date Mar 19, 2024
Journal Proceedings of the National Academy of Sciences
Print ISSN 0027-8424
Electronic ISSN 1091-6490
Publisher National Academy of Sciences
Peer Reviewed Peer Reviewed
Volume 121
Issue 11
DOI https://doi.org/10.1073/pnas.2309576121
Keywords Multidisciplinary
Additional Information Received: 2023-06-08; Accepted: 2023-12-19; Published: 2024-03-04

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