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Open Access 17-08-2023 | Fatigue | Experimental

Take a break: should breaks be enforced during digital breast tomosynthesis reading sessions?

Authors: George John William Partridge, Adnan Gani Taib, Peter Phillips, Jonathan Jeffrey James, Keshthra Satchithananda, Nisha Sharma, Juliet Morel, Rita McAvinchey, Alexandra Valencia, William Teh, Humaira Khan, Elizabeth Muscat, Michael James Michell, Yan Chen

Published in: European Radiology | Issue 2/2024

Abstract

Objectives

Digital breast tomosynthesis (DBT) can improve diagnostic accuracy compared to 2D mammography, but DBT reporting is time-consuming and potentially more fatiguing. Changes in diagnostic accuracy and subjective and objective fatigue were evaluated over a DBT reporting session, and the impact of taking a reporting break was assessed.

Materials and methods

Forty-five National Health Service (NHS) mammography readers from 6 hospitals read a cancer-enriched set of 40 DBT cases whilst eye tracked in this prospective cohort study, from December 2020 to April 2022. Eye-blink metrics were assessed as objective fatigue measures. Twenty-one readers had a reporting break, 24 did not. Subjective fatigue questionnaires were completed before and after the session. Diagnostic accuracy and subjective and objective fatigue measures were compared between the cohorts using parametric and non-parametric significance testing.

Results

Readers had on average 10 years post-training breast screening experience and took just under 2 h (105.8 min) to report all cases. Readers without a break reported greater levels of subjective fatigue (44% vs. 33%, p = 0.04), which related to greater objective fatigue: an increased average blink duration (296 ms vs. 286 ms, p < 0.001) and a reduced eye-opening velocity (76 mm/s vs. 82 mm/s, p < 0.001). Objective fatigue increased as the trial progressed for the no break cohort only (ps < 0.001). No difference was identified in diagnostic accuracy between the groups (accuracy: 87% vs. 87%, p = 0.92).

Conclusions

Implementing a break during a 2-h DBT reporting session resulted in lower levels of subjective and objective fatigue. Breaks did not impact diagnostic accuracy, which may be related to the extensive experience of the readers.

Clinical relevance statement

DBT is being incorporated into many mammography screening programmes. Recognising that reporting breaks are required when reading large volumes of DBT studies ensures this can be factored in when setting up reading sessions.

Trial registration

Clinical trials registration number: NCT03733106

Key Points

• Use of digital breast tomosynthesis (DBT) in breast screening programmes can cause significant reader fatigue.

• The effectiveness of incorporating reading breaks into DBT reporting sessions, to reduce mammography reader fatigue, was investigated using eye tracking.

• Integrating breaks into DBT reporting sessions reduced reader fatigue; however, diagnostic accuracy was unaffected.

Available only for authorised users

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Title: Take a break: should breaks be enforced during digital breast tomosynthesis reading sessions?
Authors: George John William Partridge
Adnan Gani Taib
Peter Phillips
Jonathan Jeffrey James
Keshthra Satchithananda
Nisha Sharma
Juliet Morel
Rita McAvinchey
Alexandra Valencia
William Teh
Humaira Khan
Elizabeth Muscat
Michael James Michell
Yan Chen
Publication date: 17-08-2023
Publisher: Springer Berlin Heidelberg
Keywords: Fatigue
Mammography
Mammography
Published in: European Radiology / Issue 2/2024
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-10086-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Take a break: should breaks be enforced during digital breast tomosynthesis reading sessions?

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance statement

Trial registration

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance statement

Trial registration

Key Points

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