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BMC Medical Informatics and Decision Making
Published in: BMC Medical Informatics and Decision Making 1/2016

Open Access 01-12-2016 | Research article

Pupil diameter changes reflect difficulty and diagnostic accuracy during medical image interpretation

Authors: Tad T. Brunyé, Marianna D. Eddy, Ezgi Mercan, Kimberly H. Allison, Donald L. Weaver, Joann G. Elmore

Published in: BMC Medical Informatics and Decision Making | Issue 1/2016

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Abstract

Background

No automated methods exist to objectively monitor and evaluate the diagnostic process while physicians review computerized medical images. The present study tested whether using eye tracking to monitor tonic and phasic pupil dynamics may prove valuable in tracking interpretive difficulty and predicting diagnostic accuracy.

Methods

Pathologists interpreted digitized breast biopsies varying in diagnosis and rated difficulty, while pupil diameter was monitored. Tonic diameter was recorded during the entire duration of interpretation, and phasic diameter was examined when the eyes fixated on a pre-determined diagnostic region during inspection.

Results

Tonic pupil diameter was higher with increasing rated difficulty levels of cases. Phasic diameter was interactively influenced by case difficulty and the eventual agreement with consensus diagnosis. More difficult cases produced increases in pupil diameter, but only when the pathologists’ diagnoses were ultimately correct. All results were robust after adjusting for the potential impact of screen brightness on pupil diameter.

Conclusions

Results contribute new understandings of the diagnostic process, theoretical positions regarding locus coeruleus-norepinephrine system function, and suggest novel approaches to monitoring, evaluating, and guiding medical image interpretation.
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Metadata
Title
Pupil diameter changes reflect difficulty and diagnostic accuracy during medical image interpretation
Authors
Tad T. Brunyé
Marianna D. Eddy
Ezgi Mercan
Kimberly H. Allison
Donald L. Weaver
Joann G. Elmore
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2016
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-016-0322-3

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