Pupil Diameter Changes Reflect Difficulty and Diagnostic Accuracy During Medical Image Interpretation

Overview

Journal BMC Med Inform Decis Mak

Publisher Biomed Central

Specialty Medical Informatics

Date 2016 Jul 6

PMID 27378371

Citations 8

Authors

Tad T Brunye

Marianna D Eddy

Ezgi Mercan

Kimberly H Allison

Donald L Weaver

Joann G Elmore

Affiliations

Soon will be listed here.

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.

Citing Articles

Eye tracking in digital pathology: A comprehensive literature review.

Lopes A, Ward A, Cecchini M J Pathol Inform. 2024; 15:100383.

PMID: 38868488 PMC: 11168484. DOI: 10.1016/j.jpi.2024.100383.

A time slice analysis of dentistry students' visual search strategies and pupil dilation during diagnosing radiographs.

Borchers C, Eder T, Richter J, Keutel C, Huettig F, Scheiter K PLoS One. 2023; 18(6):e0283376.

PMID: 37289785 PMC: 10249848. DOI: 10.1371/journal.pone.0283376.

Pathologist pupil dilation reflects experience level and difficulty in diagnosing medical images.

Drew T, Konold C, Lavelle M, Brunye T, Kerr K, Shucard H J Med Imaging (Bellingham). 2023; 10(2):025503.

PMID: 37096053 PMC: 10122150. DOI: 10.1117/1.JMI.10.2.025503.

Zoom behavior during visual search modulates pupil diameter and reflects adaptive control states.

Brunye T, Drew T, Kerr K, Shucard H, Powell K, Weaver D PLoS One. 2023; 18(3):e0282616.

PMID: 36893083 PMC: 9997932. DOI: 10.1371/journal.pone.0282616.

Changes in Radiologists' Gaze Patterns Against Lung X-rays with Different Abnormalities: a Randomized Experiment.

Pershin I, Mustafaev T, Ibragimova D, Ibragimov B J Digit Imaging. 2023; 36(3):767-775.

PMID: 36622464 PMC: 9838425. DOI: 10.1007/s10278-022-00760-2.

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