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. 2016 Aug;13(8):973-978.e4.
doi: 10.1016/j.jacr.2016.04.014. Epub 2016 Jun 18.

Trauma in CT: The Role of Severe Injury on Satisfaction of Search Revised

Kevin M Schartz  1 , Mark T Madsen  2 , John Kim  3 , Riko Ohashi  4 , Kenjirou Ohashi  2 , George Y El-Khoury  2 , Robert T Caldwell  2 , Edmund A Franken Jr  2 , Kevin S Berbaum  2
Affiliations

Trauma in CT: The Role of Severe Injury on Satisfaction of Search Revised

Kevin M Schartz et al. J Am Coll Radiol. 2016 Aug.

Abstract

Purpose: The satisfaction-of-search (SOS) effect occurs when an abnormality on an image is missed because another is found. The aim of this experiment was to test whether severe distracting fractures control the magnitude of SOS on other fractures when both appear in a single CT image.

Methods: The institutional review board approved this study. The experimental (SOS) condition included 35 cervical spine CT cases, all of which contained severe cervical spine injuries. For each of these cases, a similar case was found that had no injuries. Image modification software was developed to add simulated fractures to each pair of cases, with and without a major injury. Sixteen different minor fractures were added to 16 of the 35 pairs of images. The 35 cases without native injuries constituted a control (non-SOS) condition mixed in a random order. Twenty radiologists read 35 mixed cases in each of two sessions. False-positive evaluations were collected only for cases without simulated fractures.

Results: An SOS effect on the detection of simulated fractures was not observed. There was a nonsignificant (P = .07) finding of poorer detection in the presence of cases with severe injuries. However, the magnitude of the effect was no greater than has been observed for less severe distracting injuries.

Conclusions: The outcome agrees with the results of two previous experiments that failed to yield an SOS effect associated with detecting severe injuries, suggesting that the severity of a distracting injury does not determine whether a second injury is discovered.

Keywords: Diagnostic radiology; images; interpretation; observer performance; quality assurance.

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Figures

Figure 1
Figure 1
A and B images are from a patient with a serious fracture as shown in the upper left slice and indicated by the white rectangle. The C and D images are from a matched patient without a fracture (as shown in C at a similar location as image A). The same simulated fracture was added to a rib of the paired patients shown in the images B and D indicated by white rectangles.
See this image and copyright information in PMC

References

    1. Rogers LF. Radiology of skeletal trauma. New York: Churchill-Livingstone; 1982.
    1. Rogers LF. Common oversights in the evaluation of the patient with multiple injuries. Skel Radiol. 1984;12:103–111. - PubMed
    1. Berbaum KS, Schartz KM, Caldwell RT, et al. Satisfaction-of-search for subtle skeletal fractures may not be induced by more serious injury. J Am Coll Radiol. 2012;9:344–351. PMCID: PMC 3345121, NIHMSID: NIHMS347566. - PMC - PubMed
    1. Cain G, Shepherdson J, Elliot V, Svensson J, Brennan P. Imaging suspected cervical spine injury: plain radiography or computed tomography? Radiography. 2010;16:68–77.
    1. Nuñez DB, Zuluaga A, Fuentes-Bernardo DA, Rivas LA, Becerra JL. Cervical spine trauma: how much more do we learn by routinely using helical CT? Radiographics. 1996;16:1307–1318. - PubMed

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