Satisfaction of search in osteoradiology

"Satisfaction of search" describes a situation in which the detection of one radiographic abnormality interferes with that of others. This phenomenon has not been investigated for the interpretation of skeletal radiographs. We determined whether satisfaction of search occurs in the interpretation of conventional radiographs of the musculoskeletal system.

Twelve volunteers from radiology (10 residents and two staff members) and 13 volunteers from orthopedic surgery (all residents) were shown in random order 15 cases in which one abnormality was present and 15 cases in which either two or three abnormalities were present. The cases with multiple findings contained a total of 19 abnormalities. All cases were selected from the emergency department. The volunteers received three scores reflecting their ability to detect abnormalities on a single-finding case, at least one abnormality on a multiple-finding case, and additional findings in cases with multiple abnormalities. The scores were compared using the chi-square test with Yates correction. Analysis of variance and Bonferroni adjustment were also performed.

Among the cases with single findings, detection rates averaged 11.25; for the 15 multiple-finding cases, the detection rate for one finding averaged 11.72. The difference was not statistically significant. Detection rates for the second and third abnormalities in the multiple-finding cases were significantly lower, averaging 6.12 (p < 0.01).

A significant satisfaction of search effect occurred and was operative in the interpretation of radiographs of the musculoskeletal system.