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

Area of Science:

• Radiology and Medical Imaging
• Human Factors and Ergonomics

Background:

• Digital breast tomosynthesis (DBT) improves diagnostic accuracy but increases reader fatigue.
• Reader fatigue can impact performance in mammography screening.
• Optimizing reporting workflows is essential for sustainable DBT implementation.

Purpose of the Study:

• To evaluate changes in diagnostic accuracy and reader fatigue during DBT reporting.
• To assess the impact of incorporating a reporting break on fatigue and accuracy.
• To investigate objective and subjective fatigue measures using eye-tracking technology.

Main Methods:

• Prospective cohort study involving 45 mammography readers reporting 40 DBT cases.
• Eye-tracking metrics (blink duration, eye-opening velocity) used for objective fatigue assessment.
• Subjective fatigue questionnaires and diagnostic accuracy were compared between readers with and without a break.

Main Results:

• Readers without a break reported significantly higher subjective fatigue.
• Objective fatigue measures (increased blink duration, reduced eye-opening velocity) were significantly higher in the no-break group.
• No significant difference in diagnostic accuracy was observed between groups (87% vs. 87%).

Conclusions:

• Incorporating a break into 2-hour DBT reporting sessions effectively reduces both subjective and objective reader fatigue.
• Breaks did not compromise diagnostic accuracy, likely due to reader experience.
• Recognizing the need for breaks is vital for planning efficient DBT reading sessions in screening programs.