The influence of viewing time on visual diagnostic accuracy: Less is more

Area of Science:

• Cognitive psychology
• Medical decision making
• Diagnostic error analysis

Background:

• Diagnostic errors are a significant concern in healthcare.
• Dual-process theory suggests cognitive reasoning impacts diagnostic accuracy.
• This study investigates the role of dual-process theory in diagnostic error reduction.

Purpose of the Study:

• To examine the validity of dual-process theory in explaining diagnostic errors.
• To assess the impact of clinical experience and viewing time on diagnostic accuracy.
• To evaluate the practical application of dual-process models for error reduction.

Main Methods:

• Two studies were conducted with physicians categorizing chest X-rays (CXRs) and electrocardiograms (ECGs).
• Viewing times were manipulated to encourage System 1 (fast) and System 2 (slow) processing.
• Analysis involved comparing true positive and false positive rates based on experience and viewing time.

Main Results:

• Physicians demonstrated high accuracy in detecting abnormalities in CXRs and ECGs.
• Clinical experience significantly impacted ECG interpretation accuracy, with staff physicians outperforming residents.
• Viewing time and experience showed minor interactions with diagnostic accuracy, questioning the direct link to dual-process theory.

Conclusions:

• Findings raise concerns about the direct application of dual-process theory to diagnostic error reduction strategies.
• The study suggests that models linking processing type to error reduction may have limited practical utility.
• Further research is needed to understand the complex factors influencing diagnostic errors.