Do Physicians Remember Cases? Implications for Longitudinal Designs in Medical Research and Competency Assessment.

Area of Science:

• Medical Informatics
• Pathology
• Digital Health

Background:

• Longitudinal studies in diagnostic medicine require repeated image interpretation.
• Washout periods are crucial to mitigate prior exposure bias in such studies.

Purpose of the Study:

• To evaluate if a 9-39 month washout period prevents prior exposure effects on pathologists' review of digital breast biopsies.
• To assess the impact of prior exposure on case review duration, confidence, and perceived difficulty.

Main Methods:

• 48 resident pathologists reviewed novel and repeated digital whole slide images (WSI) in Phase 2, 9-39 months after Phase 1.
• Statistical analysis compared review duration, confidence, and difficulty for novel versus repeated cases.

Main Results:

• No statistically significant differences were found in review time, confidence, or difficulty between novel and repeated cases.
• This finding held true even for a subset with a shorter 9-14 month washout period.

Conclusions:

• A minimum 9-month washout period is effective in longitudinal medical imaging studies.
• This interval ensures initial exposure does not influence subsequent case reviews in pathology.