In radiology, 60% to 80% of diagnostic errors are perceptual. The use of more efficient visual search behaviors is expected to reduce these errors. We collected eye-tracking data from participants with different levels of experience when interpreting chest X-rays during the completion of a pathology-detection task. Eye-tracking measures were assessed in the context of three existing visual search theories from the literature to understand the association between visual search behavior and underlying processes: the long-term working memory theory, the information-reduction hypothesis, and the holistic model of image perception. The most experienced participants (radiology residents) showed the highest level of performance, albeit their visual search behaviors did not differ from the intermediate group. This suggests that radiology residents better processed the represented information on the X-ray, using a visual search strategy similar to the intermediate group. Since similar visual search resulted in more information extraction in the radiology residents compared with the intermediates, we suggest that this result might support the long-term working memory theory. Furthermore, compared with novices, intermediates and radiology residents fixated longer on areas that were more important to avoid missing any pathology, which possibly confirms the information-reduction hypothesis. Finally, the larger distances between fixations observed in more experienced participants could support the holistic model of image perception. In addition, measures of generic skills were related to a lower time cost for switching between global and local information processing. Our findings suggest that the three theories may be complementary in chest X-ray interpretation. Therefore, a unified theory explaining perceptual-cognitive superiority in radiology is considered.

中文翻译：

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放射学中的局灶性肺病理检测：经验对视觉搜索行为有影响吗？

在放射学中，60% 到 80% 的诊断错误是可感知的。使用更有效的视觉搜索行为有望减少这些错误。我们从具有不同经验水平的参与者那里收集了在完成病理检测任务期间解读胸部 X 光片时的眼动追踪数据。在文献中的三种现有视觉搜索理论的背景下评估了眼动追踪测量，以了解视觉搜索行为与潜在过程之间的关联：长期工作记忆理论、信息减少假设和图像整体模型洞察力。最有经验的参与者（放射科住院医师）表现出最高水平的表现，尽管他们的视觉搜索行为与中间组没有区别。这表明放射科住院医师使用类似于中间组的视觉搜索策略更好地处理了 X 射线上的代表信息。由于与中间人相比，类似的视觉搜索导致放射科住院医师的信息提取更多，我们认为这一结果可能支持长期工作记忆理论。此外，与新手相比，中级和放射科住院医师更关注更重要的领域，以避免遗漏任何病理，这可能证实了信息简化假设。最后，在更有经验的参与者中观察到的注视之间的较大距离可以支持图像感知的整体模型。此外，通用技能的衡量标准与在全球和本地信息处理之间切换的时间成本较低有关。我们的研究结果表明，这三种理论在胸部 X 射线解释方面可能是互补的。因此，考虑了解释放射学中感知认知优势的统一理论。