Fatigue impacts inexperienced breast radiologists’ performance, underlining importance of regular breaks

New data demonstrate that fatigue may impact breast radiologists’ performance, underlining the importance of regular work breaks, experts detailed Tuesday in Radiology.

Digital breast tomosynthesis, or 3D mammography, is becoming the gold standard in screening for the disease. But it requires hundreds of views of the breast when compared to just four for the traditional 2D approach, possibly posing problems for overworked physicians who are new to the profession.

Experts from Brown University recently analyzed data from 40,000 tomosynthesis exams and another 57,000 digital mammography scans performed across 12 offices in Rhode Island. They found that rads with five or fewer years of experience were more likely to order additional imaging when reading DBT exams later in the day.

“It’s useful to know that fatigue is a factor that impacts performance metrics,” study co-author Ana Lourenco, MD, with Brown University’s Warren Alpert Medical School, said in a statement. “As we’re trying to do the best job for our patients and handle increased imaging volumes, these results suggest that regular breaks may have tangible benefits for outcome measures.”

Lourenco and co-authors also discovered higher recall rates for digital mammography at more than 10% when compared to 9% for DBT. False positives were also higher for the older 2D approach at nearly 10% versus less than 9% for 3D mammography. But the numbers changed when factoring in an inexperienced radiologist, with odds of a recall for DBT climbing almost 12% every hour when using the technology. Physicians with more than five years of experience witnessed no changes in recall rates tied to time of day.

Future investigations could seek to incorporate more radiologists and varied intervals of experience to combat fatigue’s effect on mammogram interpretation, the authors noted.

“I hope this study spurs additional research to look at more of the details of what it is that goes on in humans who interpret these images,” Lourenco said in the RSNA announcement.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

Trimed Popup
Trimed Popup