Role of faulty visual search in the satisfaction of search effect in chest radiography.

RATIONALE AND OBJECTIVES: The authors tested the hypothesis that satisfaction of search effect, which is associated with the failure to detect native chest abnormalities in the presence of simulated nodules, is caused by reduced gaze on the native abnormalities. MATERIALS AND METHODS: Gaze dwell time of 20 radiologists was recorded for the region around abnormalities on images. Ten radiographs were reviewed, nine of which contained native abnormalities. Each image was seen with and without a simulated nodule. RESULTS: The decrease in the rate of true-positive findings in the detection of native abnormalities on images that contained simulated nodules confirmed the occurrence of a satisfaction of search effect. Gaze times on native abnormalities (up to the time of report of the abnormalities) were the same for images with nodules in which native abnormalities were missed (gaze time, 9.4 seconds) as they were for images without nodules in which native abnormalities were detected (gaze time, 9.5 seconds). Gaze time on missed native abnormalities was not affected by the presence (7.80 seconds) or absence (7.45 seconds) of nodules. CONCLUSION: Reduction in gaze dwell time on the missed abnormalities is not the cause of satisfaction of search errors in chest radiographs.