Brain computed tomography reading of stroke patients by resident doctors from different medical specialities: An eye-tracking study

Chi-Hung Liu; Chun-Wei Chang; June Hung; John J H Lin; Pi-Shan Sung; Li-Ang Lee; Cheng-Ting Hsiao; Yi-Ping Chao; Elaine Shinwei Huang; Shu-Ling Wang

doi:10.1016/j.jocn.2023.10.004

Brain computed tomography reading of stroke patients by resident doctors from different medical specialities: An eye-tracking study

J Clin Neurosci. 2023 Nov:117:173-180. doi: 10.1016/j.jocn.2023.10.004. Epub 2023 Oct 12.

Authors

Affiliations

¹ Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Division of Medical Education, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan.
² Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Graduate Institute of Science Education, National Taiwan Normal University, Taipei City, Taiwan. Electronic address: john.jrhunglin@ntnu.edu.tw.
⁴ Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁵ School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otorhinolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁶ School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Chang Gung Medical Education Research Centre, Taoyuan, Taiwan.
⁷ Department of Computer Science and Information Engineering, Chang Gung University, Taoyuan, Taiwan; Department of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan.
⁸ Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.
⁹ Graduate Institute of Digital Learning and Education, National Taiwan University of Science and Technology, Taiwan.

PMID: 37837935
DOI: 10.1016/j.jocn.2023.10.004

Abstract

Background: Using the eye-tracking technique, our work aimed to examine whether difference in clinical background may affect the training outcome of resident doctors' interpretation skills and reading behaviour related to brain computed tomography (CT).

Methods: Twelve resident doctors in the neurology, radiology, and emergency departments were recruited. Each participant had to read CT images of the brain for two cases. We evaluated each participant's accuracy of lesion identification. We also used the eye-tracking technique to assess reading behaviour. We recorded dwell times, fixation counts, run counts, and first-run dwell times of target lesions to evaluate visual attention. Transition entropy was applied to assess the temporal relations and spatial dynamics of systematic image reading.

Results: The eye-tracking results showed that the image reading sequence examined by transition entropy was comparable among resident doctors from different medical specialties (p = 0.82). However, the dwell time of the target lesions was shorter for the resident doctors from the neurology department (4828.63 ms, p = 0.01) than for those from the resident doctors from the radiology (6275.88 ms) and emergency (5305.00 ms) departments. The eye-tracking results in individual areas of interest only showed differences in the eye-tracking performance of the first-run dwell time (p = 0.05) in the anterior cerebral falx.

Discussion: Our findings demonstrate that resident doctors from different medical specialties may achieve similar imaging reading patterns for brain CT. This may mitigate queries regarding the influence of different backgrounds on training outcomes.

Keywords: Emergency department; Eye-tracking; Image reading behaviour; Neurology; Radiology.

MeSH terms

Clinical Competence
Eye-Tracking Technology
Humans
Radiology* / education
Stroke* / diagnostic imaging
Tomography, X-Ray Computed / methods