Time awake and hours slept significantly impact less experienced radiologists’ performance
The time a less experienced radiologist spent awake, or hours slept the previous night, can significantly impact their reading performance, according to an analysis published Tuesday.
Fledgling physicians who were awake for less than two hours demonstrated much lower sensitivity at spotting lesions on mammograms compared to those awake 8-10 hours. And the previous night’s rest also influenced radiologists’ receiver under the operating characteristic curve values, with more well-rested individuals besting others who barely slept, Australian researchers detailed in JACR.
“In contrast, more experienced radiologists, despite the added responsibilities and pressure to read more images in less time, develop coping mechanisms to withstand the pressure and manage their fatigue,” Abdulaziz Alshabibi, with the Medical Image Optimization and Perception Group at the University of Sydney, and colleagues wrote Jan. 19. “A lack of this skill exacerbates the effects of fatigue in less experienced individuals,” they added later. “Moreover, novices tend to be less aware of their own limitations than experts, thus failing to employ fatigue-relieving mechanisms.”
For the analysis, researchers utilized images from the university’s BreastScreen Reader Assessment Strategy database, with each test set containing 60 anonymized digital mammography cases. Alshabibi and co-authors administered a reading test to 133 radiologists attending the Royal Australian and New Zealand College of Radiologists’ conferences in 2018 and 2019. They further gathered information on their hours awake and hours slept, and determined whether these two variables impacted sensitivity, specificity, lesion sensitivity and ROC curve.
Bottom line: They did not for experienced radiologists who read more than 2,000 mammograms per year. They did, however, for physicians who fall below that threshold, Alshabibi and colleagues noted. Inexperienced radiologists who slept less than 2 hours had a significantly lower lesion sensitivity that those awake for 8-10 hours (P = .01). And those awake for 4-6 hours had a much lower lesion sensitivity than those awake for 8-10 hours (P = .002) and 10 to 12 hours (P = .02).
Hours slept also impacted ROC values of less seasoned physicians. For instance, radiologists with up to 6 hours of sleep had a much lower value (0.72) than those who slept more than 6 hours (0.77), Alshabibi et al. determined. The study did have a several limitations—including its execution in a nonclinical setting, and higher proportion of cancer cases than real world practice—but the research team believe the results warrant discussion.
“Overall, our findings and those of previous studies, highlight the importance of radiologists—especially less experienced ones—being aware of these effects and acting responsibly to minimize them,” they advised. “Further research should explore the effects of these factors in contexts more closely resembling real clinical settings and measure other physiological and psychological parameters, such as blood sugar, body temperature, food intake, fatigue levels, sleep quality, visual function, mood, and concentration,” they added later.
You can read more about the investigation in the Journal of the American College of Radiology here.
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.