Evaluation of a Novel Content-Based Image Retrieval System for the Differentiation of Interstitial Lung Diseases in CT Examinations

To evaluate the reader’s diagnostic performance against the ground truth with and without the help of a novel content-based image retrieval system (CBIR) that retrieves images with similar CT patterns from a database of 79 different interstitial lung diseases. We evaluated three novice readers’ and three resident physicians‘ (with at least three years of experience) diagnostic performance evaluating 50 different CTs featuring 10 different patterns (e.g., honeycombing, tree-in bud, ground glass, bronchiectasis, etc.) and 24 different diseases (sarcoidosis, UIP, NSIP, Aspergillosis, COVID-19 pneumonia etc.). The participants read the cases first without assistance (and without feedback regarding correctness), and with a 2-month interval in a random order with the assistance of the novel CBIR. To invoke the CBIR, a ROI is placed into the pathologic pattern by the reader and the system retrieves diseases with similar patterns. To further narrow the differential diagnosis, the readers can consult an integrated textbook and have the possibility of selecting high-level semantic features representing clinical information (chronic, infectious, smoking status, etc.). We analyzed readers’ accuracy without and with CBIR assistance and further tested the hypothesis that the CBIR would help to improve diagnostic performance utilizing Wilcoxon signed rank test. The novice readers demonstrated an unassisted accuracy of 18/28/44%, and an assisted accuracy of 84/82/90%, respectively. The resident physicians demonstrated an unassisted accuracy of 56/56/70%, and an assisted accuracy of 94/90/96%, respectively. For each reader, as well as overall, Sign test demonstrated statistically significant (p < 0.01) difference between the unassisted and the assisted reads. For students and physicians, Chi²-test and Mann-Whitney-U test demonstrated statistically significant (p < 0.01) difference for unassisted reads and statistically insignificant (p > 0.01) difference for assisted reads. The evaluated CBIR relying on pattern analysis and featuring the option to filter the results of the CBIR by predominant characteristics of the diseases via selecting high-level semantic features helped to drastically improve novices’ and resident physicians’ accuracy in diagnosing interstitial lung diseases in CT.

Using Moment-by-Moment Reading Protocols to Understand Students’ Processes of Reading Mathematical Proof

This article documents differences between novice and experienced undergraduate students’ processes of reading mathematical proofs as revealed by moment-by-moment, think-aloud protocols. We found three key reading behaviors that describe how novices’ reading differed from that of their experienced peers: alternative task models, accrual of premises, and warranting. Alternative task models refer to the types of goals that students set up for their reading of the text, which may differ from identifying and justifying inferences. Accrual of premises refers to the way novice readers did not distinguish propositions in the theorem statement as assumptions or conclusions and thus did not use them differently for interpreting the proof. Finally, we observed variation in the type and quality of warrants, which we categorized as illustrate with examples, construct a miniproof, or state the warrant in general form.

Differences in echocardiography interpretation techniques among trainees and expert readers

Background Trainees learn transthoracic echocardiogram (TTE) interpretation through independently completing and reviewing selected portions of the study with experts. The diagnostic accuracy of novice TTE interpretation is known to be low and schema for reading TTEs systematically are lacking. The purpose of our study is to identify techniques experts use while reading TTEs which could be used to more effectively teach novice readers. Methods We performed a prospective qualitative case study to observe how experts and trainees interpret TTEs in an academic institution using a concurrent think aloud (CTA) method. Three TTEs of intermediate complexity were given to 3 advanced imaging fellows, 3 first year fellows and 3 expert TTE readers Participants filled out a report while reading and described aloud their thought processes. Sessions were video and audiotaped for analysis. Results Experts and advanced fellows used specific techniques that novices did not including: previewing studies, reviewing multiple images simultaneously, having flexibility in image review order and disease coding, and saving hardest elements to code for the end. Direct observation of TTE reading informed trainee inefficiencies and was a well-received educational tool. Conclusions In this single centered study we identified several unique approaches experts use to interpret TTEs which may be teachable to novices. Although limited in generalizability the findings of this study suggests that a more systematic approach to TTE interpretation, using techniques found in experts, might be of significant value for trainees. Further study is needed to evaluate teaching practices at other institutions and to assess whether implementation of these techniques by novices improves can improve their diagnostic accuracy and efficiency of reading at an earlier stage in their training.

Interrater and Intrarater Reliability of Musculoskeletal Ultrasonographic Findings for the Common Extensor Tendon of the Elbow

Objectives: This retrospective case study evaluated the interrater and intrarater reliability of seven common extensor tendon pathologic features on musculoskeletal ultrasonography (MSK-US). Materials and Methods: A cohort of 50 patients were imaged due to presenting with atraumatic nonradicular lateral elbow pain. Three experienced and two novice readers rated the images on two separate occasions, and AC1 and kappa coefficients were calculated for each feature. Results: The interrater reliability was fair with respect to fascial thickening/scarring (AC1 = 0.26), tearing (AC1 = 0.35), tendon thickening (AC1 = 0.38), and intratendinous calcification (AC1 = 0.33); substantial for enthesophytes (AC1 = 0.80); and near complete for hyperemia (AC1 = 0.83) and hypoechogenicity (AC1 = 0.92). Intrarater reliability was moderate for fascial thickening/scarring (κ = 0.48), tearing (κ = 0.41), tendon thickening (0.47), intratendinous calcification (κ = 0.56), and hypoechogenicity (κ = 0.47); substantial for hyperemia (κ = 0.71); and almost perfect for enthesophytes (κ = 0.86). Conclusion: MSK-US may be a reliable tool to determine soft tissue changes in common extensor tendon pathology.

Constructing Cohesive Meaning: A Textual Analysis of Diseases in an 11th-Grade U.S. History Textbook

Social studies texts often pose a challenge for readers because of their complex linguistics features, which can cause comprehension issues. Drawing upon Systemic Functional Linguistics (SFL), this study examines how authors create cohesive messages and meaning in an 11th-grade U.S. history textbook in relation to the history of diseases. Findings reveal four main cohesive resources: (1) referring words, (2) ellipses, (3) lexical cohesion, and (4) text connectives, are utilized to construct a message that holds together and builds from clause to clause. Consequently, a responsibility is placed on the reader to track the participant(s) while also forcing them to track the events in the rest of the clause. Although the function of cohesive resources helps the writer to express their ideas, it may also impede novice readers, such as emergent bilinguals, from keeping track of all the participants and information. Implications provide ways social studies teachers can take up a role as a language teacher to support comprehension of social studies content and language development.