Incorporation of Eye-Tracking and Gaze Feedback to Characterize and Improve Radiologist Search Patterns of Chest X-rays: A Randomized Controlled Clinical Trial

Diagnostic errors in radiology often result from incomplete visual assessments attributed to insufficient training in search patterns. Radiologists lack consistent feedback, relying on ad-hoc strategies, leading to suboptimal patterns and potential false negatives. This study used eye tracking to analyze search patterns, quantify performance metrics, and evaluate the impact of an automated continuous improvement feedback-driven framework on detection accuracy. In a controlled trial with ten residents, the intervention group (received feedback) demonstrated a significant 38.9% absolute improvement in detecting suspicious pulmonary nodules compared to the control group (5.6%, p=0.006). While improvements were more rapid over sessions (p=0.0001), other metrics showed no significant changes. The findings highlight the potential of automated feedback systems to enhance radiologist accuracy and reduce errors, emphasizing the need for further research and broader implementation in radiology training.