Worse in real life: An eye-tracking examination of the cost of CAD at low prevalence.

Computer-aided detection (CAD) is applied during screening mammography for millions of women each year. Despite its popularity, several large studies have observed no benefit in breast cancer detection for practices that use CAD. This lack of benefit may be driven by how CAD information is conveyed to the radiologist. In the current study, we examined this possibility in an artificial task modeled after screening mammography. Prior work at high (50%) target prevalence suggested that CAD marks might disrupt visual attention: Targets that are missed by the CAD system are more likely to be missed by the user. However, targets are much less common in screening mammography. Moreover, the prior work on this topic has focused on simple binary CAD systems that place marks on likely locations, but some modern CAD systems employ interactive CAD (iCAD) systems that may mitigate the previously observed costs. Here, we examined the effects of target prevalence and CAD system. We found that the costs of binary CAD were exacerbated at low prevalence. Meanwhile, iCAD did not lead to a cost on unmarked targets, which suggests that this sort of CAD implementation may be superior to more traditional binary CAD implementations when targets occur infrequently. (PsycInfo Database Record (c) 2020 APA, all rights reserved).