Influence of clinical history on perception of abnormalities in pediatric radiographs.

RATIONALE AND OBJECTIVES We tested whether having clinical information would improve perception or simply decision making. METHODS Sixty-four pediatric chest and abdominal radiographs, half of which had abnormalities, were presented to nine radiologists under one of two conditions. In one condition, history consistent with abnormalities actually present for positive cases was provided for positive and matched negative cases before inspection. In a second condition, this information was provided only after inspection was completed and the radiograph was no longer available. Because detailed visual memory is short-lived, the image information was no longer available when the history was provided after inspection. A control condition measured detection without history. RESULTS Detection was significantly better with history provided before inspection. Detection did not differ for history provided after inspection and inspection without history. CONCLUSION The only difference between conditions with history was in whether history influenced perception; history affected decision making in both conditions. Clinical history affected perception in interpreting radiographs, not simply decision making.