The objective of the present study was to reassess the magnitude of observer error by dental students observing dental radiographs. Additionally, the effects of different payoff conditions on observer responses were examined. These data indicated high false positive rates as well as an inability to judge which radiographs were most difficult to assess. Further analyses indicated that false positive rates remained high even when payoff conditions penalized such responses. A payoff condition specifically designed to lower the false positive rate instead resulted in subjects lowering their hit rate and thus raising the miss rate. It is apparent that control of observer error must not only consider the technical quality of the radiograph but also the decision processes of the observer.
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