An individual differences approach to multiple-target visual search errors: How search errors relate to different characteristics of attention

Individual differences in visual search: A systematic review of the link between visual search performance and traits or abilities

Visual search (VS) comprises a class of tasks that we typically perform several times during a day and requires intentionally scanning (with or without moving the eyes) the environment for a specific target (be it an object or a feature) among distractor stimuli. Experimental research in lab-based or real-world settings has offered insight into its underlying neurocognitive mechanisms from a nomothetic point of view. A lesser-known but rapidly growing body of quasi-experimental and correlational research has explored the link between individual differences and VS performance. This combines different research traditions and covers a wide range of individual differences in studies deploying a vast array of VS tasks. As such, it is a challenge to determine whether any associations highlighted in single studies are robust when considering the wider literature. However, clarifying such relationships systematically and comprehensively would help build more accurate models of VS, and it would highlight promising directions for future research. This systematic review provides an up to date and comprehensive synthesis of the existing literature investigating associations between common indices of performance in VS tasks and measures of individual differences mapped onto four categories of cognitive abilities (short-term working memory, fluid reasoning, visual processing and processing speed) and seven categories of traits (Big Five traits, trait anxiety and autistic traits). Consistent associations for both traits (in particular, conscientiousness, autistic traits and trait anxiety - the latter limited to emotional stimuli) and cognitive abilities (particularly visual processing) were identified. Overall, however, informativeness of future studies would benefit from checking and reporting the reliability of all measurement tools, applying multiplicity correction, using complementary techniques, study preregistration and testing why, rather than only if, a robust relation between certain individual differences and VS performance exists.

Inattentional blindness in medicine

People often fail to notice unexpected stimuli when their attention is directed elsewhere. Most studies of this "inattentional blindness" have been conducted using laboratory tasks with little connection to real-world performance. Medical case reports document examples of missed findings in radiographs and CT images, unintentionally retained guidewires following surgery, and additional conditions being overlooked after making initial diagnoses. These cases suggest that inattentional blindness might contribute to medical errors, but relatively few studies have directly examined inattentional blindness in realistic medical contexts. We review the existing literature, much of which focuses on the use of augmented reality aids or inspection of medical images. Although these studies suggest a role for inattentional blindness in errors, most of the studies do not provide clear evidence that these errors result from inattentional blindness as opposed to other mechanisms. We discuss the design, analysis, and reporting practices that can make the contributions of inattentional blindness unclear, and we describe guidelines for future research in medicine and similar contexts that could provide clearer evidence for the role of inattentional blindness.

When Not to Operate on Acute Cases-A Surgeon's Perspective on Rapid Assessment of Emergency Abdominopelvic Computed Tomography

Clinical problem solving evolves in parallel with advances in technology and discoveries in the medical field. However, it always reverts to basic cognitive processes involved in critical thinking, such as hypothetical-deductive reasoning, pattern recognition, and compilation models. When dealing with cases of acute abdominal pain, clinicians should employ all available tools that allow them to rapidly refine their analysis for a definitive diagnosis. Therefore, we propose a standardized method for the quick assessment of abdominopelvic computed tomography as a supplement to the traditional clinical reasoning process. This narrative review explores the cognitive basis of errors in reading imaging. It explains the practical use of attenuation values, contrast phases, and windowing for non-radiologists and details a multistep protocol for finding radiological cues during CT reading and interpretation. This systematic approach describes the salient features and technical tools needed to ascertain the causality between clinical patterns and abdominopelvic changes visible on CT scans from a surgeon's perspective. It comprises 16 sections that should be read successively and that cover the entire abdominopelvic region. Each section details specific radiological signs and provides clear explanations for targeted searches, as well as anatomical and technical hints. Reliance on imaging in clinical problem solving does not make a decision dichotomous nor does it guarantee success in diagnostic endeavors. However, it contributes exact information for supporting the clinical assessments even in the most subtle and intricate conditions.

Assessing satisfaction of search in virtual mammograms for experienced and novice searchers

Purpose

Satisfaction of search (SOS) is a phenomenon where searchers are more likely to miss a lesion/target after detecting a first lesion/target. Here, we investigated SOS for masses and calcifications in virtual mammograms with experienced and novice searchers to determine the extent to which: (1) SOS affects breast lesion detection, (2) similarity between lesions impacts detection, and (3) experience impacts SOS rates.

Approach

The open virtual clinical trials framework was used to simulate the breast anatomy of patients, and up to two simulated masses and/or single-calcifications were inserted into the breast models. Experienced searchers (residents, fellows, and radiologists with breast imaging experience) and novice searchers (undergraduates who had no breast imaging experience) were instructed to search for up to two lesions (masses and calcifications) per image.

Results

2 × 2 mixed factors analysis of variances (ANOVAs) were run with: (1) single versus second lesion hit rates, (2) similar versus dissimilar second-lesion hit rates, and (3) similar versus dissimilar second-lesion response times as within-subject factors and experience as the between subject's factor. The ANOVAs demonstrated that: (1) experienced and novice searchers made a significant amount of SOS errors, (2) similarity had little impact on experienced searchers, but novice searchers were more likely to miss a dissimilar second lesion compared to when it was similar to a detected first lesion, (3) experienced and novice searchers were faster at finding similar compared to dissimilar second lesions.

Conclusions

We demonstrated that SOS is a significant cause of lesion misses in virtual mammograms and that reader experience impacts detection rates for similar compared to dissimilar abnormalities. These results suggest that experience may impact strategy and/or recognition with theoretical implications for determining why SOS occurs.

From "satisfaction of search" to "subsequent search misses": a review of multiple-target search errors across radiology and cognitive science

For over 50 years, the satisfaction of search effect has been studied within the field of radiology. Defined as a decrease in detection rates for a subsequent target when an initial target is found within the image, these multiple target errors are known to underlie errors of omission (e.g., a radiologist is more likely to miss an abnormality if another abnormality is identified). More recently, they have also been found to underlie lab-based search errors in cognitive science experiments (e.g., an observer is more likely to miss a target 'T' if a different target 'T' was detected). This phenomenon was renamed the subsequent search miss (SSM) effect in cognitive science. Here we review the SSM literature in both radiology and cognitive science and discuss: (1) the current SSM theories (i.e., satisfaction, perceptual set, and resource depletion theories), (2) the eye movement errors that underlie the SSM effect, (3) the existing efforts tested to alleviate SSM errors, and (4) the evolution of methodologies and analyses used when calculating the SSM effect. Finally, we present the attentional template theory, a novel mechanistic explanation for SSM errors, which ties together our current understanding of SSM errors and the attentional template literature.

How to Read an Abdominal CT: Insights from the Visual and Cognitive Sciences Translated for Clinical Practice

When first learning abdominal CT studies, residents are often given little concrete, practical direction. There is, however, a large literature from the visual and cognitive sciences that can provide guidance towards search strategies that maximize efficiency and comprehensiveness. This literature has not penetrated radiology teaching to any great extent. In this article, we will examine the current pedagogy (and why that falls short), why untutored search fails, where misses occur in abdomen/pelvis CT, why these misses occur where they do, how expert radiologists search 3d image stacks, and how novices might expedite the acquisition of expertise.

Prospects for using visual search tasks in modern cognitive psychology

The article describes the main results of modern foreign studies with modifications of classical visual search tasks, as well as proposed classification of such modifications. The essence of visual search is to find target stimuli among the distracters, and the standard task involves finding one target stimulus, which is usually a simple object. Modifications to the standard task may include the presence of more than one target on the screen, the search for more than one type of target, and options that combine both of these modifications. Proposed modifications of the standard task allow not only to study new aspects of visual attention, but also to approach real-life tasks within laboratory studies.

Distracting Objects Induce Early Quitting in Visual Search

Task-irrelevant objects can sometimes capture attention and increase the time it takes an observer to find a target. However, less is known about how these distractors impact visual search strategies. Here, I found that salient distractors reduced rather than increased response times on target-absent trials (Experiment 1; N = 200). Combined with higher error rates on target-present trials, these results indicate that distractors can induce observers to quit search earlier than they otherwise would. These effects were replicated when target prevalence was low (Experiment 2; N = 200) and with different stimuli that elicited shallower search slopes (Experiment 3; N = 75). These results demonstrate that salient distractors can produce at least two consequences in visual search: They can capture attention, and they can cause observers to quit searching early. This novel finding has implications both for understanding visual attention and for examining distraction in real-world domains where targets are often absent, such as medical image screening.

Spotting rare items makes the brain "blink" harder: Evidence from pupillometry

In many visual search tasks (e.g., cancer screening, airport baggage inspections), the most serious search targets occur infrequently. As an ironic side effect, when observers finally encounter important objects (e.g., a weapon in baggage), they often fail to notice them, a phenomenon known as the low-prevalence effect (LPE). Although many studies have investigated LPE search errors, we investigated the attentional consequences of successful rare target detection. Using an attentional blink paradigm, we manipulated how often observers encountered the first serial target (T1), then measured its effects on their ability to detect a following target (T2). Across two experiments, we show that the LPE is more than just an inflated miss rate: When observers successfully detected rare targets, they were less likely to spot subsequent targets. Using pupillometry to index locus-coeruleus (LC) mediated attentional engagement, Experiment 2 confirmed that an LC refractory period mediates the attentional blink (`Nieuwenhuis, Gilzenrat, Holmes, & Cohen, 2005, Journal of Experimental Psychology: General, 134[3], 291-307), and that these effects emerge relatively quickly following T1 onset. Moreover, in both behavioral and pupil analyses, we found that detecting low-prevalence targets exacerbates the LC refractory period. Consequences for theories of the LPE are discussed.

Dual-target hazard perception: Could identifying one hazard hinder a driver's capacity to find a second?

Low-level cognitive processes like visual search are crucial for hazard detection. In dual-target searches, subsequent search misses (SSMs) are known to occur when the identification of one target impedes detection of another that is concurrently presented. Despite the high likelihood of concurrent hazards in busy driving environments, SSMs have not been empirically investigated in driving. In three studies, participants were asked to identify safety-related target(s) in simulated traffic scenes that contained zero, one, or two target(s) of low or high perceptual saliency. These targets were defined as objects or events that would have prevented safe travel in the direction indicated by an arrow preceding the traffic scene. Findings from the pilot study (n = 20) and Experiment 1 (n = 29) demonstrated that detecting one target hindered drivers' abilities to find a second from the same scene. In Experiment 2 (n = 30), explicit instructions regarding the level of risk were manipulated. It was found that search times were affected by the instructions, though SSMs persisted. Implications of SSMs in understanding the causes of some crashes are discussed, as well as future directions to improve ecological and criterion validity and to explore the roles of expertise and cognitive capabilities in multi-hazard detection.

The Role of Working Memory in Dual-Target Visual Search

Visual search (VS) for multiple targets is especially error prone. One of these errors is called subsequent search misses (SSM) and represents a decrease in accuracy at detecting a second target after a first target has been found. One of the possible explanations of SSM errors is working memory (WM) resource depletion. Three experiments investigated the role of WM in SSM errors using a dual task paradigm. The first experiment investigated the role of object WM using a classical color change detection task. In the second and the third experiments, a modified change detection task was applied, using shape as the relevant feature. The results of our study revealed no effect of additional WM task on second target detection in dual-target VS. To this end, SSM errors are not related to WM resource depletion. On the contrary, WM task performance was violated by dual-target VS as compared to single-target VS, when the targets in VS task were defined by the same feature used in the WM task.

"Satisfaction" in search: Individuals' own search expectations predict their errors in multiple-target search

When people search for multiple targets in a display, finding one target hinders their ability to find additional targets. These errors were originally proposed to stem from a "satisfaction" with finding a first target that leads people to prematurely stop searching. However, empirical evidence for this premise has been elusive, prompting consideration of other theories. We returned to the satisfaction proposal and assessed whether people generate expectations regarding the likelihood of multiple targets that lead to search biases that, in turn, predict the rates at which additional targets are missed. Participants searched for one or two targets among distractors. To measure accuracy, most trials allowed search to progress to completion. The remaining trials terminated when participants had found their first target. In these cases, participants guessed whether an additional (unfound) target was present. The time needed to find a first target was inversely related to the searchers' expectations that a second target would be present. These expectations underestimated objective reality, and the strength of an individual's one-target bias was directly related to his or her likelihood of missing subsequent targets. Thus, people's expectations-based on their own behavior-likely impacted search performance, providing a novel mechanistic explanation for the previously posited "satisfaction-of-search" errors.

Using Eye Movements to Understand how Security Screeners Search for Threats in X-Ray Baggage

There has been an increasing drive to understand failures in searches for weapons and explosives in X-ray baggage screening. Tracking eye movements during the search has produced new insights into the guidance of attention during the search, and the identification of targets once they are fixated. Here, we review the eye-movement literature that has emerged on this front over the last fifteen years, including a discussion of the problems that real-world searchers face when trying to detect targets that could do serious harm to people and infrastructure.

Mammography to tomosynthesis: examining the differences between two-dimensional and segmented-three-dimensional visual search

BACKGROUND

Radiological techniques for breast cancer detection are undergoing a massive technological shift-moving from mammography, a process that takes a two-dimensional (2D) image of breast tissue, to tomosynthesis, a technique that creates a segmented-three-dimensional (3D) image. There are distinct benefits of tomosynthesis over mammography with radiologists having fewer false positives and more accurate detections; yet there is a significant and meaningful disadvantage with tomosynthesis in that it takes longer to evaluate each patient. This added time can dramatically impact workflow and have negative attentional and cognitive impacts on interpretation of medical images. To better understand the nature of segmented-3D visual search and the implications for radiology, the current study looked to establish a new testing platform that could reliably examine differences between 2D and segmented-3D search.

RESULTS

In Experiment 1, both professionals (radiology residents and certified radiologists) and non-professionals (undergraduate students) were found to have fewer false positives and were more accurate in segmented-3D displays, but at the cost of taking significantly longer in search. Experiment 2 tested a second group of non-professional participants, using a background that more closely resembled a mammogram, and replicated the results of Experiment 1-search was more accurate and there were fewer false alarms in segmented 3D displays but took more time.

CONCLUSION

The results of Experiments 1 and 2 matched the performance patterns found in previous radiology studies and in the clinic, suggesting this novel experimental paradigm potentially provides a flexible and cost-effective tool that can be utilized with non-professional populations to inform relevant visual search performance. From an academic perspective, this paradigm holds promise for examining the nature of segmented-3D visual search.