The role of cue-based strategies in skilled diagnosis among pathologists

Journal article

Carrigan, Ann J., Charlton, Amanda, Foucar, Elliott, Wiggins, Mark W., Georgiou, Andrew, Palmeri, Thomas J. and Curby, Kim M.. (2022). The role of cue-based strategies in skilled diagnosis among pathologists. Human Factors. 64(7), pp. 1154-1167. https://doi.org/10.1177/0018720821990160

Publication dates
Authors	Carrigan, Ann J., Charlton, Amanda, Foucar, Elliott, Wiggins, Mark W., Georgiou, Andrew, Palmeri, Thomas J. and Curby, Kim M.
Abstract	Objective This research was designed to test whether behavioral indicators of pathology-related cue utilization were associated with performance on a diagnostic task. Background Across many domains, including pathology, successful diagnosis depends on pattern recognition that is supported by associations in memory in the form of cues. Previous studies have focused on the specific information or knowledge on which medical image expertise relies. The target in this study is the more general ability to identify and interpret relevant information. Method Data were collected from 54 histopathologists in both conference and online settings. The participants completed a pathology edition of the Expert Intensive Skills Evaluation 2.0 (EXPERTise 2.0) to establish behavioral indicators of context-related cue utilization. They also completed a separate diagnostic task designed to examine related diagnostic skills. Results Behavioral indicators of higher or lower cue utilization were based on the participants’ performance across five tasks. Accounting for the number of cases reported per year, higher cue utilization was associated with greater accuracy on the diagnostic task. A post hoc analysis suggested that higher cue utilization may be associated with a greater capacity to recognize low prevalence cases. Conclusion This study provides support for the role of cue utilization in the development and maintenance of skilled diagnosis amongst pathologists. Application Pathologist training needs to be structured to ensure that learners have the opportunity to form cue-based strategies and associations in memory, especially for less commonly seen diseases.
Keywords	medical image perception; cue utilization; cognitive load; prevalence
Year	01 Jan 2022
Journal	Human Factors
Journal citation	64 (7), pp. 1154-1167
Publisher	Sage Publications, Inc. (US)
ISSN	0018-7208
Digital Object Identifier (DOI)	https://doi.org/10.1177/0018720821990160
Web address (URL)	https://journals.sagepub.com/doi/10.1177/0018720821990160
Open access	Published as non-open access
Research or scholarly	Research
Page range	1154-1167
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Online	13 Feb 2021
Publication process dates
Accepted	21 Dec 2020
Deposited	05 Sep 2024
ARC Funded Research	This output has been funded, wholly or partially, under the Australian Research Council Act 2001
Grant ID	DP5056000
Additional information	Copyright © 2021, Human Factors and Ergonomics Society.
	This work is supported by an ARC Discovery Project grant awarded to M.W.W (CI) K.M.C., A.G., and T.P. (DP5056000).
Place of publication	United States

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