Yonsei Med J.  2018 May;59(3):445-451. 10.3349/ymj.2018.59.3.445.

The Effect of Mental Rotation on Surgical Pathological Diagnosis

Affiliations
  • 1Department of Pathology, National Health Insurance Service Ilsan Hospital, Goyang, Korea.
  • 2Graduate School, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea. paxco@yuhs.ac
  • 4Department of Pathology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
  • 5College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei Univesity, Incheon, Korea.
  • 6Department of Neurology, Kangnam Sacred Heart Hospital, Hallym University, Seoul, Korea.
  • 7Department of Surgery, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea. kskim88@yuhs.ac
  • 8Department of Medical Education, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea.

Abstract

PURPOSE
Pathological diagnosis involves very delicate and complex consequent processing that is conducted by a pathologist. The recognition of false patterns might be an important cause of misdiagnosis in the field of surgical pathology. In this study, we evaluated the influence of visual and cognitive bias in surgical pathologic diagnosis, focusing on the influence of "mental rotation."
MATERIALS AND METHODS
We designed three sets of the same images of uterine cervix biopsied specimens (original, left to right mirror images, and 180-degree rotated images), and recruited 32 pathologists to diagnose the 3 set items individually.
RESULTS
First, the items found to be adequate for analysis by classical test theory, Generalizability theory, and item response theory. The results showed statistically no differences in difficulty, discrimination indices, and response duration time between the image sets.
CONCLUSION
Mental rotation did not influence the pathologists' diagnosis in practice. Interestingly, outliers were more frequent in rotated image sets, suggesting that the mental rotation process may influence the pathological diagnoses of a few individual pathologists.

Keyword

Pattern recognition; image rotation; mental rotation; pathology; item-response theory

MeSH Terms

Bias (Epidemiology)
Cervix Uteri
Diagnosis*
Diagnostic Errors
Discrimination (Psychology)
Female
Pathology
Pathology, Surgical

Figure

  • Fig. 1 An example of each item set: (A) original, (B) left to right mirror images, and (C) 180-degree rotated images.

  • Fig. 2 Distribution of the scores according to item type (total 60 items, A type 20 items, B type 20 items, and C type 20 items). In C type items, three outliers below 2-SD are noted. 2-SD, two-standard deviation.

  • Fig. 3 Vertical ruler, produced by many-facet Rasch analysis using the Facets program. From left, the columns are measurement, +examinee facet (pathologists), −gender (male=1, female=2), −task (item type) and −item (items). The numbers of task refer to type A, B, C, and the numbers in item columns refer to the item numbers (no. 1 to no. 20). The A, B, and C sets are located very closely, and males and females are assessed by the same measurement line.


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