The document summarizes a trial called the CO-OPS Trial which studied the effects of fatigue on radiologists' performance in breast cancer screening. It tested whether reversing the order radiologists read screening mammograms (to optimize performance patterns) and taking breaks could help address the normal vigilance decrement seen in tasks requiring sustained attention over long periods. The document outlines the trial methods, results, and interpretations that will be presented on fatigue and changing case order in breast screening radiology.

1. The last fellowship…
The next fellowship application
Dr Sian Taylor-Phillips
Assistant Professor in Screening and Test Evaluation

2. Fatigue and Changing Case
order in Breast Screening
Radiology:
The CO-OPS Trial
s.taylor-phillips@warwick.ac.uk

3. Contents
• Trial methods
• Results
• Interpretation
s.taylor-phillips@warwick.ac.uk

4. Fatigue and Performance
• The vigilance decrement
s.taylor-phillips@warwick.ac.uk

5. Fatigue and Performance
The vigilance decrement
“Sensitivity decrements occur chiefly in tasks
which that couple successive discrimination
with a high event rate”
See et al, 1995, Meta-analysis of vigilance studies
s.taylor-phillips@warwick.ac.uk

6. The CO-OPS Trial
Changing Case Order to Optimise Patterns of
Performance in Screening
• Is there a vigilance decrement?
• Does reverse reading help?
s.taylor-phillips@warwick.ac.uk

7. The CO-OPS Trial
Primary Analysis
• Multi-level model of the predictors of cancer
detection rate
Secondary Analyses
• Multi-level model of the predictors of recall rate
and rate of disagreements
• Patterns of performance with time since a break
• Health Economics
s.taylor-phillips@warwick.ac.uk