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Open Access Publications from the University of California

Improving Medical Image Decision Making by Leveraging Metacognitive Processes and Representational Similarity


Improving the accuracy of medical image interpretation is critical to improving the diagnosis of many diseases. Using both novices (undergraduates) and experts (medical professionals), we investigate methods for improving the accuracy of a single decision maker by aggregating repeated decisions from an individual in different ways. Our participants made classification decisions (cancerous versus non-cancerous) and confidence judgments on a series of cell images, viewing and classifying each image twice. We first applied the maximum confidence slating algorithm (Koriat, 2012), which leverages metacognitive ability by using the most confident response for an image as the `final response'. We also examined algorithms that aggregated decisions based on image similarity, leveraging neural network models to determine similarity. We found maximum confidence slating improves classification accuracy for both novices and experts. However, aggregating responses on similar images improves classification accuracy for novices and not experts, suggesting differences in the decision mechanisms of novices and experts.

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