V Omaleki, A Flores Gonzalez, A Hassani, M Flores, S Streuli, A Wishard Guerra, R Fielding-Miller
"They Protect us as if they were our Mom" Masking Attitudes from Freelist Survey Data and Qualitative Interviews in San Diego School Communities
Journal of community health
plus disease important parameter characterizes severe treatmentrequiring retinopathy prematurity yet diagnostic agreement among experts imperfect precise factors involved clinical diagnosis unclear study designed address gaps knowledge analyzing cognitive aspects plus disease diagnostic process experts examine diagnostic reasoning process experts plus disease retinopathy prematurity using qualitative research techniques cognitive walkthrough qualitative analysis videotaped expert responses quantitative analysis expert diagnoses experimental setting experts videotaped reviewing study data panel international retinopathy prematurity experts experience using qualitative retinal features primary basis clinical diagnosis six experts video recorded independently reviewing 7 wideangle retinal images infants retinopathy prematurity experts asked explain diagnostic process detail thinkaloud protocol mark findings relevant reasoning diagnose image plus vs preplus vs neither subsequently expert viewed images asked examine arteries veins isolation answer specific questions video recordings transcribed reviewed diagnostic process experts analyzed using published cognitive model interexpert intraexpert agreement based thinkaloud protocol 5 6 experts agreed diagnosis 3 study images 3 6 experts agreed 3 images experts asked rank images order severity mean correlation coefficient pairs experts 033 range 004 075 experts considered arterial tortuosity venous dilation reviewing image considered venous tortuosity arterial dilation peripheral retinal features factors experts asked rereview images diagnose plus disease based strictly definitions sufficient arterial tortuosity venous dilation 1 expert changed diagnosis compared thinkaloud protocol diagnostic consistency plus disease imperfect experts differ reasoning process retinal features focus interpretations features understanding factors may improve diagnosis education future research defining precise diagnostic criteria may warranted