Impact of time of day on radiology image interpretations

To examine the impact of the time of day on radiologists' mammography reading performance. Retrospective mammographic reading assessment data were collected from the BreastScreen Reader Assessment Strategy database and included timestamps of the readings and reader-specific demographic data of 197 radiologists. The radiologists performed the readings in a workshop setting with test case sets enriched with malignancies (one-third of cases were malignant). The collected data were evaluated with an analysis of covariance to determine whether time of day influenced radiologists' specificity, lesion sensitivity or the jackknife alternative free-response receiver operating characteristic (JAFROC). After adjusting for radiologist experience and fellowship, specificity varied significantly by time of day (p=0.027), but there was no evidence of any significant impact on lesion sensitivity (p=0.441) or JAFROC (p=0.120). The collected data demonstrated that specificity during the late morning (10.00–12.00) was 71.7%; this was significantly lower than in the early morning (08.00–10.00) and mid-afternoon (14.00–16.00), which were 82.74% (p=0.003) and 81.39% (p=0.031), respectively. Specificity during the late afternoon (16.00–18.00) was 73.95%; this was significantly lower than in the early morning (08.00–10.00) and mid-afternoon (14.00–16.00), which were 82.74% (p=0.003) and 81.39% (p=0.031), respectively. The results indicated that the time of day may influence radiologists' performance, specifically their ability to identify normal images correctly. •Specificity of mammography readings significantly varied by time of day (p=.027).•Generally, specificity decreased during the late morning and late afternoon.•Thus, the time of day may influence radiologists' mammography reading performance.•In particular, it might reduce their ability to identify normal images correctly.