1. What was I thinking? Eye-tracking experiments underscore the bias that architecture exerts on nuclear grading in prostate cancer
- Author
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Bombari D Mora B Schaefer SC Mast FW Lehr HA.
- Abstract
We previously reported that nuclear grade assignment of prostate carcinomas is subject to a cognitive bias induced by the tumor architecture. Here we asked whether this bias is mediated by the non conscious selection of nuclei that "match the expectation" induced by the inadvertent glance at the tumor architecture. 20 pathologists were asked to grade nuclei in high power fields of 20 prostate carcinomas displayed on a computer screen. Unknown to the pathologists each carcinoma was shown twice once before a background of a low grade tubule rich carcinoma and once before the background of a high grade solid carcinoma. Eye tracking allowed to identify which nuclei the pathologists fixated during the 8 second projection period. For all 20 pathologists nuclear grade assignment was significantly biased by tumor architecture. Pathologists tended to fixate on bigger darker and more irregular nuclei when those were projected before kigh grade solid carcinomas than before low grade tubule rich carcinomas (and vice versa). However the morphometric differences of the selected nuclei accounted for only 11 of the architecture induced bias suggesting that it can only to a small part be explained by the unconscious fixation on nuclei that "match the expectation". In conclusion selection of « matching nuclei » represents an unconscious effort to vindicate the gravitation of nuclear grades towards the tumor architecture.
- Published
- 2012