The study took into account at what time the radiologists woke up on the day of the experiment, how many hours of sleep they'd had, how long they had been reading cases that day, the number of cases, what percentage of them had colds, allergies and itchy or watery eyes, and what percentage had used eye drops.
The authors described several study weaknesses. Only radiology exams were used but CT and MRI exams contain hundreds of images that must be scrolled, potentially more fatigue producing than looking at static images.
Krupinski and colleagues also noted, "Many radiologists work more hours than we studied. Even when sleep loss is not a factor, some radiologists work considerably longer on a given day than those in our study.
"Given that a small but significant reduction in detection accuracy was demonstrated for an average workday of about 8 hours, we suspect that more extended reading may expose the reader to greater decrements in accuracy."
With the increase in teleradiology and remote group radiology reading for rapid diagnostic response in healthcare settings, especially hospitals, the issue may have some worrisome implications for maintaining high accuracy rates necessary to maintain and improve quality of care.