Effects of Prior Diagnosis on Second Opinions and Pathologist Viewing Behaviors: Results from a Randomized Trial in Breast Pathology

Kathleen F. Kerr, Megan M. Eguchi, Hannah Shucard, Trafton Drew, Donald L. Weaver, Joann G. Elmore and Tad T. Brunyé
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Kathleen F. Kerr: Department of Biostatistics, University of Washington, Seattle, WA, USA
Megan M. Eguchi: David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles
Hannah Shucard: Department of Biostatistics, University of Washington, Seattle, WA, USA
Trafton Drew: Sirona Medical, San Francisco, CA, USA
Donald L. Weaver: Department of Pathology, University of Vermont Larner College of Medicine and Vermont Cancer Center, Burlington, VT, USA
Joann G. Elmore: David Geffen School of Medicine, Department of Medicine, University of California, Los Angeles
Tad T. Brunyé: Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, USA

Medical Decision Making, 2026, vol. 46, issue 1, 76-87

Abstract: Objective To study the effects of exposure to a prior diagnosis (PD) on second opinions in breast pathology. Materials and Methods Pathologists interpreted digital breast biopsy cases in 2 phases separated by a washout. Phase 2 interpretations were randomly assigned to PD or no PD. When presented, PD was always more or less severe than a participant’s phase 1 diagnosis. Viewing behaviors, including zoom level, were recorded during all interpretations. Twenty pathologists yielded 556 interpretations of 32 different cases. Results Pathologists were 71% more likely to give a less severe diagnosis when exposed to a less severe PD than with no PD (RR 1.71, 95% CI 1.33–2.20, P

Keywords: breast cancer; pathology; second opinions; medical image perception; eye tracking (search for similar items in EconPapers)
Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:46:y:2026:i:1:p:76-87

DOI: 10.1177/0272989X251368886

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