You’ve almost certainly seen the dancing gorilla video which demonstrates the theory of change blindness — a phenomenon which means we don’t see changes we’re not expecting. Now, an updated experiment shows that the same may be true of radiologists analysing CT images.
A team of psychological scientists from Brigham and Women’s Hospital in Boston wanted to work out if the previous dancing gorilla experiment ony worked because test subjects were naive, untrained, and thus less aware. So they thought they’d see if radiologists — the physicians who analyse medical images like MRIs, X-rays and CT scans — would fall for a similar trick. The Association for Psychological Science explains:
They recruited 24 experienced and credentialed radiologists-and a comparable group of naïve volunteers. They tracked their eye movements as they examined five patients’ CT scans, each made up of hundreds of images of lung tissue. Each case had about ten nodules [minuscule signs of lung cancer] hiding somewhere in the scans, and the radiologists were instructed to click on these nodules with a mouse. On the final case, the scientists inserted a tiny image of a gorilla (an homage to the original work) into the lung. They wanted to see if the radiologists, focused on the telltale nodules, would be blind to the easily detectable and highly anomalous gorilla… The gorilla was miniscule, but huge compared to the nodules. It was about the size of a box of matches-or 48 times the size of a typical nodule.
After they were done scrolling through the images as much as they wanted, the scientists asked them: Did that last trial seem any different? Did you notice anything unusual on the final trial? And finally: Did you see a gorilla on the final trial? Twenty of the 24 radiologists failed to see the gorilla, despite scrolling past it more than four times on average. And this was not because it was difficult to see: When shown the image again after the experiment, all of them saw the gorilla. What’s more, the eye-tracking data showed clearly that most of those who did not see the gorilla did in fact look right at it.
What can we learn from the experiment? Well, the point isn’t to admonish radiologists. Rather, the test was designed to investigate whether being highly trained made people less susceptible to the phenomenon of change blindness. Clearly, it doesn’t.
It is, however, hard to get round the fact that 83 per cent of highly trained physicians missed what could’ve been a life-threatening anomaly. If that had been a tumour not a gorilla, it may never have been spotted — and that’s certainly something worth worrying about. [Psychological Science]













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This is exactly why there’s a push to get this analysis done algorithmically.
Have they considered maybe its just a gorilla thing?
SPOILER ALERT ANYONE?!?!
Why not give US the chance to stop it….bloooody helllll
What?
instead of telling us there is a gorilla there before we see the picture…..it’s not that difficult to grasp
Years ago there was a series about how our brains process information….. I think (my brain can’t process the memory correctly). There was a scene where the presenter was simply talking to the camera by a beach.
At the end of the programme, the presenter said something about our brains being remarkable tools that processes the information it needs to survive etc etc.
He showed the beach clip again and none of my family had notices the man in the gorilla suit dancing behind the presenter.
So, maybe it’s a gorilla thing.
There are two things here which my experience interpreting x-rays has shown me. First, familiarity. The more often you see a pathology the more confident you are reporting it. Perhaps the radiologists hadn’t encountered many gorillas on HRCT slices? Secondly request cards. When interpreting images you always have the request to hand to know why you are looking at the image and what you are looking for. Did the request for these say ?gorilla or were they suspecting the usual reduced air entry?
Silly question but do you not look for all anomalies or does the request card give you some clues as to the size/shape of the anomalie you are looking for.
In the example you used reduced air intake, does this have a set pattern in a certain part of the lung so you would only concentrate on that thing, or do you take a more general overview and look for anything odd.
Im interested not criticising props to all Doctors and Nurses for fixing us when we break.
I’m a radiographer so I’m only looking for gross abnormalities, leaving the really clever stuff for my medical colleagues. Yes you assess everything and yes 80odd percent of them missing this is pretty shocking. However there are variants which aren’t pathological (normal variants) which wouldn’t be reported and if the gorilla was interpreted as something along these lines then it may not have been considered worth mentioning. These HRCT scans are used to find areas of obstruction in the fine tubules of the lung so the radiologists would be looking for uninflated lung on the insp slice or trapped air on the exp slice. The gorilla is entirely unenhanced so doesn’t look much like the tumour they are taking about in the article.
When I posted this yesterday I didn’t notice the gorilla as I was concentrating around the bottom middle of the image where the larger airways are.
So its not just the experts that miss the gorilla,
“If that had been a tumour not a gorilla, it may never have been spotted”
But isn’t that what the article is saying? That if it was a tumour (instead of a gorilla) in the same spot they would have noticed it because they were looking for it?
but what if it had been a (admittedly huge) gorilla (or one assumes any other animal) shaped tumour?
Exactly what I was thinking. These kind of experiments highlight that there’s an unconscious step as the brain is building the model of the world we experience that can filter out unexpected/incongrous information without flagging it to our conciousness.
@JulianT I’d predict that the image processcing would flag that as a real tumor of anomoly on the scan would appear part of the image rather than obviously ‘stuck on’ as the gorilla used in the test is