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Sessions included two pre-shift readings (morning\/afternoon, without AI) and two post-shift readings (morning, with\/without AI). Eye tracking captured fixation duration and saccade count, and fatigue was defined as a\u2009\u2265\u20095% reduction in the slope of the saccadic main sequence between pre- and post-shift sessions. Diagnostic accuracy (Cohen\u2019s\n                      <jats:italic>\u03ba<\/jats:italic>\n                      vs. expert majority vote), efficiency (mean reporting time per radiograph), eye-tracking metrics, and user surveys were analyzed with generalized linear mixed models and post-hoc Tukey-adjusted pairwise comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Six of ten radiology residents were classified as fatigued, among whom diagnostic accuracy declined significantly post-shift (from\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.71\u2009\u00b1\u20090.05 to\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.61\u2009\u00b1\u20090.10;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with reduced fixation duration (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.010) and saccade count (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.015). Non-fatigued readers showed a smaller decline in accuracy (from\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.72\u2009\u00b1\u20090.03 to\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.65\u2009\u00b1\u20090.03;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). Reporting times remained stable pre- and post-shift (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2265\u20090.463). AI assistance did not significantly improve diagnostic accuracy (\u0394\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.03\u20130.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2265\u20090.525). Reporting times were numerically shorter with AI assistance in fatigued readers (\u03946.3\u2009s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.122) and significantly shorter in non-fatigued readers (\u03949.9\u2009s;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031). Surveys indicated mental exhaustion and reduced focus in fatigued readers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Night-shift-induced fatigue impaired diagnostic accuracy without slowing reporting speed, raising patient safety concerns. The utilized AI model did not restore pre-shift performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Night-shift-induced fatigue may reduce diagnostic accuracy of radiology residents in chest radiography, yet its objective quantification and the compensatory potential of AI assistance remain unclear<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Fatigue, based on eye-tracking measurements of oculomotor efficiency, reduced diagnostic accuracy after night shifts without slowing reporting speed; AI assistance did not significantly improve accuracy<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevanc<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:bold>\n                        <jats:italic>e<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Night-shift-induced fatigue can lower diagnostic accuracy in chest radiography despite unchanged reporting speed, posing patient-safety risks. The AI model used in this study cannot fully compensate for fatigue-related performance decline<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12969-8","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:54:32Z","timestamp":1792691672000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From dusk till dawn?\u2014Night shift-induced fatigue, diagnostic performance, and AI assistance in chest radiography"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4608-5180","authenticated-orcid":false,"given":"Robert Malte","family":"Siepmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahta","family":"Khoobi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc Sebastian","family":"von der St\u00fcck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Barajas Ordonez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca-Maria","family":"Theis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malin","family":"Cubukcu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher","family":"Deeb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Post","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Rastkhiz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Corban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Reen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Topp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiane","family":"Kuhl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Truhn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Nebelung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,22]]},"reference":[{"key":"12969_CR1","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1016\/j.jacr.2010.03.004","volume":"7","author":"EA Krupinski","year":"2010","unstructured":"Krupinski EA, Berbaum KS, Caldwell RT, Schartz KM, Kim J (2010) Long radiology workdays reduce detection and accommodation accuracy. 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