{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:25:49Z","timestamp":1740147949920,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computational and Mathematical Methods in Medicine"],"published-print":{"date-parts":[[2014]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. To quantify the impact of diagnostic confidence on radiological diagnosis with a fuzzy logic-based method.<jats:italic>Materials and Methods<\/jats:italic>. Twenty-two oncologic patients with 20 cysts and 30 metastases \u22641\u2009cm in size found at 64-row computed tomography were included. Two readers (R1\/R2) expressed diagnoses as a subjective level of confidence<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>P<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>d<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>in malignancy within the interval [0,1] rather than on a \u201ccrisp\u201d basis (malignant\/benign); confidence in benignancy was<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mn>1<\/mml:mn><mml:mo>-<\/mml:mo><mml:mi>p<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>d<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>. When cross-tabulating data according to the standard of reference,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mn>2<\/mml:mn><mml:mo>\u00d7<\/mml:mo><mml:mn>2<\/mml:mn><\/mml:math>table cells resulted from the aggregation between<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>p<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>d<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><mml:mo>\/<\/mml:mo><mml:mn>1<\/mml:mn><mml:mo>-<\/mml:mo><mml:mi>p<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>d<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>and final diagnosis. We then assessed (i) readers diagnostic performance on a fuzzy and crisp basis; (ii) the \u201cdivergence\u201d<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>\u03b4<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>F<\/mml:mi><mml:mo>,<\/mml:mo><mml:mi>C<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>(%) as a measure of how confidence impacted on crisp diagnosis.<jats:italic>Results<\/jats:italic>. Diagnoses expressed with lower confidence increased fuzzy false positives compared to crisp ones (from 0 to 0.2 for R1; from 1 to 2.4 for R2). Crisp\/fuzzy accuracy was 94.0%\/93.6% (R1) and 94.0\/91.6% (R2).<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>\u03b4<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>F<\/mml:mi><mml:mo>,<\/mml:mo><mml:mi>C<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>(%) was larger in the case of the less experienced reader (R2) (up to +7.95% for specificity). According to simulations,<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mi>\u03b4<\/mml:mi><mml:mo stretchy=\"false\">(<\/mml:mo><mml:mi>F<\/mml:mi><mml:mo>,<\/mml:mo><mml:mi>C<\/mml:mi><mml:mo stretchy=\"false\">)<\/mml:mo><\/mml:math>(%) was negative\/positive depending on the level of confidence in incorrect diagnoses.<jats:italic>Conclusion.<\/jats:italic>Fuzzy evaluation shows a measurable effect of uncertainty on radiological diagnoses.<\/jats:p>","DOI":"10.1155\/2014\/587976","type":"journal-article","created":{"date-parts":[[2014,1,27]],"date-time":"2014-01-27T16:10:58Z","timestamp":1390839058000},"page":"1-9","source":"Crossref","is-referenced-by-count":0,"title":["Differentiating Small (<b>\u2264<\/b>1\u2009cm) Focal Liver Lesions as Metastases or Cysts by means of Computed Tomography: A Case-Study to Illustrate a Fuzzy Logic-Based Method to Assess the Impact of Diagnostic Confidence on Radiological Diagnosis"],"prefix":"10.1155","volume":"2014","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0904-5147","authenticated-orcid":true,"given":"Rossano","family":"Girometti","sequence":"first","affiliation":[{"name":"Institute of Diagnostic Radiology, University of Udine Az. Ospedaliero-Universitaria \u201cS. Maria della Misericordia\u201d, Via Colugna No. 50, 33100 Udine, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1950-8838","authenticated-orcid":true,"given":"Francesco","family":"Fabris","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Earth Sciences, University of Trieste, Via Valerio 12b, 34127 Trieste, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7048-1466","authenticated-orcid":true,"given":"Andrea","family":"Sgarro","sequence":"additional","affiliation":[{"name":"Department of Mathematics and Earth Sciences, University of Trieste, Via Valerio 12b, 34127 Trieste, Italy"}]},{"given":"Gloria","family":"Zanella","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Palmanova Hospital, Via Natisone 1, 33057 Palmanova, Italy"}]},{"given":"Serena","family":"Pullini","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology, University of Udine Az. Ospedaliero-Universitaria \u201cS. Maria della Misericordia\u201d, Via Colugna No. 50, 33100 Udine, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4480-8872","authenticated-orcid":true,"given":"Lorenzo","family":"Cereser","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology, University of Udine Az. Ospedaliero-Universitaria \u201cS. Maria della Misericordia\u201d, Via Colugna No. 50, 33100 Udine, Italy"}]},{"given":"Giuseppe","family":"Como","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology, University of Udine Az. Ospedaliero-Universitaria \u201cS. Maria della Misericordia\u201d, Via Colugna No. 50, 33100 Udine, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5132-3115","authenticated-orcid":true,"given":"Chiara","family":"Zuiani","sequence":"additional","affiliation":[{"name":"Institute of Diagnostic Radiology, University of Udine Az. Ospedaliero-Universitaria \u201cS. 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