# Beyond the First Read: AI-Assisted Perceptual Error Detection in Chest Radiography Accounting for Interobserver Variability

arXiv: https://arxiv.org/abs/2506.13049 · HTML: https://mlsanity.com/paper/2506.13049/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 32 references that are in the map.
- First posted on arXiv 16 Jun 2025.

## Builds on (most cited first, 7 of 7)

- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Estimating Uncertainty and Interpretability in Deep Learning for Coronavirus (COVID-19) Detection](https://mlsanity.com/paper/2003.10769/) (2020)
- [Attention-Guided Curriculum Learning for Weakly Supervised Classification and Localization of Thoracic Diseases on Chest Radiographs](https://mlsanity.com/paper/1807.07532/) (2018)
- [Enhancing Radiological Diagnosis: A Collaborative Approach Integrating AI and Human Expertise for Visual Miss Correction](https://mlsanity.com/paper/2406.19686/) (2024)

## Abstract (arXiv)

Chest radiography is widely used in diagnostic imaging. However, perceptual errors -- especially overlooked but visible abnormalities -- remain common and clinically significant. Current workflows and AI systems provide limited support for detecting such errors after interpretation and often lack meaningful human--AI collaboration. We introduce RADAR (Radiologist--AI Diagnostic Assistance and Review), a post-interpretation companion system. RADAR ingests finalized radiologist annotations and CXR images, then performs regional-level analysis to detect and refer potentially missed abnormal regions. The system supports a "second-look" workflow and offers suggested regions of interest (ROIs) rather than fixed labels to accommodate inter-observer variation. We evaluated RADAR on a simulated perceptual-error dataset derived from de-identified CXR cases, using F1 score and Intersection over Union (IoU) as primary metrics. RADAR achieved a recall of 0.78, precision of 0.44, and an F1 score of 0.56 in detecting missed abnormalities in the simulated perceptual-error dataset. Although precision is moderate, this reduces over-reliance on AI by encouraging radiologist oversight in human--AI collaboration. The median IoU was 0.78, with more than 90% of referrals exceeding 0.5 IoU, indicating accurate regional localization. RADAR effectively complements radiologist judgment, providing valuable post-read support for perceptual-error detection in CXR interpretation. Its flexible ROI suggestions and non-intrusive integration position it as a promising tool in real-world radiology workflows. To facilitate reproducibility and further evaluation, we release a fully open-source web implementation alongside a simulated error dataset. All code, data, demonstration videos, and the application are publicly available at https://github.com/avutukuri01/RADAR.