Performance Parameters for Screening and Diagnostic Mammography in a Community Practice: Are There Differences Between Specialists and General Radiologists?
- 1 January 2007
- journal article
- Published by American Roentgen Ray Society in American Journal of Roentgenology
- Vol. 188 (1), 236-241
- https://doi.org/10.2214/ajr.05.1581
Abstract
OBJECTIVE. The purpose of this study was to compare the performance of general radiologists in interpretation of mammograms with that of breast imaging specialists in a high-volume community hospital-based private practice. MATERIALS AND METHODS. A retrospective observational study was conducted with data prospectively collected over a 5-year period in a community hospital-based practice in which 106,405 screening and 52,149 diagnostic mammograms were performed. The performance of three radiologists specializing in breast imaging was compared with that of six general radiologists. The following data were extracted and analyzed: recall rate, biopsy recommendation rate, and cancer detection rate. Statistical analysis was performed with a chi-square test and two-tailed calculation of p values. RESULTS. The recall rates of the specialists and generalists were nearly the same at 6.5% and 6.7%, respectively. The biopsy recommendation rate at recall from screening examinations was nearly the same for generalists and specialists (1.2% and 1.1%, respectively; p = 0.4504). This rate also was similar for diagnostic examinations (8.5% for generalists; 8.4% for specialists; p = 0.4086). The cancer detection rate in the screening setting was slightly higher for specialists than for generalists: 2.5 and 2.0 cancers per 1,000 cases, respectively (p = 0.0614). The cancer detection rate in the diagnostic setting was 24.2% higher among specialists (20.0 cancers per 1,000 cases) compared with generalists (16.1 cancers per 1,000 cases) (p = 0.0177). CONCLUSION. The only statistically significant difference between generalists and specialists was in cancer detection rate among patients undergoing diagnostic mammography. No statistically significant difference was identified between the two groups in terms of recall rate, biopsy recommendation rate, or percentage of favorable-prognosis cases of cancer detected. There was a trend toward greater cancer detection by specialists in the screening setting.Keywords
This publication has 16 references indexed in Scilit:
- Comparison of Screening Mammography in the United States and the United KingdomJAMA, 2003
- Association of Volume and Volume-Independent Factors With Accuracy in Screening Mammogram InterpretationJNCI Journal of the National Cancer Institute, 2003
- Performance Parameters for Screening and Diagnostic Mammography: Specialist and General RadiologistsRadiology, 2002
- Factors Affecting Radiologist Inconsistency in Screening MammographyAcademic Radiology, 2002
- Does Practice Make Perfect When Interpreting Mammography?JNCI Journal of the National Cancer Institute, 2002
- THE MAMMOGRAPHY QUALITY STANDARDS ACT: An Overview of the Regulations and GuidanceRadiologic Clinics of North America, 2000
- Standardized Abnormal Interpretation and Cancer Detection Ratios to Assess Reading Volume and Reader Performance in a Breast Screening ProgramRadiology, 2000
- Does Diagnostic Accuracy in Mammography Depend on Radiologists' Experience?Journal of Women's Health, 1998
- Variability in the Interpretation of Screening Mammograms by US RadiologistsArchives of Internal Medicine, 1996
- Variability in Radiologists' Interpretations of MammogramsNew England Journal of Medicine, 1994