© 2003 by Oxford University Press
Journal of the National Cancer Institute, Vol. 95, No. 4, 282-290,
February 19, 2003
© 2003 Oxford University Press
ARTICLE |
Association of Volume and Volume-Independent Factors With Accuracy in Screening Mammogram Interpretation
Affiliations of authors: C. A. Beam, Department of Radiology, Medical College of Wisconsin, Milwaukee, and the H. Lee Moffitt Cancer Center & Research Institute at the University of South Florida, Tampa; E. F. Conant, Department of Radiology, University of Pennsylvania, Philadelphia; E. A. Sickles, Department of Radiology, University of California, San Francisco.
Correspondence to: Craig Beam, Ph.D., Biostatistics Core, H. Lee Moffitt Cancer Center & Research Institute, University of South Florida, 12902 Magnolia Dr., Tampa, FL 33612-9497 (e-mail: beamca{at}moffitt.usf.edu).
Background: Early detection of breast cancer is associated with the accurate reading of screening mammograms, but factors that influence reading accuracy are not well understood. We thus investigated whether reading volume and other factors were independently associated with accuracy in reading screening mammograms in a population of U.S. radiologists. Methods: A random selection of 110 of 292 radiologists who agreed to participate, if selected, interpreted screening mammograms from 148 randomly selected women. Original index mammograms (i.e., mediolateral oblique and craniocaudal views of each breast) were used; comparison original mammograms were provided when available. Radiologist-level and facility-level factors were surveyed. Two standard metrics of screening accuracy, both based on receiver operating characteristic curves, were analyzed. The influence of volume on accuracy after controlling for other factors was assessed with multiple regression analysis. Results: Current reading volume was not statistically significantly associated with interpretive accuracy. More recently trained radiologists interpreted mammograms more accurately than those trained earlier (-0.76% [95% confidence interval (CI) = -1.75% to -0.02%] reduction in sensitivity per year since residency). Facility-level factors that were statistically significantly and independently associated with better accuracy were the number of diagnostic breast imaging examinations and image-guided breast interventional procedures performed (0.55% [95% CI = 0.11% to 2.40%] increase in accuracy per examination or procedure offered), being classified as a comprehensive breast diagnostic and/or screening center or freestanding mammography center (1.39% [95% CI = 0.15% to 3.82%] higher than a hospital radiology department or multispecialty medical clinic), and being a facility that practiced double reading (1.61% [95% CI = 1.99% to 11.65%]) higher than in a facility without such practice). Conclusions: Individual radiologists’ current reading volume was not statistically significantly associated with accuracy in reading screening mammograms, but several other factors were. Expertise reflects a complex multifactorial process that needs further clarification.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. Gur, A. I. Bandos, C. S. Cohen, C. M. Hakim, L. A. Hardesty, M. A. Ganott, R. L. Perrin, W. R. Poller, R. Shah, J. H. Sumkin, et al. The "Laboratory" Effect: Comparing Radiologists' Performance and Variability during Prospective Clinical and Laboratory Mammography Interpretations Radiology, October 1, 2008; 249(1): 47 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S.-Y. Shiu and C. Gatsonis The predictive receiver operating characteristic curve for the joint assessment of the positive and negative predictive values Phil Trans R Soc A, July 13, 2008; 366(1874): 2313 - 2333. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. P. Lesser, H. W. Lee, W. R. S. Webber, B. Prince, N. E. Crone, and D. L. Miglioretti Short-term variations in response distribution to cortical stimulation Brain, June 1, 2008; 131(6): 1528 - 1539. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. J. A. Bowles, D. L. Miglioretti, E. A. Sickles, L. Abraham, P. A. Carney, B. C. Yankaskas, and J. G. Elmore Accuracy of Short-Interval Follow-Up Mammograms by Patient and Radiologist Characteristics Am. J. Roentgenol., May 1, 2008; 190(5): 1200 - 1208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Kuhl The Current Status of Breast MR Imaging * Part I. Choice of Technique, Image Interpretation, Diagnostic Accuracy, and Transfer to Clinical Practice Radiology, August 1, 2007; 244(2): 356 - 378. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Lewis, M. Bhargavan, and J. H. Sunshine Women Radiologists in the United States: Results from the American College of Radiology's 2003 Survey Radiology, March 1, 2007; 242(3): 802 - 810. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. L. Miglioretti and P. J. Heagerty Marginal Modeling of Nonnested Multilevel Data using Standard Software Am. J. Epidemiol., February 15, 2007; 165(4): 453 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. W. T. Leung, F. R. Margolin, K. E. Dee, R. P. Jacobs, S. R. Denny, and John. D. Schrumpf Performance Parameters for Screening and Diagnostic Mammography in a Community Practice: Are There Differences Between Specialists and General Radiologists? Am. J. Roentgenol., January 1, 2007; 188(1): 236 - 241. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. Barclay, J. J. Vicari, A. S. Doughty, J. F. Johanson, and R. L. Greenlaw Colonoscopic Withdrawal Times and Adenoma Detection during Screening Colonoscopy N. Engl. J. Med., December 14, 2006; 355(24): 2533 - 2541. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Taplin, C. M. Rutter, and C. D. Lehman Testing the effect of computer-assisted detection on interpretive performance in screening mammography. Am. J. Roentgenol., December 1, 2006; 187(6): 1475 - 1482. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Castells, E. Molins, and F. Macia Cumulative false positive recall rate and association with participant related factors in a population based breast cancer screening programme. J Epidemiol Community Health, April 1, 2006; 60(4): 316 - 321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Ganott, J. H. Sumkin, J. L. King, A. H. Klym, V. J. Catullo, C. S. Cohen, and D. Gur Screening Mammography: Do Women Prefer a Higher Recall Rate Given the Possibility of Earlier Detection of Cancer? Radiology, March 1, 2006; 238(3): 793 - 800. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. J. Coldman, D. Major, G. P. Doyle, Y. D'yachkova, N. Phillips, J. Onysko, R. Shumak, N. E. Smith, and N. Wadden Organized Breast Screening Programs in Canada: Effect of Radiologist Reading Volumes on Outcomes Radiology, March 1, 2006; 238(3): 809 - 815. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Beam, E. F. Conant, and E. A. Sickles Correlation of Radiologist Rank as a Measure of Skill in Screening and Diagnostic Interpretation of Mammograms Radiology, February 1, 2006; 238(2): 446 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Burnside, J. M. Park, J. P. Fine, and G. A. Sisney The Use of Batch Reading to Improve the Performance of Screening Mammography Am. J. Roentgenol., September 1, 2005; 185(3): 790 - 796. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Elmore, L. M. Reisch, M. B. Barton, W. E. Barlow, S. Rolnick, E. L. Harris, L. J. Herrinton, A. M. Geiger, R. K. Beverly, G. Hart, et al. Efficacy of Breast Cancer Screening in the Community According to Risk Level J Natl Cancer Inst, July 20, 2005; 97(14): 1035 - 1043. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. A. Sickles, D. L. Miglioretti, R. Ballard-Barbash, B. M. Geller, J. W. T. Leung, R. D. Rosenberg, R. Smith-Bindman, and B. C. Yankaskas Performance Benchmarks for Diagnostic Mammography Radiology, June 1, 2005; 235(3): 775 - 790. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Gur, L. P. Wallace, A. H. Klym, L. A. Hardesty, G. S. Abrams, R. Shah, and J. H. Sumkin Trends in Recall, Biopsy, and Positive Biopsy Rates for Screening Mammography in an Academic Practice Radiology, May 1, 2005; 235(2): 396 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. G. Elmore, K. Armstrong, C. D. Lehman, and S. W. Fletcher Screening for Breast Cancer JAMA, March 9, 2005; 293(10): 1245 - 1256. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Smith-Bindman, P. Chu, D. L. Miglioretti, C. Quale, R. D. Rosenberg, G. Cutter, B. Geller, P. Bacchetti, E. A. Sickles, and K. Kerlikowske Physician Predictors of Mammographic Accuracy J Natl Cancer Inst, March 2, 2005; 97(5): 358 - 367. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Shen and G. Parmigiani A Model-Based Comparison of Breast Cancer Screening Strategies: Mammograms and Clinical Breast Examinations Cancer Epidemiol. Biomarkers Prev., February 1, 2005; 14(2): 529 - 532. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Theberge, N. Hebert-Croteau, A. Langlois, D. Major, and J. Brisson Volume of screening mammography and performance in the Quebec population-based Breast Cancer Screening Program Can. Med. Assoc. J., January 18, 2005; 172(2): 195 - 199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-L. Urbain Breast cancer screening, diagnostic accuracy and health care policies Can. Med. Assoc. J., January 18, 2005; 172(2): 210 - 211. [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Rhodes, M. K. O'Connor, S. W. Phillips, R. L. Smith, and D. A. Collins Molecular Breast Imaging: A New Technique Using Technetium Tc 99m Scintimammography to Detect Small Tumors of the Breast Mayo Clin. Proc., January 1, 2005; 80(1): 24 - 30. [Abstract] [PDF]
|
|
|
|
|
|
W. E. Barlow, C. Chi, P. A. Carney, S. H. Taplin, C. D'Orsi, G. Cutter, R. E. Hendrick, and J. G. Elmore Accuracy of Screening Mammography Interpretation by Characteristics of Radiologists J Natl Cancer Inst, December 15, 2004; 96(24): 1840 - 1850. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. F. Wagner, C. A. Beam, and S. V. Beiden Reader Variability in Mammography and Its Implications for Expected Utility over the Population of Readers and Cases Med Decis Making, November 1, 2004; 24(6): 561 - 572. [Abstract] [PDF]
|
|
|
|
|
|
L. E. M. Duijm, J. H. Groenewoud, J. H. C. L. Hendriks, and H. J. de Koning Independent Double Reading of Screening Mammograms in the Netherlands: Effect of Arbitration Following Reader Disagreements Radiology, May 1, 2004; 231(2): 564 - 570. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Gur, J. H. Sumkin, H. E. Rockette, M. Ganott, C. Hakim, L. Hardesty, W. R. Poller, R. Shah, and L. Wallace Changes in Breast Cancer Detection and Mammography Recall Rates After the Introduction of a Computer-Aided Detection System J Natl Cancer Inst, February 4, 2004; 96(3): 185 - 190. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Beam, E. F. Conant, E. A. Sickles, and S. P. Weinstein Evaluation of Proscriptive Health Care Policy Implementation in Screening Mammography Radiology, November 1, 2003; 229(2): 534 - 540. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. G. Elmore, C. Y. Nakano, T. D. Koepsell, L. M. Desnick, C. J. D'Orsi, and D. F. Ransohoff International Variation in Screening Mammography Interpretations in Community-Based Programs J Natl Cancer Inst, September 17, 2003; 95(18): 1384 - 1393. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. B. Kopans Re: Association of Volume and Volume-Independent Factors With Accuracy in Screening Mammogram Interpretation J Natl Cancer Inst, May 21, 2003; 95(10): 758 - 759. [Full Text] [PDF]
|
|