Independent Double Reading of Screening Mammograms

Ciatto, Stefano; Turco, Marco Rosselli Del; Morrone, D; Catarzi, S; Ambrogetti, Daniela; Cariddi, A.; Zappa, Marco

doi:10.1177/096914139500200209

Cited by 62 publications

(44 citation statements)

References 6 publications

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“…Differences existed in the use of one-versus two-view mammography, double reading, and the method for arriving at a resolution when double reading led to different assessments. Independent double reading contributes to higher recall rates, 21,34 while consensus double reading is likely to lower them. 19 With this limited number of programs (12 for calculation of initial recall rates and 10 for subsequent recall rates), we were unable to conduct statistical modeling to test for associations of these factors with recall rates.…”

Section: Discussionmentioning

confidence: 99%

International comparison of performance measures for screening mammography: can it be done?

Yankaskas

Ancelle-Park

et al. 2004

J Med Screen

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Objective: Published screening mammography performance measures vary across countries. An international study was undertaken to assess the comparability of two performance measures: the recall rate and positive predictive value (PPV). These measures were selected because they do not require identification of all cancers in the screening population, which is not always possible. Setting:The screening mammography programs or data registries in 25 member countries of the International Breast Cancer Screening Network (IBSN). Methods:In 1999 an assessment form was distributed to IBSN country representatives in order to obtain information on how screening mammography was performed and what specific data related to recall rates and PPV were collected. Participating countries were then asked to provide data to allow calculation of recall rates, PPV and cancer detection rates for screening mammography by age group for women screened in the period 1997-1999.Results: Twenty-two countries completed the assessment form and 14 countries provided performance data. Differences in screening mammography delivery and data collection were evident. For most countries, recall rates were higher for initial than for subsequent mammograms. There was no consistent relationship of initial to subsequent PPV, although PPV generally decreased as the recall rate increased. Recall rates decreased with increasing age, while PPV increased as age increased. Conclusion:Similar patterns for mammography performance measures were evident across countries.However, the development of a more standardized approach to defining and collecting data would allow more valid international comparisons, with the potential to optimize mammography performance. At present, international comparisons of performance should be made with caution due to differences in defining and collecting mammography data.

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Section: Discussionmentioning

confidence: 99%

International comparison of performance measures for screening mammography: can it be done?

Yankaskas

Ancelle-Park

et al. 2004

J Med Screen

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“…ouble reading of screening mammograms has been shown to increase the cancer detection rate [1][2][3][4] and is recommended as a standard procedure in current service screening. 5 A discordant report at double reading, with only one reader recommending referral for diagnostic assessment, is rather frequent when 'independent' double reading is performed; that is, discordant readings are managed according to an 'or' fashion (positivity at either reading prompts assessment); referral rates are substantially increased.…”

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confidence: 99%

“…8 Double reading was introduced in 1991, and discordant cases are managed according to an 'or' fashion. In a previous study, 1 we assessed that referral rates at prevalent screening (4.6%) had a relative increase of 15% with 'independent' double reading compared with single reading (4.0%).…”

mentioning

confidence: 99%

“…5 A discordant report at double reading, with only one reader recommending referral for diagnostic assessment, is rather frequent when 'independent' double reading is performed; that is, discordant readings are managed according to an 'or' fashion (positivity at either reading prompts assessment); referral rates are substantially increased. 1,2 In order to reduce such an effect, consensus between the two radiologists originally performing double reading or arbitration by a third radiologist of discordant cases has been suggested in order to reduce unnecessary referrals. Both procedures have been shown to be effective in clinical studies.…”

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confidence: 99%

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The role of arbitration of discordant reports at double reading of screening mammograms

et al. 2005

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Objective: To asses the effectiveness of arbitration of discordant double readings in mammography screening. Design: A retrospective study of 1217 consecutive arbitrations. Setting: A subset of discordant double readings from the Florence screening programme underwent arbitration by a third reader. Results: Positive arbitration of 1217 discordant double readings prompted assessment in 476 cases (39.2%), detecting 30 cancers (6.3%). Of 741 negative arbitrations (60.8%), 311 have been followed up thus far, and two cancers (0.64%) occurred in the site previously suspected at one of the two independent readings. Arbitration had a sensitivity of 86.3% and a negative predictive value of 99.3%. Arbitration reduced the overall referral rates from 3.82% to 2.59% (relative decrease 32.1%). Due to false-negative arbitration, cancers detected per 1000 women screened would decrease from 4.58 to 4.50 (relative decrease 1.7%). For every cancer missed due to false-negative arbitration, 151 unnecessary recalls and h21,248 would have been saved, whereas the saved cost per screened woman due to arbitration was h1.72. Discussion: Arbitration of discordant double reading would substantially reduce referral rates with a limited reduction in cancer detection rate, and may be recommended as a routine procedure. Greater benefit from arbitration might be expected in the presence of high referral rates at independent double reading, a common scenario in a newly implemented service screening.

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“…The authors concluded that screening mammography in the United States did not appear to be organized for high volume or low cost [4]. Double interpretation of screening mammograms is known to increase sensitivity to breast cancer, while incurring a higher recall rate and additional costs [5][6][7][8]. Although double interpretation of mammograms is common in organized screening programs in other countries [9], its rate of use in the United States has not, to our knowledge, previously been evaluated.…”

mentioning

confidence: 99%

Community-Based Mammography Practice: Services, Charges, and Interpretation Methods

Hendrick¹,

Cutter

Berns³

et al. 2005

American Journal of Roentgenology

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OBJECTIVE-The purpose of our study was to accurately describe facility characteristics among community-based screening and diagnostic mammography practices in the United States.MATERIALS AND METHODS-A survey was developed and applied to community-based facilities providing screening mammography in three geographically distinct locations in the states of Washington, Colorado, and New Hampshire. The facility survey was conducted between December 2001 and September 2002. Characteristics surveyed included facility type, services offered, charges for screening and diagnostic mammography, information systems, and interpretation methods, including the frequency of double interpretation.RESULTS-Among 45 responding facilities, services offered included screening mammography at all facilities, diagnostic mammography at 34 facilities (76%), breast sonography at 30 (67%), breast MRI at seven (16%), and nuclear medicine breast scanning at seven (16%). Most facilities surveyed were radiology practices in nonhospital settings. Eight facilities (18%) reported performing clinical breast examinations routinely along with screening mammography. Only five screening sites (11%) used computer-aided detection (CAD) and only two (5%) used digital mammography. Nearly two thirds of facilities interpreted screening mammography examinations on-site, whereas 91% of facilities interpreted diagnostic examinations on-site. Only three facilities (7%) interpreted screening examinations on line as they were performed. Approximately half of facilities reported using some type of double interpretation, although the methods of double interpretation and the fraction of cases double-interpreted varied widely across facilities. On average, approximately 15% of screening examinations and 10% of diagnostic examinations were reported as being double-interpreted. Double interpretation of screening mammograms is known to increase sensitivity to breast cancer, while incurring a higher recall rate and additional costs [5][6][7][8]. Although double interpretation of mammograms is common in organized screening programs in other countries [9], its rate of use in the United States has not, to our knowledge, previously been evaluated. CONCLUSION-ComparisonAs part of a project exploring the practice of mammography in the United States, a survey was conducted of 45 community-based screening centers in three geographically distinct locations of the United States. This article reports the results of survey responses concerning mammography practice setting, services offered, charges for screening and diagnostic mammography, interpretation methods, and audit systems. Materials and Methods Study PopulationData for this project were acquired from a survey of community-based, multicenter facilities in three geographically distinct breast cancer surveillance programs: Mammography Facility SurveyA facility survey was developed by a panel of experts in breast imaging, medical physics, economics, biostatistics, and epidemiology. The criteria, construct, and content va...

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Independent Double Reading of Screening Mammograms

Abstract: Independent double reading results in only a modest increase in the detection of cancers and therefore may not be cost effective.

Cited by 62 publications

References 6 publications

International comparison of performance measures for screening mammography: can it be done?

International comparison of performance measures for screening mammography: can it be done?

The role of arbitration of discordant reports at double reading of screening mammograms

Community-Based Mammography Practice: Services, Charges, and Interpretation Methods

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