Interim recommendations for a digital mammography quality assurance program

McLean, I; Heggie, Jcp; Herley, J; Thomson, FJ; Grewal, R. K.

doi:10.1007/bf03178412

Cited by 5 publications

(5 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quality assurance has been little used in telemedicine, apart from in image-based areas, such as radiology ( 2 ), retinal screening ( 3 ), or cytology ( 4 ). Liddy et al added routine collection of user feedback data in a store-and-forward telemedicine network – this might be regarded as informal QA ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks

Wootton

Liu

Bonnardot

et al. 2015

Front. Public Health

View full text Add to dashboard Cite

Despite the increasing use of telemedicine around the world, little has been done to incorporate quality assurance (QA) into these operations. The purpose of the present study was to examine the feasibility of QA in store-and-forward teleconsulting using a previously published framework. During a 2-year study period, we examined the feasibility of using QA tools in two mature telemedicine networks [Médecins Sans Frontières (MSF) and New Zealand Teledermatology (NZT)]. The tools included performance reporting to assess trends, automated follow-up of patients to obtain outcomes data, automated surveying of referrers to obtain user feedback, and retrospective assessment of randomly selected cases to assess quality. In addition, the senior case coordinators in each network were responsible for identifying potential adverse events from email reports received from users. During the study period, there were 149 responses to the patient follow-up questions relating to the 1241 MSF cases (i.e., 12% of cases), and there were 271 responses to the follow-up questions relating to the 639 NZT cases (i.e., 42% of cases). The collection of user feedback reports was combined with the collection of patient follow-up data, thus producing the same response rates. The outcomes data suggested that the telemedicine advice proved useful for the referring doctor in the majority of cases and was likely to benefit the patient. The user feedback was overwhelmingly positive, over 90% of referrers in the two networks finding the advice received to be of educational benefit. The feedback also suggested that the teleconsultation had provided cost savings in about 20% of cases, either to the patient/family, or to the hospital/clinic treating the patient. Various problems were detected by regular monitoring, and certain adverse events were identified from email reports by the users. A single aberrant quality reading was detected by using a process control chart. The present study demonstrates that a QA program is feasible in store-and-forward telemedicine, and shows that it was useful in two different networks, because certain problems were detected (and then solved) that would not have been identified until much later. It seems likely that QA could be used much more widely in telemedicine generally to benefit patient care.

show abstract

Section: Introductionmentioning

confidence: 99%

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks

Wootton

Liu

Bonnardot

et al. 2015

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…The annual inspection requirements of BreastScreen Australia and the RANZCR are based on an ACPSEM position paper [16]. These requirements include two image quality tests: the ability to visualise 5 fibres, 3.5 (preferably 4) speck groups and 4 masses in the ACR phantom, and meeting a For the non-DR systems, during the change over from film-screen to CR, the system AECs were recalibrated to just meet the image quality requirements.…”

Section: Discussionmentioning

confidence: 99%

“…If these are appropriate then it is likely that the AEC system requires calibration. One must be careful that the image quality and contrast-noise ratio requirements are still met following any changes [16].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic reference levels for mammography in BreastScreen Queensland

Thiele¹,

Irvine²,

Want³

et al. 2011

Australas Phys Eng Sci Med

View full text Add to dashboard Cite

show abstract

“…Upon arriving in Australia in 2009, I was impressed to find that a group of physicists had already published interim recommendations for digital mammography QA [11]. These physicists, along with the ACPSEM and the Royal Australian and New Zealand College of Radiologists (RANZCR) must be acknowledged for their role in the development and ongoing review of QA guidelines for digital mammography.…”

Section: Quality Assurance In Mammographymentioning

confidence: 99%

How many physicists does it take to test a mammography unit?

Diffey¹

2017

Australas Phys Eng Sci Med

View full text Add to dashboard Cite

Mammography is defined as the X-ray examination of the breast. It is just one of the modalities used for breast imaging; ultrasound and magnetic resonance imaging (MRI) are incredibly valuable adjunct techniques and newer technologies are gradually being adopted, such as molecular breast imaging and dedicated breast computed tomography. Inevitably, we tend to associate the term breast imaging with breast screening. Although breast screening has its critics [3], there can be no doubt that breast cancer is a major health burden on a global scale; it is the second most common cancer in the world and is responsible for more female deaths than any other cancer type [4]. Within Australia, 1 in 8 women will be diagnosed with breast cancer by the age of 85 [5]. However, it is reassuring to note that mortality rates are decreasing despite the fact that incidence rates continue to rise and the diagnosis rates in young women are increasing [6].Mammography is considered to be the gold standard for breast screening, having an overall sensitivity of about 85% and specificity of 90% [7] in women aged 50-70. Breast imaging is challenging since it is necessary to detect and classify pathological details (microcalcifications and masses) against a background of fibrous tissue, which can vary considerably in radiological appearance depending on breast thickness and composition.Microcalcifications have a relatively high atomic number and density and hence high inherent and subject contrast. Unfortunately they are generally very small in size, ranging from 10 µm through to several mm [8]. Although masses are of moderate size (5-10 mm), detection of carcinoma is difficult since malignant tissue has negligible physical density difference from fibrous breast tissue, a similar attenuation coefficient and therefore low inherent contrast I'm sorry to lure you in with a joke for which I don't have a punchline; the answer is just one, yet there are 95 physicists in Australia and New Zealand who hold ACPSEM Certification in Mammography Equipment Testing [1]. To put this into perspective, there are only 41 medical physicists who hold ACPSEM Certification in Radiology [2].This raises the questions of why mammography is the only radiology modality to have its own certification process and why there is so much demand for this qualification. Having spent 12 years specialising in mammography physics, I'll attempt to answer these questions and look at how mammographic technology has changed over the years and how this has impacted the role of the medical physicist.

show abstract

Interim recommendations for a digital mammography quality assurance program

Cited by 5 publications

References 32 publications

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks

Experience with Quality Assurance in Two Store-and-Forward Telemedicine Networks

Diagnostic reference levels for mammography in BreastScreen Queensland

How many physicists does it take to test a mammography unit?

Contact Info

Product

Resources

About