Performance of Radiologists and Radiographers in Double Reading                     Mammograms: The UK National Health Service Breast Screening                     Program

Chen, Yan; James, Jonathan; Michalopoulou, Eleni; Darker, Iain T.; Jenkins, Jacqueline

doi:10.1148/radiol.212951

Cited by 14 publications

(12 citation statements)

References 22 publications

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“…As part of their External Quality Assurance (EQA) [1], breast screening readers participate annually by examining a test set of 60 challenging cases in their clinical workstation and record their findings about each case using the PERFORMS password protected reporting software. Upon submitting their decisions for all cases, participants receive immediate case-by-case feedback, compared with pathologic findings, and an opinion derived from a national panel of experts who provide a commentary on the radiologic appearances of the cancers and the appropriateness of recall for the normal and benign cases.…”

Section: The Performs Schemementioning

confidence: 99%

“…Upon submitting their decisions for all cases, participants receive immediate case-by-case feedback, compared with pathologic findings, and an opinion derived from a national panel of experts who provide a commentary on the radiologic appearances of the cancers and the appropriateness of recall for the normal and benign cases. Once PERFORMS is completed by all participants, comprehensive performance statistics are produced providing individuals with a comparison with their peers nationally [1].…”

Section: The Performs Schemementioning

confidence: 99%

“…Every year more than 2.23 million females undergo breast cancer screening in the UK, with approximately one in eight being diagnosed with breast cancer during their lifetime [1]. Double reading of screening mammograms, conducted by either radiologists or non-radiologists (radiographer advanced practitioners or breast clinicians trained specifically in mammographic interpretation), is the standard of care in the National Health Service Breast Screening Program (NHSBSP) in the United Kingdom [1].…”

Section: Introductionmentioning

confidence: 99%

“…Once completed by all participants, comprehensive performance statistics are produced providing an individual with a comparison with their peers nationally. Participants whose performance in the scheme falls below a minimum acceptable standard (statistically significantly lower than that of the main body of readers) are flagged as "outliers," and further action is taken, such as reviewing practice, offering suggestions, or providing additional further training [1].…”

Section: Introductionmentioning

confidence: 99%

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The performance of breast screening readers in a specificity-focused test set-based assessment scheme in a national breast screening programme

Michalopoulou,

Darker,

Chen

2024

Medical Imaging 2024: Image Perception, Observer Performance, and Technology Assessment

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Breast cancer screening is a critical component of healthcare, engaging over 2.23 million women annually in the UK. The National Health Service Breast Screening Program requires breast screening readers to participate in the PERFORMS scheme for quality assurance and training. This study investigates the potential of a specificity-focused test set within PERFORMS to reduce false positive recalls and enhance readers' image interpretation skills in England. The specificity set comprised 60 challenging breast screening cases, including 15 malignant and 45 benign/normal cases. Among the 529 participating readers in the pre-specificity (pre-SP) round, post-specificity (post-SP) round, or both, they were categorized as those who underwent the specificity set (n = 317) and those who did not (n = 212). The post-SP recall rate was significantly lower (36.0%) compared to the pre-SP rate (37.7%) (p = 0.000). This decrease was more pronounced in those who undertook the specificity set (-2.7%) than in those who did not (-0.5%) (p = 0.0018). The correct return to screen rate and positive predictive value (PPV) improved in the post-SP set, with rates of 86.4% and 76.0%, respectively, compared to 82.4% and 68.5% in the pre-SP set (p = 0.000). The increase in correct return to screen and PPV was comparable between those who undertook the specificity set and those who did not (p = 0.0933 and p = 0.2515, respectively). In conclusion, integrating a specificity-focused test set within PERFORMS shows promise in positively impacting breast screening reader performance, offering insights for future training and quality assurance enhancements.

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Section: The Performs Schemementioning

confidence: 99%

Section: The Performs Schemementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The performance of breast screening readers in a specificity-focused test set-based assessment scheme in a national breast screening programme

Michalopoulou,

Darker,

Chen

2024

Medical Imaging 2024: Image Perception, Observer Performance, and Technology Assessment

Self Cite

View full text Add to dashboard Cite

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“…However, there will be a mechanism to flag unexpected findings back to the supervising Consultant Radiologist for action if necessary. Double reading of screening is the standard of care in the National Health Service Breast Screening Program ( Chen et al 2023 ) and reporting by advanced practice radiographers is already incorporated into practice ( Snaith et al 2016 ). The Royal College of Radiologists (RCR) have formal standards for interpretation and state that reporting of imaging by non-radiologists should remain within their scope of practice, adhere to professional standards and work as part of a team with access to radiological opinion and advice ( RCR 2018 ).…”

Section: Innovative Practice In ‘Re-reporting’ Of Scans For Dementia ...mentioning

confidence: 99%

Are advanced clinical practitioners perfectly placed to re-report neuroimages to support the clinical diagnosis of dementia?

Bradley,

Harrison,

Goodall

et al. 2023

International Journal for Advancing Practice

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As the global population continues to age, the prevalence of dementia is increasing worldwide. While there is an emphasis on early, timely diagnosis and treatment options for people with a dementia, wait times from referral to diagnosis have increased. Neuroimaging performed by radiologists can be utilised to support dementia diagnoses. The purpose of this commentary is to consider whether advanced clinical practitioners, who specialise in dementia, are well placed to re-report on pre-existing neuroimages to support a clinical diagnosis of dementia.

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Take a break: should breaks be enforced during digital breast tomosynthesis reading sessions?

Partridge,

Taib,

Phillips

et al. 2023

Eur Radiol

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Objectives Digital breast tomosynthesis (DBT) can improve diagnostic accuracy compared to 2D mammography, but DBT reporting is time-consuming and potentially more fatiguing. Changes in diagnostic accuracy and subjective and objective fatigue were evaluated over a DBT reporting session, and the impact of taking a reporting break was assessed. Materials and methods Forty-five National Health Service (NHS) mammography readers from 6 hospitals read a cancer-enriched set of 40 DBT cases whilst eye tracked in this prospective cohort study, from December 2020 to April 2022. Eye-blink metrics were assessed as objective fatigue measures. Twenty-one readers had a reporting break, 24 did not. Subjective fatigue questionnaires were completed before and after the session. Diagnostic accuracy and subjective and objective fatigue measures were compared between the cohorts using parametric and non-parametric significance testing. Results Readers had on average 10 years post-training breast screening experience and took just under 2 h (105.8 min) to report all cases. Readers without a break reported greater levels of subjective fatigue (44% vs. 33%, p = 0.04), which related to greater objective fatigue: an increased average blink duration (296 ms vs. 286 ms, p < 0.001) and a reduced eye-opening velocity (76 mm/s vs. 82 mm/s, p < 0.001). Objective fatigue increased as the trial progressed for the no break cohort only (ps < 0.001). No difference was identified in diagnostic accuracy between the groups (accuracy: 87% vs. 87%, p = 0.92). Conclusions Implementing a break during a 2-h DBT reporting session resulted in lower levels of subjective and objective fatigue. Breaks did not impact diagnostic accuracy, which may be related to the extensive experience of the readers. Clinical relevance statement DBT is being incorporated into many mammography screening programmes. Recognising that reporting breaks are required when reading large volumes of DBT studies ensures this can be factored in when setting up reading sessions. Trial registration Clinical trials registration number: NCT03733106 Key Points • Use of digital breast tomosynthesis (DBT) in breast screening programmes can cause significant reader fatigue. • The effectiveness of incorporating reading breaks into DBT reporting sessions, to reduce mammography reader fatigue, was investigated using eye tracking. • Integrating breaks into DBT reporting sessions reduced reader fatigue; however, diagnostic accuracy was unaffected.

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Performance of Radiologists and Radiographers in Double Reading Mammograms: The UK National Health Service Breast Screening Program

Cited by 14 publications

References 22 publications

The performance of breast screening readers in a specificity-focused test set-based assessment scheme in a national breast screening programme

The performance of breast screening readers in a specificity-focused test set-based assessment scheme in a national breast screening programme

Are advanced clinical practitioners perfectly placed to re-report neuroimages to support the clinical diagnosis of dementia?

Take a break: should breaks be enforced during digital breast tomosynthesis reading sessions?

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