Digital Mammography: How Well Are Radiologists Doing?
This study by Lehman et al. (Radiology, 2016) aimed to establish actual performance benchmarks for screening digital mammography among practicing radiologists as well as determine the performance characteristics.
Retrospective Cohort Study
1,682,504 digital screening mammograms of 729,808 women were interpreted by 359 radiologists. Performance measures were calculated using the American College of Radiology BI-RADS atlas (5th ed.) to standardize interpretation and then the calls made by radiologists were compared to published, recommended benchmarks by the Breast Cancer Surveillance Consortium (BCSC), the National Mammography Database, and recommendations by experts. The vast majority of radiologists in community practice (92.1%) met or exceeded standards for cancer detection rates and similarly, there was a very high percentage of radiologists (97.1%) who met recommended ranges for sensitivity. However, only 59.0% met standards for abnormal interpretation rates and 64.3% for specificity. The authors conclude that radiologists are overall meeting standards when it comes to not missing cancers. However, a large number of radiologists are “overcalling” mammograms. This issue has raised previously and remains an ongoing focus area for quality assurance and improvement.
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