Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?

Joann G Elmore; Andrea J Cook; Andy Bogart; Patricia A Carney; Berta M Geller; Stephen H Taplin; Diana S M Buist; Tracy Onega; Christoph I Lee; Diana L Miglioretti

doi:10.1016/j.clinimag.2016.06.014

Radiologists' interpretive skills in screening vs. diagnostic mammography: are they related?

Clin Imaging. 2016 Nov-Dec;40(6):1096-1103. doi: 10.1016/j.clinimag.2016.06.014. Epub 2016 Jul 1.

Authors

Affiliations

¹ Division of General Internal Medicine, University of Washington, 325 Ninth Avenue, Box 359780, Seattle, WA, 98104, USA. Electronic address: jelmore@u.washington.edu.
² Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA.
³ RAND Corporation, 1776 Main Street, Santa Monica, CA, 90407, USA.
⁴ Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail Code: FM, Portland, OR, 97239, USA.
⁵ University of Vermont, 1 South Prospect Street, UHC, Burlington, VT, 05401, USA.
⁶ Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute National Institutes of Health, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
⁷ Dartmouth Medical School, One Medical Center Drive, HB7937, Lebanon, NH, 03756, USA.
⁸ Department of Radiology, University of Washington School of Medicine, 825 Eastlake Avenue E, G3-200, Seattle, WA, 98109, USA; Department of Health Services, University of Washington School of Public Health, 1959 NE Pacific St., Box 357660, Seattle, WA, 98195, USA.
⁹ Group Health Research Institute, Group Health Cooperative, 1730 Minor Avenue, Suite 1600, Seattle, WA, 98101, USA; Division of Biostatistics, Department of Public Health Sciences, University of California Davis School of Medicine, One Shields Avenue, Med Sci 1C, Room 144, Davis, CA, 95616, USA.

Abstract

Purpose: This study aims to determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography.

Materials and methods: We evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms. Adjusting for site, radiologist, and patient characteristics, we identified radiologists with performance in the highest tertile and compared to those with lower performance.

Results: A moderate correlation was noted for radiologists' accuracy when interpreting screening versus their accuracy on diagnostic examinations: sensitivity (r_spearman=0.51, 95% CI: 0.22, 0.80; P=.0006) and specificity (r_spearman=0.40, 95% CI: 0.30, 0.49; P<.0001).

Conclusion: Different educational approaches to screening and diagnostic imaging should be considered.

Keywords: Diagnostic mammography; Interpretive performance; Screening mammography; Sensitivity; Specificity.

MeSH terms

Adult
Aged
Breast Neoplasms / diagnosis*
Clinical Competence*
Female
Humans
Mammography / methods*
Mass Screening*
Middle Aged
Radiologists*
Sensitivity and Specificity

Abstract

MeSH terms

Grants and funding