Comparison of radiographer/radiologist double film reading with single reading in breast cancer screening.
OBJECTIVES - To assess the efficacy of dual film reading in screening mammography with a suitably trained radiographer as the second reader and to determine a suitable decision model for radiographer/radiologist double reading. SETTING - Three breast screening centres in South Thames (West) region. METHODS - Seven radiographers with prior film reading training double read 17 202 screening mammograms with a radiologist. Screening performance of radiographers and radiologists was assessed taking into account interval cancers. The efficacy of radiographer/radiologist double reading was assessed in terms of changes in sensitivity and specificity compared with radiologist single reading. RESULTS - Radiographers yielded equivalent sensitivity but lower specificity than radiologist film readers. The effect of double reading between radiographer/radiologist pairs was an increase in sensitivity of 6-4%, which was achieved at the cost of a 0-6% decrease in specificity. This was reached by a decision system involving radiologists' review of radiographer queries and recall classifications. If all radiographer queries were recalled a large increase in sensitivity would be counterbalanced by an equally large decrease in specificity. CONCLUSIONS - Radiographer/radiologist double reading resulted in similar increases in sensitivity as those previously reported in radiologist double reading studies. Radiologist review of radiographer reported abnormalities is a suitable means by which to limit excess recall.
Pauli
R
R
School of Psychology and Counselling, Roehampton Institute, West Hill, London, United Kingdom.
Hammond
S
S
Cooke
J
J
Ansell
J
J
D000328:Adult; D001943:Breast Neoplasms / Q000517:prevention & control*; D016022:Case-Control Studies; D004501:Education, Medical; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D012680:Sensitivity and Specificity; D014962:X-Ray Film