title: Effect of human variability on independent double reading in screening mammography.
abstract: OBJECTIVE
  To demonstrate the range of gains and losses that radiologists might experience from independent double reading in screening mammography.
  
  
  METHODS
  From a national random sample of radiologists, the authors formed 131 pairs. For each radiologist, the authors analyzed the increase relative to his or her individual true-positive rate (TPR) or false-positive rate (FPR), number of additional cancers detected, and change to negative biopsy rate that would result from independent double reading after pairing.
  
  
  RESULTS
  The average radiologist can expect an 8%-14% gain in TPR and a 4%-10% increase in FPR with pairing. For some radiologists, double reading increased the TPR with a small concomitant increase in FPR. Other radiologists, however, realized small gains in TPR with large increases in FPR. Adding the reading from a more experienced radiologist did not necessarily improve the TPR of a radiologist with less experience.
  
  
  CONCLUSIONS
  Radiologists can form complementary and noncomplementary pairs for double reading. Use of this procedure must be decided on an individual basis.
authors.affiliation: Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Beam
authors.forename: D C
authors.initials: DC
authors.lastname: Sullivan
authors.forename: P M
authors.initials: PM
authors.lastname: Layde
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000517:prevention & control*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D015588:Observer Variation