title: Potential of computer-aided diagnosis to reduce variability in radiologists' interpretations of mammograms depicting microcalcifications.
abstract: OBJECTIVE
  To evaluate whether computer-aided diagnosis can reduce interobserver variability in the interpretation of mammograms.
  
  
  METHODS
  Ten radiologists interpreted mammograms showing clustered microcalcifications in 104 patients. Decisions for biopsy or follow-up were made with and without a computer aid, and these decisions were compared. The computer was used to estimate the likelihood that a microcalcification cluster was due to a malignancy. Variability in the radiologists' recommendations for biopsy versus follow-up was then analyzed.
  
  
  RESULTS
  Variation in the radiologists' accuracy, as measured with the SD of the area under the receiver operating characteristic curve, was reduced by 46% with computer aid. Access to the computer aid increased the agreement among all observers from 13% to 32% of the total cases (P <.001), while the kappa value increased from 0.19 to 0.41 (P <.05). Use of computer aid eliminated two-thirds of the substantial disagreements in which two radiologists recommended biopsy and routine screening in the same patient (P <.05).
  
  
  CONCLUSIONS
  In addition to its demonstrated potential to improve diagnostic accuracy, computer-aided diagnosis has the potential to reduce the variability among radiologists in the interpretation of mammograms.
authors.affiliation: Kurt Rossmann Laboratories for Radiologic Image Research, Dept of Radiology, Univ of Chicago, 5841 S Maryland Ave, MC2026, Chicago, IL 60637, USA. y-jiang@uchicago.edu
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.forename: R M
authors.initials: RM
authors.lastname: Nishikawa
authors.forename: R A
authors.initials: RA
authors.lastname: Schmidt
authors.forename: A Y
authors.initials: AY
authors.lastname: Toledano
authors.forename: K
authors.initials: K
authors.lastname: Doi
mesh_terms: D001706:Biopsy; D001941:Breast Diseases / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity