title: Assessing the impact of CAD on the sensitivity and specificity of film readers.
abstract: OBJECTIVE
  To assess the impact of computer-aided detection (CAD) prompts on film readers' sensitivity and specificity.
  
  
  METHODS
  Thirty-five readers read 120 films, including 44 cancers, 40 of which were prompted. All readers looked at all cases with and without prompts. The sensitivity and specificity were calculated for each reader under each condition.
  
  
  RESULTS
  The sensitivity improved when CAD prompts were used (0.80 from 0.77). The difference was slightly below the threshold for statistical significance (95% CI for the difference is -0.0027-0.064). The specificity also improved (0.86 from 0.85), but not significantly. There was a significant improvement in sensitivity when readers' judgements were combined to simulate double reading, from 0.77 to 0.81. (95% CI for the difference is 0.014-0.077).
  
  
  CONCLUSIONS
  Analysis of prompted cancers that readers did and did not recall, found that cases were more likely to be correctly recalled if there were emphasized prompts, more prompts or if the case was harder. There was no statistically significant effect for type of abnormality or tumour size or for the performance, attitude or experience of the reader.
authors.affiliation: CHIME, Royal Free and University College Medical School, University College London, London, UK. p.taylor@chime.ucl.ac.uk
authors.forename: P
authors.initials: P
authors.lastname: Taylor
authors.forename: R
authors.initials: R
authors.lastname: Given-Wilson
authors.forename: J
authors.initials: J
authors.lastname: Champness
authors.forename: H W W
authors.initials: HW
authors.lastname: Potts
authors.forename: K
authors.initials: K
authors.lastname: Johnston
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging; D002983:Clinical Competence; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D012680:Sensitivity and Specificity