title: Community-based mammography practice: services, charges, and interpretation methods.
abstract: OBJECTIVE
  The purpose of our study was to accurately describe facility characteristics among community-based screening and diagnostic mammography practices in the United States.
  
  
  METHODS
  A survey was developed and applied to community-based facilities providing screening mammography in three geographically distinct locations in the states of Washington, Colorado, and New Hampshire. The facility survey was conducted between December 2001 and September 2002. Characteristics surveyed included facility type, services offered, charges for screening and diagnostic mammography, information systems, and interpretation methods, including the frequency of double interpretation.
  
  
  RESULTS
  Among 45 responding facilities, services offered included screening mammography at all facilities, diagnostic mammography at 34 facilities (76%), breast sonography at 30 (67%), breast MRI at seven (16%), and nuclear medicine breast scanning at seven (16%). Most facilities surveyed were radiology practices in nonhospital settings. Eight facilities (18%) reported performing clinical breast examinations routinely along with screening mammography. Only five screening sites (11%) used computer-aided detection (CAD) and only two (5%) used digital mammography. Nearly two thirds of facilities interpreted screening mammography examinations on-site, whereas 91% of facilities interpreted diagnostic examinations on-site. Only three facilities (7%) interpreted screening examinations on line as they were performed. Approximately half of facilities reported using some type of double interpretation, although the methods of double interpretation and the fraction of cases double-interpreted varied widely across facilities. On average, approximately 15% of screening examinations and 10% of diagnostic examinations were reported as being double-interpreted.
  
  
  CONCLUSIONS
  Comparison of this survey's results with those collected a decade earlier indicates dramatic changes in the practice of mammography, including a clear distinction between screening and diagnostic mammography, batch interpretation of screening mammograms, and improved quality assurance and medical audit tools. Diffusion of new technologies such as CAD and digital mammography was not widespread. The methods of double-interpretation and the fraction of cases double-interpreted varied widely across study sites.
authors.affiliation: Department of Radiology, Lynn Sage Comprehensive Breast Center, Northwestern University Feinberg School of Medicine, Galter Pavilion, 13th Floor, 251 E Huron St., Chicago, IL 60611, USA. ehendrick@radiology.northwestern.edu
authors.forename: R Edward
authors.initials: RE
authors.lastname: Hendrick
authors.forename: Gary R
authors.initials: GR
authors.lastname: Cutter
authors.forename: Eric A
authors.initials: EA
authors.lastname: Berns
authors.forename: Connie
authors.initials: C
authors.lastname: Nakano
authors.forename: Joseph
authors.initials: J
authors.lastname: Egger
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Linn
authors.initials: L
authors.lastname: Abraham
authors.forename: Stephen H
authors.initials: SH
authors.lastname: Taplin
authors.forename: Carl J
authors.initials: CJ
authors.lastname: D'Orsi
authors.forename: William
authors.initials: W
authors.lastname: Barlow
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control*; D003120:Colorado; D003153:Community Health Services / Q000592:standards / Q000706:statistics & numerical data; D003936:Diagnosis, Computer-Assisted / Q000706:statistics & numerical data; D005249:Fees and Charges; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D008327:Mammography / Q000592:standards* / Q000706:statistics & numerical data; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D008485:Medical Audit / Q000379:methods*; D009513:New Hampshire; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D014861:Washington