Is maximum positive predictive value a good indicator of an optimal screening mammography practice?
OBJECTIVE
Positive predictive value (PPV1) has been used as one important indicator of the quality of screening mammography programs. We show how the relationship between sensitivity and recall rate may affect the operating point at which optimal (maximum) PPV1 occurs.


CONCLUSIONS
Optimal (maximum) PPV1 can occur at any sensitivity level and should not be used as the sole indicator for practice optimization because it does not take into account the number of cancers that would be missed at that sensitivity.
Hardesty
Lara A
LA
Department of Radiology, University of Pittsburgh Medical Center, Magee Women's Hospital, 300 Halket St., Ste. 4200, Pittsburgh, PA 15213, USA. lhardesty@mail.magee.edu
Klym
Amy H
AH
Shindel
Betty E
BE
Chough
Denise M
DM
Sumkin
Jules H
JH
Gur
David
D
D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D003951:Diagnostic Errors; D006801:Humans; D008327:Mammography / Q000592:standards* / Q000706:statistics & numerical data; D008403:Mass Screening; D011237:Predictive Value of Tests; D011787:Quality of Health Care; D012680:Sensitivity and Specificity