title: Effect of computer-aided detection on mammographic performance: experimental study on readers with different levels of experience.
abstract: OBJECTIVE
  To evaluate the effect of computer-aided detection (CAD) on the reader's performance.
  
  
  METHODS
  Four screening radiologists, two novice radiologists, and two residents with no prior experience in CAD read films of 200 women without and with CAD. The films, including 16 screen-detected cancers and 35 cancers "missed" on prior screening, were divided into two rollers: A (free time schedule) and B (prompted time schedule). Reading times were noted. Individual readings without and with CAD were compared, sensitivities and specificities were calculated.
  
  
  RESULTS
  The sensitivity of CAD was 70.6% and specificity 15.8%. In 408 cancer readings, the screeners found 10 and other readers 7 new cancers with the aid of CAD. The screeners changed their opinion four times and others six times from true positive to false negative when CAD was negative. CAD output produced 12 versus 13 new false-positive findings respectively after 2352 readings. CAD did not significantly affect the reader's sensitivities/specificities regardless of the time limit (P = not significant). The use of CAD increased mean time for roller reading from 56 to 63 min (P = 0.053).
  
  
  CONCLUSIONS
  Screening radiologists benefited slightly more from CAD than other readers did, but no statistical significant difference was found in personal readings without and with CAD.
authors.affiliation: Department of Mammography, Helsinki University Central Hospital, Helsinki, Finland. katja.hukkinen@hus.fi
authors.forename: K
authors.initials: K
authors.lastname: Hukkinen
authors.forename: T
authors.initials: T
authors.lastname: Vehmas
authors.forename: M
authors.initials: M
authors.lastname: Pamilo
authors.forename: L
authors.initials: L
authors.lastname: Kivisaari
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D002278:Carcinoma in Situ / Q000000981:diagnostic imaging*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011857:Radiographic Image Interpretation, Computer-Assisted; D012680:Sensitivity and Specificity