title: Radiologists' attitudes and use of mammography audit reports.
abstract: OBJECTIVE
  The US Mammography Quality Standards Act mandates medical audits to track breast cancer outcomes data associated with interpretive performance. The objectives of our study were to assess the content and style of audits and examine use of, attitudes toward, and perceptions of the value that radiologists' have regarding mandated medical audits.
  
  
  METHODS
  Radiologists (n = 364) at mammography registries in seven US states contributing data to the Breast Cancer Surveillance Consortium (BCSC) were invited to participate. We examined radiologists' demographic characteristics, clinical experience, use, attitudes, and perceived value of audit reports from results of a self-administered survey. Information on the content and style of BCSC audits provided to radiologists and facilities was obtained from site investigators. Radiologists' characteristics were analyzed according to whether or not they self-reported receiving regular mammography audit reports. Latent class analysis was used to classify radiologists' individual perceptions of audit reports into overall probabilities of having "favorable," "less favorable," "neutral," or "unfavorable" attitudes toward audit reports.
  
  
  RESULTS
  Seventy-one percent (257 of 364) of radiologists completed the survey; two radiologists did not complete the audit survey question, leaving 255 for the final study cohort. Most survey respondents received regular audits (91%), paid close attention to their audit numbers (83%), found the reports valuable (87%), and felt that audit reports prompted them to improve interpretative performance (75%). Variability was noted in the style, target audience, and frequency of reports provided by the BCSC registries. One in four radiologists reported that if Congress mandates more intensive auditing requirements, but does not provide funding to support this regulation they may stop interpreting mammograms.
  
  
  CONCLUSIONS
  Radiologists working in breast imaging generally had favorable opinions of audit reports, which were mandated by Congress; however, almost 1 in 10 radiologists reported that they did not receive audits.
authors.affiliation: Division of General Internal Medicine, 325 Ninth Avenue, University of Washington, Seattle, WA 98104, USA.
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
authors.forename: Erin J
authors.initials: EJ
authors.lastname: Aiello Bowles
authors.forename: Berta
authors.initials: B
authors.lastname: Geller
authors.forename: Natalia Vukshich
authors.initials: NV
authors.lastname: Oster
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Diana L
authors.initials: DL
authors.lastname: Miglioretti
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
authors.forename: Edward A
authors.initials: EA
authors.lastname: Sickles
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.forename: Robert D
authors.initials: RD
authors.lastname: Rosenberg
authors.forename: Bonnie C
authors.initials: BC
authors.lastname: Yankaskas
mesh_terms: D001291:Attitude of Health Personnel; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D054869:Clinical Audit / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D011871:Radiology / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
references.citation: Int J Radiat Oncol Biol Phys. 2008;71(1 Suppl):S195-9
references.pmid: 18406927
references.citation: AJR Am J Roentgenol. 2009 Feb;192(2):327-33
references.pmid: 19155390
references.citation: Breast Dis. 2001;13:97-107
references.pmid: 15687627
references.citation: Radiology. 1989 Apr;171(1):91-3
references.pmid: 2928551
references.citation: Am J Epidemiol. 2000 Aug 15;152(4):371-8
references.pmid: 10968382
references.citation: Semin Roentgenol. 2007 Oct;42(4):211-7
references.pmid: 17919523
references.citation: Ann Intern Med. 2003 Feb 4;138(3):168-75
references.pmid: 12558355
references.citation: Adm Radiol. 1995 Mar;14(3):29-31
references.pmid: 10142158
references.citation: AJR Am J Roentgenol. 1995 Jul;165(1):19-25
references.pmid: 7785586
references.citation: AJR Am J Roentgenol. 2009 Jul;193(1):157-64
references.pmid: 19542408
references.citation: Radiol Manage. 1996 Jan-Feb;18(1):40-6
references.pmid: 10154334
references.citation: AJR Am J Roentgenol. 1997 Oct;169(4):1001-8
references.pmid: 9308451
references.citation: J Natl Cancer Inst. 2007 Dec 19;99(24):1854-63
references.pmid: 18073379
references.citation: Radiology. 2009 Dec;253(3):641-51
references.pmid: 19864507
references.citation: Radiol Clin North Am. 2000 Jul;38(4):759-72
references.pmid: 10943276
references.citation: Radiology. 2009 Dec;253(3):632-40
references.pmid: 19789234
references.citation: Radiol Clin North Am. 1992 Jan;30(1):265-75
references.pmid: 1732933
references.citation: J Clin Epidemiol. 1997 Oct;50(10):1129-36
references.pmid: 9368521
references.citation: Struct Equ Modeling. 2007;14(4):671-694
references.pmid: 19953201
references.citation: Radiology. 2007 May;243(2):360-7
references.pmid: 17456866
references.citation: Perm J. 2004 Spring;8(2):12-8
references.pmid: 26704912