title: Clinical image evaluation of film mammograms in Korea: comparison with the ACR standard.
abstract: OBJECTIVE
  The goal of this study is to compare the overall quality of film mammograms taken according to the Korean standards with the American College of Radiology (ACR) standard for clinical image evaluation and to identify means of improving mammography quality in Korea.
  
  
  METHODS
  Four hundred and sixty eight sets of film mammograms were evaluated with respect to the Korean and ACR standards for clinical image evaluation. The pass and failure rates of mammograms were compared by medical facility types. Average scores in each category of the two standards were evaluated. Receiver operating characteristic curve analysis was used to identify an optimal Korean standard pass mark by taking the ACR standard as the reference standard.
  
  
  RESULTS
  93.6% (438/468) of mammograms passed the Korean standard, whereas only 80.1% (375/468) passed the ACR standard (p < 0.001). Non-radiologic private clinics had the lowest pass rate (88.1%: Korean standard, 71.8%: ACR standard) and the lowest total score (76.0) by the Korean standard. Average scores of positioning were lowest (19.3/29 by the Korean standard and 3.7/5 by the ACR standard). A cutoff score of 77.0 for the Korean standard was found to correspond to a pass level when the ACR standard was applied.
  
  
  CONCLUSIONS
  We suggest that tighter regulations, such as, raising the Korean pass mark, subtracting more for severe deficiencies, or considering a very low scores in even a single category as failure, are needed to improve the quality of mammography in Korea.
authors.affiliation: Department of Radiology, Kyungpook National University Medical Center, Daegu 702-210, Korea.
authors.forename: Yeon Joo
authors.initials: YJ
authors.lastname: Gwak
authors.forename: Hye Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Kwak
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Son
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Ko
authors.forename: Jin Hwa
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyo Soon
authors.initials: HS
authors.lastname: Lim
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Lee
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Park
authors.forename: Kyung Min
authors.initials: KM
authors.lastname: Shin
authors.forename: Yun-Jin
authors.initials: YJ
authors.lastname: Jang
mesh_terms: D000068:Accreditation / Q000592:standards*; D005260:Female; D006801:Humans; D008327:Mammography / Q000592:standards*; D058996:Quality Improvement; D012372:ROC Curve; D056910:Republic of Korea; D012189:Retrospective Studies
keywords: Accreditation; Breast; Mammography; Quality assurance
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