A multi-site study led by an Oregon Health & Science University Knight Cancer Institute researcher has identified set criteria that could be used to help identify physicians who might benefit from additional training in interpreting screening mammograms.
Patricia A. Carney, Ph.D., OHSU School of Medicine professor of family medicine, and of public health and preventive Medicine; and associate director of Cancer Prevention, Control and Population Studies in the OHSU Knight Cancer Institute, is the principal investigator on the study, and the lead author of a paper on these findings published in the May edition of the journal Radiology.
The study was performed over eight months in 2009. A panel of 10 expert radiologists was chosen to analyze performance data from hundreds of interpreting physicians across the United States. The panel members were considered experts because they had devoted more than 75 percent of their time to breast imaging, had been interpreting mammograms for at least 10 years, had either completed fellowship training in breast imaging, or had more than 15 years’ experience interpreting mammograms. The majority of the interpreting physicians whose performance data were analyzed were radiologists.
The study did not identify individual physicians, but rather looked at several measures that reflect the accuracy of interpretive performance, such as accuracy of detecting breast cancer, and potential overuse of additional tests for findings that turn out to be benign. The panel identified criteria, or “cut points,” that targeted ranges of low-performance measures. By applying these criteria to physicians interpreting screening mammograms whose performance is known, the researchers found that as many as 18 percent to 28 percent of physicians interpreting screening mammography could benefit from additional training in detecting breast cancer accurately, and as many as 34 percent to 49 percent may need help to reduce the likelihood of unnecessary work ups.
“It is important to note that mammography is not a perfect test, even with the most expert radiologists,” says Carney. “We have identified what we believe to be minimally acceptable performance levels for interpreters of screening mammography. It is also important to note that we looked at several ranges of measures, all of which need to be taken into account when identifying low performers. Physicians who interpret screening mammograms and whose performance fall outside the identified cut-points might benefit from additional training to improve their interpretive performance.”
“It is true that physicians who interpret screening mammograms below our cut points may be missing cancers and doing unnecessary workups,” says Carney. “We want to give these physicians the tools they need to interpret screening mammograms at the highest level.”
Carney acknowledges the results of the study are controversial. “This is the first time anyone has identified criteria for low performance,” she says, “but women having mammograms should not be overly concerned by these findings because every mammography facility has a designated physician who is charged with monitoring available performance measures.” Carney advises all women to talk to their physicians about their concerns regarding screening mammograms and their personal risk factors for breast cancer. “If you have any concerns at all, based upon your risk, you could ask for a second interpreter to look at your film.”
The study was a collaboration among OHSU; the Universities of California: San Francisco, Los Angeles, and Irvine; Washington University; St. Louis, Carol Anne Read Breast Health Center, Oakland, Calif.; the American Cancer Society; University of New Mexico, Albuquerque; Group Health Research Institute, Seattle, Wash; Stevens Hospital Breast Center, Edmonds, Wash.; Swedish Medical Center, Seattle, Wash.; Carol Milgard Breast Center, Tacoma, Wash.; University of Washington, Seattle; University of Vermont; University of North Carolina; Dartmouth Medical School; and The Cooper Institute in Denver, Colo.
The study was supported by the American Cancer Society and the National Cancer Institute Breast Cancer Surveillance Consortium . The collection of cancer data used in this study was supported in part by several state public health departments and cancer registries throughout the United States. The study was made possible by a generous donation from the Longaberger Company's Horizon of Hope Campaign.About the OHSU Knight Cancer Institute Visit www.ohsuhealth.com/cancer
Reed Coleman | EurekAlert!
Drone vs. truck deliveries: Which create less carbon pollution?
31.05.2017 | University of Washington
New study: How does Europe become a leading player for software and IT services?
03.04.2017 | Fraunhofer-Institut für System- und Innovationsforschung (ISI)
An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.
Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...
Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.
Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...
Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.
As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...
Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.
With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...
Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine
Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...
19.06.2017 | Event News
13.06.2017 | Event News
13.06.2017 | Event News
23.06.2017 | Physics and Astronomy
23.06.2017 | Physics and Astronomy
23.06.2017 | Information Technology