CAD in mammography: lesion-level versus case-level analysis of the effects of prompts on human decisions
CAD in mammography: lesion-level versus case-level analysis of the effects of prompts on human decisions
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DOI：
10.1007/s11548-008-0213-x
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发表时间：
2008-06-01
影响因子：
3
通讯作者：
Given-Wilson, Rosalind
中科院分区：
文献类型：
--
作者：
Alberdi, Eugenio;Povyakalo, Andrey A.;Given-Wilson, Rosalind
目的通过分析提示对阅片者对乳腺X线特征（病灶）判断的影响，了解CAD支持下乳腺筛查的决策过程。为此，我们分析了迄今为止未检查的细节的报告完成的乳房X线摄影读者在早期评估的CAD tool.Material和方法评估病变提取59例癌症病例的5,839份报告。这些数据的统计分析集中在什么功能的读者认为回忆癌症的情况下，读者如何反应CAD prompts.Results约13.5%的召回决定被发现是由反应功能以外的实际癌症。CAD的影响：如果提示，病变更有可能被检查;癌症提示的存在增加了检测和回忆的可能性，特别是对于在微妙情况下不太准确的读者;缺乏提示使癌症特征不太可能被检测到;虚假提示，结论在一些研究中，CAD的影响报告明显缺乏，这可能是由于CAD系统地影响读者对个体特征的识别，对于读者和特征的某些组合是有益的，而对于其他组合是有害的。乳房X光片阅读器不会忽略提示。从方法上讲，通过回顾癌症病例的数量来评估CAD可能会产生误导。
Object To understand decision processes in CAD-supported breast screening by analysing how prompts affect readers' judgements of individual mammographic features (lesions). To this end we analysed hitherto unexamined details of reports completed by mammogram readers in an earlier evaluation of a CAD tool.Material and methods Assessments of lesions were extracted from 5,839 reports for 59 cancer cases. Statistical analyses of these data focused on what features readers considered when recalling a cancer case and how readers reacted to CAD prompts.Results About 13.5% of recall decisions were found to be caused by responses to features other than those indicating actual cancer. Effects of CAD: lesions were more likely to be examined if prompted; the presence of a prompt on a cancer increased the probability of both detection and recall especially for less accurate readers in subtler cases; lack of prompts made cancer features less likely to be detected; false prompts made non-cancer features more likely to be classified as cancer.Conclusion The apparent lack of impact reported for CAD in some studies is plausibly due to CAD systematically affecting readers' identification of individual features, in a beneficial way for certain combinations of readers and features and a damaging way for others. Mammogram readers do not ignore prompts. Methodologically, assessing CAD by numbers of recalled cancer cases may be misleading.