Factors Influencing the False Positive Rate in CT Lung Cancer Screening.
Factors Influencing the False Positive Rate in CT Lung Cancer Screening.
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DOI：
10.1016/j.acra.2020.07.040
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发表时间：
2022-03
影响因子：
4.8
通讯作者：
Kong, Chung Yin
中科院分区：
文献类型：
--
作者：
Hammer, Mark M.;Byrne, Suzanne C.;Kong, Chung Yin
确定影响肺癌筛查（LCS）CT假阳性可能性的因素，这可能导致成本增加和患者焦虑。在这项回顾性研究中，我们检查了2014 - 2018年在我们的医疗保健网络中进行的所有LCS CT，记录了Lung-RADS类别和肺癌诊断。假阳性定义为Lung-RADS 3-4X，1年内未诊断为肺癌。在多变量logistic回归模型中评估患者人口统计学和吸烟史、肺气肿的存在、COPD的诊断、放射科医生的经验年数和年量以及筛查机构，以确定假阳性检查。共纳入3735例患者的5835例LCS CT。肺癌142例（2%）。在LCS CT中，905例（16%）为肺RADS阳性，766例（13%）为假阳性。Logistic回归分析显示，筛查机构（比值比[OR] 0.91 - 2.43）、基线扫描（OR 1.43）、放射科医生经验（OR 0.59）、患者年龄（OR 2.08）、COPD诊断（OR 1.34）、肺气肿存在（OR 1.32）和收入水平（OR 0.43）是假阳性的显著预测因素。许多患者特异性和部位/放射科医师特异性因素影响CT LCS的假阳性率。特别是，经验较少的放射科医生有较高的假阳性率。筛查项目可能希望制定质量保证计划，以将其放射科医生的假阳性率与国家基准进行比较。
To identify factors influencing the likelihood of a false positive lung cancer screening (LCS) CT, which may lead to increased costs and patient anxiety. In this retrospective study, we examined all LCS CTs performed across our healthcare network from 2014 – 2018, recording Lung-RADS category and diagnosis of lung cancer. A false positive was defined by Lung-RADS 3-4X and no diagnosis of lung cancer within 1 year. Patient demographics and smoking history, presence of emphysema, diagnosis of COPD, radiologist years of experience and annual volume, and screening institution were evaluated in a multivariate logistic regression model for false positive exams. A total of 5835 LCS CTs were included from 3735 patients. Lung cancer was diagnosed in 142 cases (2%). Of the LCS CTs, 905 (16%) were positive by Lung-RADS, and 766 (13%) represented false positives. Logistic regression analysis showed that screening institution (odds ratios [OR] 0.91 – 2.43), baseline scan (OR 1.43), radiologist experience (OR 0.59), patient age (OR 2.08), diagnosis of COPD (OR 1.34), presence of emphysema (OR 1.32), and income level (OR 0.43) were significant predictors of false positives. A number of patient-specific and site/radiologist-specific factors influence the false positive rate in CT LCS. In particular, radiologists with less experience had a higher false positive rate. Screening programs may wish to develop quality assurance programs to compare the false positive rates of their radiologists to national benchmarks.
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DOI：
10.1056/nejmoa1312547
发表时间：
2014-11-06
期刊：
The New England journal of medicine
影响因子：
--
作者：
Black WC;Gareen IF;Soneji SS;Sicks JD;Keeler EB;Aberle DR;Naeim A;Church TR;Silvestri GA;Gorelick J;Gatsonis C;National Lung Screening Trial Research Team
通讯作者：
National Lung Screening Trial Research Team
DOI：
10.1164/rccm.201505-0894oc
发表时间：
2015-11-01
影响因子：
24.7
作者：
Young, Robert P.;Duan, Fenghai;Aberle, Denise
通讯作者：
Aberle, Denise
影响因子：
10.3
作者：
Theberge, Isabelle;Chang, Sue-Ling;Brisson, Jacques
通讯作者：
Brisson, Jacques
影响因子：
39.2
作者：
Pinsky PF;Gierada DS;Black W;Munden R;Nath H;Aberle D;Kazerooni E
通讯作者：
Kazerooni E
影响因子：
39.2
作者：
Criss, Steven D.;Cao, Pianpian;Kong, Chung Yin
通讯作者：
Kong, Chung Yin