Time Trends in Radiologists' Interpretive Performance at Screening Mammography from the Community-based Breast Cancer Surveillance Consortium, 1996-2004
Time Trends in Radiologists' Interpretive Performance at Screening Mammography from the Community-based Breast Cancer Surveillance Consortium, 1996-2004
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DOI：
10.1148/radiol.10091881
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发表时间：
2010-07-01
期刊：
影响因子：
19.7
通讯作者：
Brenner, R. James
中科院分区：
文献类型：
--
作者：
Ichikawa, Laura E.;Barlow, William E.;Brenner, R. James
目的：研究1996年至2004年期间放射科医师在筛查性乳腺X线摄影中判读性能的时间趋势。材料和方法：所有研究程序均经机构审查委员会批准，符合HIPAA。收集了1996年至2004年40-79岁女性乳腺癌随访1年的后续筛查乳房X线照片数据。回忆率，敏感性和特异性每年进行检查。使用广义估计方程（GEE）和随机效应模型来检验线性趋势。受试者工作特征曲线（AUC）下的面积，肿瘤组织学检查结果，和大小的最大尺寸或直径的肿瘤也examined.Results：2542049随后的筛查乳腺X线照片和12498癌症诊断的后续期间的数据包括在这项研究中。召回率从6.7%上升到8.6%，敏感性从71.4%上升到83.8%，特异性从93.6%下降到91.7%。在GEE模型中，每个日历年的召回率调整比值比为1.04（95%置信区间[CI]：1.02，1.05），召回率为1.09（95% CI：1.07，1.05）。敏感性为0.96（95%CI：0.95，0.98）（P <0.001）。随机效应模型结果相似。AUC随时间增加：1996-1998年为0.869（95%CI：0.861，0.877），1999-2001年为0.884（95%CI：0.879，0.890），2002-2004年为0.891（95%CI：0.885，0.896）（P < .001）。肿瘤组织学检查结果和大小保持constant.Conclusion：召回率和敏感性筛查乳腺X线照片增加，而特异性下降，从1996年至2004年的妇女与以前的乳腺X线照片。在考虑到风险因素后，这一趋势仍然存在。净效应是总体区分度的改善，这是一个衡量指标，衡量的是随访期间患有癌症的乳房X光检查比随访期间没有癌症的乳房X光检查具有更高的乳房成像报告和数据系统评估类别的可能性。(C)RSNA，2010年
Purpose: To examine time trends in radiologists' interpretive performance at screening mammography between 1996 and 2004.Materials and Methods: All study procedures were institutional review board approved and HIPAA compliant. Data were collected on subsequent screening mammograms obtained from 1996 to 2004 in women aged 40-79 years who were followed up for 1 year for breast cancer. Recall rate, sensitivity, and specificity were examined annually. Generalized estimating equation (GEE) and random-effects models were used to test for linear trend. The area under the receiver operating characteristic curve (AUC), tumor histologic findings, and size of the largest dimension or diameter of the tumor were also examined.Results: Data on 2 542 049 subsequent screening mammograms and 12 498 cancers diagnosed in the follow-up period were included in this study. Recall rate increased from 6.7% to 8.6%, sensitivity increased from 71.4% to 83.8%, and specificity decreased from 93.6% to 91.7%. In GEE models, adjusted odds ratios per calendar year were 1.04 (95% confidence interval [CI]: 1.02, 1.05) for recall rate, 1.09 (95% CI: 1.07. 1.12) for sensitivity, and 0.96 (95% CI: 0.95, 0.98) for specificity (P < .001 for all). Random-effects model results were similar. The AUC increased over time: 0.869 (95% CI: 0.861, 0.877) for 1996-1998, 0.884 (95% CI: 0.879, 0.890) for 1999-2001, and 0.891 (95% CI: 0.885, 0.896) for 2002-2004 (P < .001). Tumor histologic findings and size remained constant.Conclusion: Recall rate and sensitivity for screening mammograms increased, whereas specificity decreased from 1996 to 2004 among women with a prior mammogram. This trend remained after accounting for risk factors. The net effect was an improvement in overall discrimination, a measure of the probability that a mammogram with cancer in the follow-up period has a higher Breast Imaging Reporting and Data System assessment category than does a mammogram without cancer in the follow-up period. (C) RSNA, 2010