International comparison of performance measures for screening mammography: can it be done?
International comparison of performance measures for screening mammography: can it be done?
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DOI：
10.1258/0969141042467430
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发表时间：
2004-01-01
影响因子：
2.9
通讯作者：
Bulliard, JL
中科院分区：
文献类型：
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作者：
Yankaskas, BC;Klabunde, CN;Bulliard, JL
目的：已发表的筛查性乳腺X射线摄影性能指标因国家而异。进行了一项国际研究，以评估两个性能指标的可比性：召回率和阳性预测值（PPV）。选择这些方法是因为它们不需要识别筛查人群中的所有癌症，而这并不总是可能的。设置：国际乳腺癌筛查网络（IBSN）25个成员国的筛查乳腺X线摄影项目或数据登记处。1999年，向IBSN的国家代表分发了一份评估表，以了解如何进行乳房X线检查以及收集了哪些与回忆率和PPV相关的具体数据。然后要求参与国家提供数据，以便计算1997- 1999年期间按年龄组筛查的妇女的筛查性乳腺X射线摄影的召回率、PPV和癌症检出率。结果：22个国家完成了评估表，14个国家提供了性能数据。筛查性乳房X线摄影的提供和数据收集方面的差异是明显的。对于大多数国家，初次乳房X线检查的召回率高于随后的乳房X线检查。初始PPV与后续PPV之间没有一致的关系，尽管PPV通常随着回忆率的增加而降低。召回率随着年龄的增长而下降，而PPV随着年龄的增长而增加。结论：乳腺X线摄影性能指标的相似模式在各国都很明显。然而，制定一个更标准化的方法来定义和收集数据将允许更有效的国际比较，并有可能优化乳房X线摄影的性能。目前，由于定义和收集乳腺X线摄影数据的差异，应谨慎进行国际性能比较。
Objective: Published screening mammography performance measures vary across countries. An international study was undertaken to assess the comparability of two performance measures: the recall rate and positive predictive value (PPV). These measures were selected because they do not require identification of all cancers in the screening population, which is not always possible.Setting: The screening mammography programs or data registries in 25 member countries of the International Breast Cancer Screening Network (IBSN).Methods: In 1999 an assessment form was distributed to IBSN country representatives in order to obtain information on how screening mammography was performed and what specific data related to recall rates and PPV were collected. Participating countries were then asked to provide data to allow calculation of recall rates, PPV and cancer detection rates for screening mammography by age group for women screened in the period 1997-1999.Results: Twenty-two countries completed the assessment form and 14 countries provided performance data. Differences in screening mammography delivery and data collection were evident. For most countries, recall rates were higher for initial than for subsequent mammograms. There was no consistent relationship of initial to subsequent PPV, although PPV generally decreased as the recall rate increased. Recall rates decreased with increasing age, while PPV increased as age increased.Conclusion: Similar patterns for mammography performance measures were evident across countries. However, the development of a more standardized approach to defining and collecting data would allow more valid international comparisons, with the potential to optimize mammography performance. At present, international comparisons of performance should be made with caution due to differences in defining and collecting mammography data.