National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium
National Performance Benchmarks for Modern Screening Digital Mammography: Update from the Breast Cancer Surveillance Consortium
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DOI：
10.1148/radiol.2016161174
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发表时间：
2017-04-01
期刊：
影响因子：
19.7
通讯作者：
Miglioretti, Diana L.
中科院分区：
文献类型：
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作者：
Lehman, Constance D.;Arao, Robert F.;Miglioretti, Diana L.
目的：为现代筛查数字乳房X线摄影建立绩效基准，并评估美国社区实践中的绩效趋势。材料和方法：这项由六个乳腺癌的六个乳腺癌症协会中95个设施的359个放射学家解释的数字筛查乳房X线摄影的性能（BCSScscscsscsscsscscries）。该研究包括1 682 504个数字筛查乳房X线照片，在2007年至2013年之间进行了792 808名女性。绩效指标是根据美国放射学学院乳房成像报告和数据系统（第5版）计算的，并与BCSC，全国乳房X线摄影数据库和专家意见的绩效建议进行了比较。基准是从放射科医生跨性能指标的分布得出的，并以第50（中位数），第10、25、75、75和90个百分位数的形式得出，使用平滑曲线进行图形演示：平均筛选绩效措施如下：如下：异常解释率（AIR），11.6（空气），11.6（空气），11.6（95％置信度间隔[CII]：11.11.6.5.5，1.5，11.5，1.5，1.5，[1.5]。每1000个筛查或癌症检测率（CDR），5.1（95％CI：5.0，5.2）被检测到的癌症；敏感性为86.9％（95％CI：86.3％，87.6％）；特异性为88.9％（95％CI：88.8％，88.9％）；每1000个屏幕的假阴性率为0.8（95％CI：0.7，0.8）;正预测值（PPV）1，4.4％（95％CI：4.3％，4.5％）； PPV2，25.6％（95％CI：25.1％，26.1％）; PPV3，28.6％（95％CI：28.0％，29.3％）;癌症阶段0或1，76.9％；最小的癌症，57.7％；和节点阴性侵入性癌症，79.4％。 92.1％的放射科医生在社区实践中实现了建议的CDR，而97.1％的CDR则获得了敏感性的建议范围。只有59.0％的放射科医生获得了建议的空气，只有63.0％的放射科医生达到了建议的特异性水平。判断：BCSC中的大多数放射科医生超过癌症乳房X线摄影的癌症检测建议；然而，对于几乎一半的放射科医生解释筛查乳房X线照片的放射科医生，空气仍然高于建议的速率。 （c）RSNA，2016年
Purpose: To establish performance benchmarks for modern screening digital mammography and assess performance trends over time in U.S. community practice.Materials and Methods: This HIPAA-compliant, institutional review board-approved study measured the performance of digital screening mammography interpreted by 359 radiologists across 95 facilities in six Breast Cancer Surveillance Consortium (BCSC) registries. The study included 1 682 504 digital screening mammograms performed between 2007 and 2013 in 792 808 women. Performance measures were calculated according to the American College of Radiology Breast Imaging Reporting and Data System, 5th edition, and were compared with published benchmarks by the BCSC, the National Mammography Database, and performance recommendations by expert opinion. Benchmarks were derived from the distribution of performance metrics across radiologists and were presented as 50th (median), 10th, 25th, 75th, and 90th percentiles, with graphic presentations using smoothed curves.Results: Mean screening performance measures were as follows: abnormal interpretation rate (AIR), 11.6 (95% confidence interval [CI]: 11.5, 11.6); cancers detected per 1000 screens, or cancer detection rate (CDR), 5.1 (95% CI: 5.0, 5.2); sensitivity, 86.9% (95% CI: 86.3%, 87.6%); specificity, 88.9% (95% CI: 88.8%, 88.9%); false-negative rate per 1000 screens, 0.8 (95% CI: 0.7, 0.8); positive predictive value (PPV) 1, 4.4% (95% CI: 4.3%, 4.5%); PPV2, 25.6% (95% CI: 25.1%, 26.1%); PPV3, 28.6% (95% CI: 28.0%, 29.3%); cancers stage 0 or 1, 76.9%; minimal cancers, 57.7%; and node-negative invasive cancers, 79.4%. Recommended CDRs were achieved by 92.1% of radiologists in community practice, and 97.1% achieved recommended ranges for sensitivity. Only 59.0% of radiologists achieved recommended AIRs, and only 63.0% achieved recommended levels of specificity.Conclusion: The majority of radiologists in the BCSC surpass cancer detection recommendations for screening mammography; however, AIRs continue to be higher than the recommended rate for almost half of radiologists interpreting screening mammograms. (C) RSNA, 2016