Malignancy Detection in Digital Mammograms: Important Reader Characteristics and Required Case Numbers
Malignancy Detection in Digital Mammograms: Important Reader Characteristics and Required Case Numbers
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DOI：
10.1016/j.acra.2010.06.016
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发表时间：
2010-11-01
影响因子：
4.8
通讯作者：
Brennan, Patrick C.
中科院分区：
文献类型：
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作者：
Reed, Warren M.;Lee, Warwick B.;Brennan, Patrick C.
理由和目标：根据阅读的病例数量和先前的经验确定读者表现水平提高与读者实践之间的关系。材料和方法：开发了包含 50 个病例的乳房 X 光检查测试集。这些病例包括 15 例异常（活检证实）和 35 例正常（在随后的重新筛查中得到证实）。 69 名乳房图像阅读者独立审查了这些病例，并通过记录他们的个体接受者操作特征评分（曲线下面积）、敏感性和特异性来衡量他们的表现。然后将这些绩效衡量标准与与读者相关的一系列因素进行比较，例如认证和报告的年限、每年阅读的案例数量、以前的经验和满意度。使用 Spearman 方法和 Mann-Whitney 检验进行相关分析，以检测特定阅读器组之间的性能差异。 结果：通过与 Az 值（接收者操作特征曲线下的面积）呈正统计显着关系，发现认证年数 (P = .004)、经验年数 (P = .0001) 和每周阅读时间 (P = .003) 的阅读器性能有所提高。对每年阅读不同病例数的个体进行 Az 值评分的统计比较表明，那些每年乳腺 X 光检查病例数为 5000 或更多 (P = .03) 或在 2000 至 4999 之间 (P = .05) 的个体，其得分在统计学上显着高于每年阅读少于 1000 例病例的个体。 结论：本研究的结果显示，与读者实践和经验参数相关的读者表现存在差异。显示了差异水平并提出了诊断功效的潜在接受水平，这可以为政策制定者、司法系统和公众辩论提供信息。
Rationale and Objectives: To determine the relationship between heightened levels of reader performance and reader practice in terms of number of cases read and previous experience.Materials and Methods: A test set of mammograms was developed comprising 50 cases. These cases consisted of 15 abnormals (biopsy proven) and 35 normals (confirmed at subsequent rescreen). Sixty-nine breast image readers reviewed these cases independently and their performance was measured by recording their individual receiver operating characteristic score (area under the curve), sensitivity, and specificity. These measures of performance were then compared to a range of factors relating to the reader such as years of certification and reporting, number of cases read per year, previous experiences, and satisfaction levels. Correlation analyses using Spearman methods were performed along with the Mann-Whitney test to detect differences in performance between specific reader groups.Results: Improved reader performance was found for years certified (P = .004), years of experience (P = .0001), and hours reading per week (P = .003) shown by positive statistical significant relationships with Az values (area under receiver operating characteristic curve). Statistical comparisons of Az values scored for individuals who read varying number of cases per year showed that those individuals whose annual mammographic case load was 5000 or more (P = .03) or between 2000 and 4999 (P = .05), had statistically significantly higher scores than those who read less than 1000 cases per year.Conclusion: The results of this study have shown variations in reader performance relating to parameters of reader practice and experience. Levels of variance are shown and potential acceptance levels for diagnostic efficacy are proposed which may inform policy makers, judicial systems and public debate.