Monitoring and evaluating the UK National Health Service Breast Screening Programme: evaluating the variation in radiological performance between individual programmes using PPV-referral diagrams
Monitoring and evaluating the UK National Health Service Breast Screening Programme: evaluating the variation in radiological performance between individual programmes using PPV-referral diagrams
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DOI：
10.1136/jms.8.1.24
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发表时间：
2001-01-01
影响因子：
2.9
通讯作者：
Wallis, MG
中科院分区：
文献类型：
--
作者：
Blanks, RG;Moss, SM;Wallis, MG
一个高质量的乳腺癌筛查方案可以被定义为一个既能提供高癌症检出率，又能提供低转诊率的妇女接受进一步检查的方案。这样的计划将尽可能少的妇女接受进一步的调查，谁没有最终诊断为乳腺癌，也就是说，一个高的阳性预测值转诊作进一步的调查。本文介绍了一种图形技术，以说明个别方案的性能。该图绘制了转诊的阳性预测值对转诊率，癌症检测率在图上表示为"等压线"。置信限可以在图中表示为"方框"。该图不仅说明了方案执行情况，而且使人们能够提出改进执行情况的建议。高质量筛查的定义被认为具有主观因素和客观因素，因为放射科医生必须平衡筛查的灵敏度和特异性。该技术说明使用的数据从个人的筛查方案在英国国家卫生服务乳腺癌筛查计划的筛查年1998年4月1日至1999年3月31日。这一方法也可适用于其他国家的筛查方案。
A high quality breast cancer screening programme can be defined as one offering both a high cancer detection rate and a low referral rate of women for further investigation. Such a programme will have as few women as possible undergoing further investigations who do not have a final diagnosis of breast cancer-that is, a high positive predictive value of referral for further investigation. This paper introduces a graphical technique to illustrate individual programme performance. The graph plots positive predictive value of referral against referral rate, with the cancer detection rate expressed as "isobars" on the graph. Confidence limits can be expressed as "boxes" on the diagram. The graph not only illustrates programme performance but also enables suggestions to be made to improve performance. The definition of high quality screening is seen to have a subjective element as well as an objective element, as radiologists have to balance screening sensitivity with specificity. The technique is illustrated using data from the individual screening programmes in the UK National Health Service Breast Screening Programme for the screening year 1 April 1998 to 31 March 1999. The methodology could also be applied to other national screening programmes.