Technologists Effect on the Accuracy of Mammography (TEAM)

描述（由申请人提供）：该项目的总体目标是评估放射技术人员在社区实践中对乳房x光检查的准确性和结果的影响，社区实践中放射技术人员特征的组合，以及放射技术人员个人特征与他们执行的乳房x光检查的解释之间的关系。随着时间的推移，来自69个不同放射机构的57.5万人的180多万张乳房x光照片的数据，卡罗来纳州乳房x光检查登记处（CMR）在进行这项研究方面处于独特的地位。CMR数据包括人口统计信息、个人健康史、家庭健康史、乳腺癌危险因素、乳房x光检查结果和评估、后续护理建议、病理结果和癌症结局。CMR记录还包括负责每次乳房x光检查的技术人员和放射科医生的信息。我们与整个北卡罗莱纳州的放射学实践有着长期的合作关系，这将使我们能够使用作为该项目一部分开发的调查仪器收集有关放射学技术人员特征的准确和完整的数据。在接下来的四年里，我们将：1)使用现有的CMR数据来确定筛查和诊断乳房x光检查的性能特征是否因技术人员（胶片和数字）而异；2)制定并实施一项调查，收集全州范围内技术人员样本的技术人员特征数据；3)描述技术人员特征的可变性；4)评估技师对乳房x光筛查和诊断效果的影响。这个项目将扩大我们对放射科医生最终解释和建议的可变性的理解。这项工作是新颖的。由于技术人员的培训和与放射科医生合作的方法是可以改变的，这项工作的影响可能非常重要，导致筛查结果的改善。

DESCRIPTION (provided by applicant): The overall goals of this project are to assess the impact radiologic technologists have on the accuracy and outcomes of mammograms in community practice, the mix of radiologic technologist characteristics in community practice, and the relationship between radiologic technologists individual characteristics and the interpretation of the mammograms they perform. With data on more that 1,800,000 mammograms for 575,000 individuals from 69 different radiology facilities over time, the Carolina Mammography Registry (CMR) is in a unique position to conduct this research. CMR data includes demographic information, individual health history, family health history, breast cancer risk factors, mammographic findings and assessments, recommendations for follow up care, pathology findings, and cancer outcomes. CMR records also include information on the technologist and radiologist responsible for each mammogram. We have longstanding collaborative relationships with radiology practices throughout the state of North Carolina, which will allow us to collect accurate and complete data on radiologic technologists characteristics using a survey instrument to be developed as a part of this project. Over the next four years we will: 1) Use existing CMR data to determine whether performance characteristics of screening and diagnostic mammography vary by technologist, (for screen-film and digital) from all facilities; and for technologists currently practicing in 48 facilities 2) Develop and implement a survey to collect data on technologist characteristics for a statewide sample of technologists; 3) Describe the variability of technologist characteristics; 4) Estimate the effect of technologist on the performance of screening and diagnostic mammography. This project will expand our understanding of the variability in radiologists final interpretations and recommendations. This work is novel. As technologists training and method of working with their radiologists is something that can be altered, the impact of this work could be extremely important, leading to improvement in screening outcomes.