Evaluation of False Positive Mammography in Community Practice

社区实践中乳房 X 光检查假阳性的评估

• 批准号: 7274194
• 负责人: BONNIE C YANKASKAS
• 金额: $ 19.97万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-08-10 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7274194
• 关键词: Affect; Biopsy; Breast Cancer Detection; Breast Cancer Surveillance Consortium; Cancer Detection; Characteristics; Community Practice; Data; Diagnostic; Economics; Evaluation; Film; Funding; Goals; Health; Healthcare Systems; Image; Laboratories; Link; Logistics; Malignant Neoplasms; Mammography; North Carolina; Outcome; Pathology; Population; Population-Based Registry; Predictive Value; Procedures; Rate; Recommendation; Recording of previous events; Registries; Research; Research Infrastructure; Screening procedure; Stress; Testing; Woman; Work; base; cancer diagnosis; cost; cost effective; experience; improved; neoplasm registry; prospective; psychologic; radiologist

DESCRIPTION (provided by applicant): In community practice in the U.S., data have shown that around 90% of abnormal screening mammograms do not end in a cancer diagnosis, or are false positive (FP). The long term goal of this project is to reduce FP results in screening mammography, both to reduce the burden of extra unnecessary imaging work-ups and unnecessary biopsies. Our specific aims are to: 1) identify the characteristics of women, mammographic examinations, radiologists and practices that discriminate a FP from a TP mammogram; and 2) identify the descriptive characteristics of abnormalities seen on mammograms that will improve the ability to discriminate a FP from TP mammography result when added to the findings of Aim 1. This study will use the infrastructure of the Carolina Mammography Registry (CMR), a population-based registry that collects prospective data on women and mammography examinations in mammography facilities in North Carolina. Data routinely collected by CMR that can be used for this study include demographic and health history on the women and the results and recommendations from imaging studies performed in the screening work-up. Mammography data are linked to cancer outcome data from the NC Central Cancer Registry and pathology laboratories, providing outcome data form the screening work-up. An active review of the films of positive mammograms identified from CMR will be conducted by outside reviewers, to classify the findings on the mammograms in a standardized way. The routinely collected CMR data will be combined with the descriptive data from the film review to test the ability to discriminate a FP from TP result, using GEE logistic analyses. In addition, other variables that could affect the prediction of a FP or TP that will be used in analyses include: mammography practice procedures; radiologist characteristics; and practice setting and type. The goal is to be improve the ability to identify false positive results, to ultimately reduce recall rates, increase positive predictive value, without a decrease in cancer detection rates. Work that has the potential to reduce the extra imaging studies and procedures that women experience in screening for breast cancer would go a long way toward making screening mammography more cost effective in terms of the monetary, physical and psychological costs to women, and the economic costs to the health care system.

描述（由申请人提供）：在美国的社区实践中，数据显示，大约90%的异常筛查乳房X线照片不会以癌症诊断结束，或者是假阳性（FP）。该项目的长期目标是减少筛查性乳腺X线摄影的FP结果，以减少额外的不必要的成像检查和不必要的活检的负担。我们的具体目标是：1）识别区分FP与TP乳房X线摄影的女性、乳房X线摄影检查、放射科医生和实践的特征;以及2）识别在乳房X线摄影上观察到的异常的描述性特征，当添加到目标1的发现中时，这些特征将提高区分FP与TP乳房X线摄影结果的能力。本研究将使用卡罗莱纳乳腺X射线摄影登记处（CMR）的基础设施，CMR是一个基于人群的登记处，收集了北卡罗来纳州乳腺X射线摄影机构中女性和乳腺X射线摄影检查的前瞻性数据。CMR常规收集的可用于本研究的数据包括妇女的人口统计学和健康史以及筛选检查中进行的成像研究的结果和建议。乳腺X线摄影数据与NC中央癌症登记处和病理学实验室的癌症结果数据相关联，提供了筛查结果数据。将由外部审查员对CMR中确定的阳性乳房X线照片进行积极审查，以标准化方式对乳房X线照片的结果进行分类。常规收集的CMR数据将与来自电影审查的描述性数据相结合，以使用GEE逻辑分析测试区分FP与TP结果的能力。此外，可能影响分析中使用的FP或TP预测的其他变量包括：乳腺摄影实践程序;放射科医生特征;实践环境和类型。我们的目标是提高识别假阳性结果的能力，最终降低召回率，提高阳性预测值，而不降低癌症检测率。有可能减少妇女在筛查乳腺癌时所经历的额外成像研究和程序的工作将大大有助于使筛查乳房X光检查在妇女的金钱，身体和心理成本以及医疗保健系统的经济成本方面更具成本效益。