Taylor P M, Champness J, Given-Wilson R M, Potts H W W, Johnston K
Centre for Health Informatics and Multiprofessional Education, University College London, Archway Campus, Highgate Hill, London, UK.
Br J Radiol. 2004 Jan;77(913):21-7. doi: 10.1259/bjr/34203805.
The NHS Breast Screening Programme is changing working practices in response to increased workload and manpower shortages. Radiographers are being trained as film readers. Computer aids are being considered. We have evaluated the impact of prompts placed by the R2 ImageChecker 1000 on the sensitivity and specificity of film readers, including non-radiologist film readers. 30 radiologists, 5 breast clinicians and 15 radiographers each read 180 films, including 60 cancers (20 false negative interval cases and 40 screen detected cancers). Each reader read each case twice, once with and once without computer prompts. The order in which the reading sessions were carried out was randomized separately for each reader. 36 out of 40 screen-detected cases were prompted by the ImageChecker, a sensitivity of 90%. Eight out of 20 interval cases were prompted, a sensitivity of 40%. No significant difference was found for readers' sensitivity or specificity between the prompted and unprompted conditions. No significant difference was found between the sensitivity and specificity of the different groups of film reader. No difference in impact of prompts was found for well or poorly performing film readers. The result suggests that this version of the ImageChecker would not have a significant impact on the UK screening programme.
英国国家医疗服务体系（NHS）乳腺筛查计划正在改变工作方式，以应对工作量增加和人力短缺的问题。放射技师正在接受胶片阅片培训。计算机辅助手段也在考虑之中。我们评估了R2 ImageChecker 1000给出的提示对包括非放射科胶片阅片者在内的胶片阅片者的敏感性和特异性的影响。30名放射科医生、5名乳腺科临床医生和15名放射技师每人阅读180张胶片，其中包括60例癌症（20例假阴性间隔期病例和40例筛查发现的癌症）。每位阅片者对每个病例阅读两次，一次有计算机提示，一次没有。阅片环节的顺序对每位阅片者分别进行随机安排。40例筛查发现的病例中有36例得到了ImageChecker的提示，敏感性为90%。20例假阴性间隔期病例中有8例得到了提示，敏感性为40%。在有提示和无提示的情况下，阅片者的敏感性或特异性没有显著差异。不同组别的胶片阅片者在敏感性和特异性方面没有显著差异。表现好或差的胶片阅片者在提示的影响方面没有差异。结果表明，这个版本的ImageChecker对英国的筛查计划不会有显著影响。
