Geller Berta M, Bowles Erin J A, Sohng Hee Yon, Brenner R James, Miglioretti Diana L, Carney Patricia A, Elmore Joann G
Office of Health Promotion Research, Departments of Family Medicine and Radiology and the Vermont Cancer Center, University of Vermont, 1 S Prospect St., Rm. 4426, Burlington, VT 05401-3444.
AJR Am J Roentgenol. 2009 Feb;192(2):361-9. doi: 10.2214/AJR.08.1647.
One might speculate that radiologists who enjoy mammography may exhibit better performance than radiologists who do not.
One hundred thirty-one radiologists at three Breast Cancer Surveillance Consortium (BCSC) registries completed a survey about their characteristics, clinical practices, and attitudes related to screening mammography. Survey results were linked with BCSC performance data for 662,084 screening and 33,977 diagnostic mammograms. Using logistic regression, we modeled the odds of an abnormal interpretation, cancer detection, sensitivity, and specificity among radiologists who reported they enjoy interpreting screening mammograms compared with those who do not.
Overall, 44.3% of radiologists reported not enjoying interpreting screening mammograms. Radiologists who reported enjoying interpreting screening mammograms were more likely to be women, spend at least 20% of their time in breast imaging, have a primary academic affiliation, read more than 2,000 mammograms per year, and be salaried. Enjoyment was not associated with screening mammography performance. Among diagnostic mammograms, there was a significant increase in sensitivity among radiologists who reported enjoyment (85.2%) compared with those who did not (78.2%). In models adjusting for radiologist characteristics, similar trends were found; however, no statistically significant associations remained.
Almost one half of radiologists actively interpreting mammograms do not enjoy that part of their job. Once we adjusted for radiologist and patient characteristics, we found that reported enjoyment was not related to performance in our study, although suggestive trends were noted.
有人可能会推测,喜欢乳腺钼靶检查的放射科医生可能比不喜欢的医生表现更好。
来自三个乳腺癌监测联盟(BCSC)登记处的131名放射科医生完成了一项关于他们的特征、临床实践以及与乳腺钼靶筛查相关态度的调查。调查结果与BCSC的662,084例筛查性乳腺钼靶检查和33,977例诊断性乳腺钼靶检查的性能数据相关联。使用逻辑回归,我们对报告喜欢解读筛查性乳腺钼靶检查的放射科医生与不喜欢的医生相比,出现异常解读、癌症检测、敏感性和特异性的几率进行了建模。
总体而言,44.3%的放射科医生报告不喜欢解读筛查性乳腺钼靶检查。报告喜欢解读筛查性乳腺钼靶检查的放射科医生更有可能是女性,将至少20%的时间用于乳腺影像诊断,有主要学术附属关系,每年阅读超过2000例乳腺钼靶检查,并且是受薪人员。喜欢程度与筛查性乳腺钼靶检查的性能无关。在诊断性乳腺钼靶检查中,报告喜欢解读的放射科医生的敏感性(85.2%)与不喜欢的医生(78.2%)相比有显著提高。在对放射科医生特征进行调整的模型中,发现了类似趋势;然而,没有统计学上的显著关联。
几乎一半积极解读乳腺钼靶检查的放射科医生不喜欢他们工作的这一部分。在我们对放射科医生和患者特征进行调整后,我们发现报告的喜欢程度与我们研究中的表现无关,尽管注意到了一些提示性趋势。