Choudhery Sadia, Patel Bhavika K, Johnson Matthew, Geske Jennifer, Fazzio Robert T, Lee Christine, Pruthi Sandhya
Department of Radiology, Mayo Clinic, Rochester, Minnesota.
Department of Radiology, Mayo Clinic, Phoenix, Arizona.
J Am Coll Radiol. 2020 Aug;17(8):990-998. doi: 10.1016/j.jacr.2019.12.031. Epub 2020 Feb 24.
The objective of this study was to survey current trends in supplemental screening across various practice types and to understand factors that affect these practice patterns.
In this institutional review board-exempt study, a 12-question survey was sent out to ACR lead interpreting physicians. The survey inquired about practice features and the utilization of supplemental screening.
A total of 902 of 4,688 lead interpreting breast imaging physicians (19.2%) responded to our survey. Of those respondents, 617 respondents (68.4%) worked in practices that offered supplemental breast cancer screening. Screening ultrasound was the most commonly utilized supplemental screening modality (53%). There was variability in methods of referral for supplemental screening, with referral through the ordering provider (56%) being the most common. Academic practices, private practices with breast specialization, and practices in the Northeast were more likely to provide supplemental screening (P < .05). There were significant relationships between the presence of state density notification legislation, the number of breast imaging trained radiologists, and the volume of mammographic studies performed per day and the availability of supplemental screening (P < .05). The use of automated breast density assessment software and patient education brochures about density and supplemental screening also had significant relationships with the availability of supplemental screening (P < .05).
The majority of practices surveyed are utilizing supplemental screening, but there is significant variability in the modalities used and the methods of referral. There are practice features that correlate with the availability of supplemental screening, and understanding these features provides further insight into current trends in supplemental screening utilization.
本研究的目的是调查不同类型医疗机构中补充筛查的当前趋势，并了解影响这些实践模式的因素。
在这项经机构审查委员会豁免的研究中，向美国放射学会（ACR）的首席解读医师发送了一份包含12个问题的调查问卷。该问卷询问了实践特征以及补充筛查的使用情况。
4688名首席解读乳腺影像医师中有902名（19.2%）回复了我们的调查。在这些受访者中，617名受访者（68.4%）所在的医疗机构提供补充乳腺癌筛查。筛查超声是最常用的补充筛查方式（53%）。补充筛查的转诊方法存在差异，通过开单医生转诊（56%）是最常见的方式。学术性医疗机构、有乳腺专科的私人诊所以及东北部的诊所更有可能提供补充筛查（P < 0.05）。州密度通知立法的存在、接受乳腺影像培训的放射科医生数量、每天进行的乳腺X线检查数量与补充筛查的可及性之间存在显著关系（P < 0.05）。自动乳腺密度评估软件的使用以及关于密度和补充筛查的患者教育手册与补充筛查的可及性也存在显著关系（P < 0.05）。
大多数接受调查的医疗机构正在使用补充筛查，但所使用的方式和转诊方法存在显著差异。存在与补充筛查可及性相关的实践特征，了解这些特征有助于进一步洞察补充筛查利用的当前趋势。
