From the University of Nottingham, School of Medicine, Division of Cancer and Stem Cells, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, United Kingdom (Y.C., E.M., I.T.D.); Nottingham University Hospitals NHS Trust, Nottingham Breast Institute, City Hospital Campus, Nottingham, United Kingdom (J.J.J.); and Public Health Commissioning and Operations, Directorate of the Chief Operating Officer, NHS England and NHS Improvement, Redditch, United Kingdom (J.J.).
Radiology. 2023 Jan;306(1):102-109. doi: 10.1148/radiol.212951. Epub 2022 Sep 13.
Background Double reading can be used in screening mammography, but it is labor intensive. There is limited evidence on whether trained radiographers (ie, technologists) may be used to provide double reading. Purpose To compare the performance of radiologists and radiographers double reading screening mammograms, considering reader experience level. Materials and Methods In this retrospective study, performance and experience data were obtained for radiologists and radiographer readers of all screening mammograms in England from April 2015 to March 2016. Cancer detection rate (CDR), recall rate (RR), and positive predictive value (PPV) of recall based on biopsy-proven findings were calculated for first readers. Performance metrics were analyzed according to reader professional group and years of reading experience using the analysis of variance test. values less than .05 were considered to indicate statistically significant difference. Results During the study period, 401 readers (224 radiologists and 177 radiographers) double read 1 404 395 screening digital mammograms. There was no difference in CDR between radiologist and radiographer readers (mean, 7.84 vs 7.53 per 1000 examinations, respectively; = .08) and no difference for readers with more than 10 years of experience compared with 5 years or fewer years of experience, regardless of professional group (mean, 7.75 vs 7.71 per 1000 examinations respectively, = .87). No difference in the mean RR was observed between radiologists and radiographer readers (5.0% vs 5.2%, respectively, = .63). A lower RR was seen for readers with more than 10 years of experience compared with 5 years or fewer, regardless of professional group (mean, 4.8% vs 5.8%, respectively; = .001). No variation in PPV was observed between them ( = .42), with PPV values of 17.1% for radiologists versus 16.1% for radiographers. A higher PPV was seen for readers with more than 10 years of experience compared with 5 years or less, regardless of professional group (mean, 17.5% and 14.9%, respectively; = .02). Conclusion No difference in performance was observed between radiographers and radiologists reading screening mammograms in a program that used double reading. Published under a CC BY 4.0 license See also the editorial by Hooley and Durand in this issue.
背景 乳腺 X 线摄影筛查中可以采用双读片，但这很耗费人力。关于是否可以使用受过培训的放射技师（即技师）来提供双读片，目前相关证据有限。 目的 本研究旨在比较放射科医师和放射技师在乳腺 X 线摄影筛查中的双读片表现，并考虑到阅读者的经验水平。 材料与方法 本回顾性研究获取了 2015 年 4 月至 2016 年 3 月期间英格兰所有筛查性乳腺 X 线摄影中放射科医师和放射技师的表现和经验数据。计算了第一读片者的癌症检出率（CDR）、召回率（RR）和基于活检证实结果的召回阳性预测值（PPV）。使用方差分析检验，根据阅读者的专业组别和阅读经验年限分析了表现指标。 值＜.05 被认为具有统计学显著差异。 结果 在研究期间，401 名阅读者（224 名放射科医师和 177 名放射技师）对 1404395 份数字化筛查乳腺 X 线摄影进行了双读片。放射科医师和放射技师读片者的 CDR 无差异（平均值分别为每 1000 次检查 7.84 和 7.53， =.08），经验超过 10 年的阅读者与经验不足 10 年的阅读者之间也无差异，无论其专业组别如何（平均值分别为每 1000 次检查 7.75 和 7.71， =.87）。放射科医师和放射技师读片者的 RR 平均值也无差异（分别为 5.0%和 5.2%， =.63）。经验超过 10 年的阅读者的 RR 低于经验不足 10 年的阅读者，无论其专业组别如何（平均值分别为 4.8%和 5.8%， =.001）。两者的 PPV 无差异（ =.42），放射科医师的 PPV 值为 17.1%，放射技师的为 16.1%。经验超过 10 年的阅读者的 PPV 高于经验不足 10 年的阅读者，无论其专业组别如何（平均值分别为 17.5%和 14.9%， =.02）。 结论 在采用双读片的筛查项目中，放射技师和放射科医师读片的表现无差异。 本刊 Hooley 和 Durand 的述评文章对本研究进行了讨论。 基于 CC BY 4.0 许可获取此内容
