Medical Image Optimisation and Perception Research Group (MIOPeG), Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; Department of Radiological Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Medical Image Optimisation and Perception Research Group (MIOPeG), Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Australia; The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Australia; Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
Clin Radiol. 2023 Mar;78(3):e260-e267. doi: 10.1016/j.crad.2022.11.012. Epub 2022 Dec 22.
To investigate if mammographic test-set participation affects routine breast cancer screening performance.
Clinical audit data between 2008 and 2018 were collected for 35 breast screen readers who participated in the BreastScreen Reader Assessment Strategy (BREAST) and 22 readers with no history of test-set participation. For BREAST readers, the annual audit data were divided according to the year they completed their first test set, and the same years were used randomly to align and divide the data of non-BREAST readers into pre- and post-test set periods. Multiple audit parameters were inspected retrospectively for the two cohorts to identify how their reading performance has evolved in screening mammography.
Investigating 2 calendar years before and after test-set participation, BREAST and non-BREAST readers recalled lower rates of women in the latter period (p=0.03 and p=0.02, respectively). They also improved their positive predictive value (PPV; p=0.01 and p=0.02, respectively). BREAST readers additionally improved their detection rates of invasive cancer (p=0.02) and all cancers (p=0.01). In an extended 3-year comparison, similar improvements occurred in the recall rate for BREAST (p=0.02) and non-BREAST readers (p=0.02) and in PPV (p=0.001, 0.01, respectively); however, improvements in detection rates also occurred exclusively in BREAST readers' performance for invasive cancer (p=0.04), DCIS (p=0.05), and all cancers (p=0.02); however, significant improvements in detection did not involve <15 mm invasive cancers in both periods. Meanwhile, non-BREAST readers demonstrated a decrease in sensitivity (p=0.02).
Participation in test sets is linked to over-time improvements in most audit-measured cancer detection rates.
探讨乳腺影像学检查参与是否会影响常规乳腺癌筛查的表现。
对 2008 年至 2018 年间参与乳腺筛查读片者评估策略（BREAST）的 35 名乳腺影像读片者和 22 名无检查集参与史的读片者的临床审核数据进行了收集。对于 BREAST 读片者，根据他们完成第一个检查集的年份，将每年的审核数据进行划分，同时随机使用相同年份，将非 BREAST 读片者的数据分为检查集参与前和参与后时期。对两组读片者进行回顾性检查，以评估多个审核参数，以确定他们在筛查乳腺 X 线摄影中的阅读表现如何演变。
在检查集参与前后的 2 个日历年内，BREAST 和非 BREAST 读片者对后者时期的女性召回率较低（p=0.03 和 p=0.02）。他们还提高了阳性预测值（PPV；p=0.01 和 p=0.02）。BREAST 读片者还提高了浸润性癌（p=0.02）和所有癌症（p=0.01）的检出率。在为期 3 年的扩展比较中，BREAST（p=0.02）和非 BREAST 读片者的召回率（p=0.02）和 PPV（p=0.001，0.01）均出现类似的提高；然而，仅在 BREAST 读片者的浸润性癌（p=0.04）、导管原位癌（p=0.05）和所有癌症（p=0.02）表现中观察到检出率的提高，然而，在两个时期，<15mm 的浸润性癌症并未出现显著的检出提高。同时，非 BREAST 读片者的敏感性下降（p=0.02）。
参与检查集与大多数经审核测量的癌症检出率的提高有关。
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