Seitzman Robin L, Pushkin JoAnn, Berg Wendie A
Seitzman Consulting, San Diego, CA.
DenseBreast-info, Inc., Deer Park, NY.
J Breast Imaging. 2020 Aug 10;2(4):315-329. doi: 10.1093/jbi/wbaa039.
We sought to identify provider knowledge gaps and their predictors, as revealed by a breast density continuing education course marketed to the radiology community.
The course, continually available online during the study period of November 2, 2016 and December 31, 2018, includes demographics collection; a monograph on breast density, breast cancer risk, and screening; and a post-test. Four post-test questions were modified during the study period, resulting in different sample sizes pre- and postmodification. Multiple logistic regression was used to identify predictors of knowledge gaps (defined as > 25% of responses incorrect).
Of 1649 analyzable registrants, 1363 (82.7%) were radiologic technologists, 226 (13.7%) were physicians, and 60 (3.6%) were other nonphysicians; over 90% of physicians and over 90% of technologists/nonphysicians specialized in radiology. Sixteen of 49 physicians (32.7%) and 80/233 (34.3%) technologists/nonphysicians mistakenly thought the Gail model should be used to determine "high-risk" status for recommending MRI or genetic testing. Ninety-nine of 226 (43.8%) physicians and 682/1423 (47.9%) technologists/nonphysicians misunderstood the inverse relationship between increasing age and lifetime breast cancer risk. Fifty-two of 166 (31.3%) physicians and 549/1151 (47.7%) technologists/nonphysicians were unaware that MRI should be recommended for women with a family history of BRCA1/BRCA2 mutations. Tomosynthesis effectiveness was overestimated, with 18/60 (30.0%) physicians and 95/272 (34.9%) technologists/nonphysicians believing sensitivity nearly equaled MRI. Knowledge gaps were more common in technologists/nonphysicians.
Important knowledge gaps about breast density, breast cancer risk assessment, and screening exist among radiologic technologists and radiologists. Continued education efforts may improve appropriate breast cancer screening recommendations.
我们试图确定在面向放射学界推广的乳腺密度继续教育课程中所揭示的医疗服务提供者的知识差距及其预测因素。
该课程在2016年11月2日至2018年12月31日的研究期间持续在线提供，包括人口统计学信息收集；一本关于乳腺密度、乳腺癌风险和筛查的专著；以及一次课后测试。在研究期间，对四个课后测试问题进行了修改，导致修改前后的样本量不同。采用多元逻辑回归来确定知识差距的预测因素（定义为超过25%的回答错误）。
在1649名可分析的注册者中，1363人（82.7%）是放射技师，226人（13.7%）是医生，60人（3.6%）是其他非医生人员；超过90%的医生以及超过90%的技师/非医生人员专门从事放射学工作。49名医生中有16人（32.7%），233名技师/非医生人员中有80人（34.3%）错误地认为应使用盖尔模型来确定推荐MRI或基因检测的“高风险”状态。226名医生中有99人（43.8%），1423名技师/非医生人员中有682人（47.9%）误解了年龄增长与终生乳腺癌风险之间的反比关系。166名医生中有52人（31.3%），1151名技师/非医生人员中有549人（47.7%）不知道对于有BRCA1/BRCA2基因突变家族史的女性应推荐MRI检查。乳腺断层合成的有效性被高估，18名医生中有60人（30.0%），272名技师/非医生人员中有95人（34.9%）认为其敏感性几乎等同于MRI。知识差距在技师/非医生人员中更为常见。
放射技师和放射科医生在乳腺密度、乳腺癌风险评估和筛查方面存在重要的知识差距。持续的教育努力可能会改善适当的乳腺癌筛查建议。
