From the laboratory to the clinic

Gur, David; Rockette, Howard E.; Warfel, Thomas; Lacomis, Joan M.; Fuhrman, Carl R.

doi:10.1016/s1076-6332(03)00466-5

Cited by 24 publications

(19 citation statements)

References 8 publications

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“…Likewise, context bias 60 has been shown to influence the interpretation and evaluation of varying prevalence (pre-set high and low abnormality) test banks, which illustrates the complexity in achieving unbiased performance levels. Although this is not without its critics and challenges to provide exact measures of accuracy in performance using varying levels of disease prevalence 50,61,62 .…”

Section: A Study By Abujudeh Et Al (2010)mentioning

confidence: 99%

Observer Performance in Computed Tomography Head Reporting

Lockwood

2017

Journal of Medical Imaging and Radiation Sciences

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Aim: To audit the reporting results of a cohort of radiographers (n=6) completing an accredited academic programme in clinical reporting of Computed Tomography (CT) head examinations.Methods: An audit of retrospective academic image case banks and prospective random clinical workload case banks. Both the academic test banks and clinical workload banks included a wide range of normal and abnormal cases of different levels of difficulty and pathology. Abnormalities included: haemorrhage, fractures, lesions, infarctions, degeneration, and normal variants from a variety of referral sources. True positive and negative, as well as false positive and negative fractions were used to mark the reports, which were analysed for accuracy against a reference standard. Further interobserver variability was assessed using Cohens Kappa, one-way analysis of variance and Tukey for multiple comparisons and significance testing at 95% confidence intervals. Results:The mean accuracy score for all radiographers (n=6) and reports (n=3,008) was 90.7% (95%CI 88.3%-93.0%). Mean sensitivity and specificity rate was 86.9% (95%CI 85.8%-88.2%), and 94% (95%CI 89.6%-98.3%) respectively. The most common errors were associated with herniation, lacunar infarctions and subtle fractures (false negatives) and involutional changes, subtle infarctions, and ventricular dilation (false positives). Conclusions:The results suggest appropriately trained radiographers can successfully undertake to report CT head examinations to a high standard. The adoption of both academic and clinical workload image banks that reflect disease examples and the prevalence that may logically be encountered in practice offers the potential for an accurate measure of performance of radiographer s abilities.

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Section: A Study By Abujudeh Et Al (2010)mentioning

confidence: 99%

Observer Performance in Computed Tomography Head Reporting

Lockwood

2017

Journal of Medical Imaging and Radiation Sciences

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“…2,3 The challenge for radiologists is to gain comprehensive experience in the appearance of abnormality and keep their recall rate within acceptable limits given the low incidence of the disease. [4][5][6] It has been proposed that the insertion of "test malignant cases" into a "real life" clinical screening mammography set may increase cancer detection rates by artificially increasing the prevalence.7 However, by specifically increasing the prevalence of abnormality, there may be inadvertent effects on the detection of subsequent "real" cases.Previous work on the impact on increasing abnormality prevalence on radiologic performance has provided diverse conclusions, with one study suggesting that varying prevalence was unlikely to alter the accuracy of the radiologists, 8 another suggesting increased diagnostic efficacy with increasing prevalence 9 and a further arguing no significant effect.10 A study focusing on prevalence expectation, whilst showing no significant impact on reporting accuracy, did show that visual search, in terms of interpretation time and the number of visual fixations per image, was significantly changed when higher prevalence was expected. …”

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confidence: 99%

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confidence: 99%

“…Previous work on the impact on increasing abnormality prevalence on radiologic performance has provided diverse conclusions, with one study suggesting that varying prevalence was unlikely to alter the accuracy of the radiologists, 8 another suggesting increased diagnostic efficacy with increasing prevalence 9 and a further arguing no significant effect. 10 A study focusing on prevalence expectation, whilst showing no significant impact on reporting accuracy, did show that visual search, in terms of interpretation time and the number of visual fixations per image, was significantly changed when higher prevalence was expected.…”

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confidence: 99%

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Assessing the effect of a true-positive recall case in screening mammography: does perceptual priming alter radiologists' performance?

Lewis

Mello‐Thoms²,

Brennan³

et al. 2014

BJR

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Objective: To measure the effect of the insertion of lessdifficult malignant cases on subsequent breast cancer detection by breast imaging radiologists. Methods: The research comprises two studies. Study 1: 8 radiologists read 2 sets of images each consisting of 40 mammographic cases. Set A contained four abnormal cases, and Set B contained six abnormal cases, including two priming cases (less difficult malignancies) placed at intervals of three and five subsequent cases before a subtle cancer. Study 2: 16 radiologists read a third condition of the same cases, known as Set C, containing six abnormal cases and two priming cases immediately preceding the subtle cancer cases. The readers were asked to localize malignancies and give confidence ratings on decisions. Results: Although not significant, a decrease in performance was observed in Set B compared with in Set A.There was a significant increase in the receiver operating characteristic (ROC) area under the curve (z 5 22.532; p 5 0.0114) and location sensitivity (z 5 22.128; p 5 0.0333) between the first and second halves of Set A and a marginal improvement in jackknife free-response ROC figure of merit (z 5 21.89; p 5 0.0587) between the first and second halves of Set B. In Study 2, Set C yielded no significant differences between the two halves of the study. Conclusion: Overall findings show no evidence that priming with lower difficulty malignant cases affects the detection of higher difficulty cancers; however, performance may decrease with priming. Advances in knowledge: This research suggests that inserting additional malignant cases in screening mammography sets as an audit tool may potentially lead to a decrease in performance of experienced breast radiologists.The effectiveness of screening mammography in detecting breast cancer relies heavily on accurate observer performance; 1 however, miss rates of 10-30% have been reported. 2,3 The challenge for radiologists is to gain comprehensive experience in the appearance of abnormality and keep their recall rate within acceptable limits given the low incidence of the disease. [4][5][6] It has been proposed that the insertion of "test malignant cases" into a "real life" clinical screening mammography set may increase cancer detection rates by artificially increasing the prevalence.7 However, by specifically increasing the prevalence of abnormality, there may be inadvertent effects on the detection of subsequent "real" cases.Previous work on the impact on increasing abnormality prevalence on radiologic performance has provided diverse conclusions, with one study suggesting that varying prevalence was unlikely to alter the accuracy of the radiologists, 8 another suggesting increased diagnostic efficacy with increasing prevalence 9 and a further arguing no significant effect.10 A study focusing on prevalence expectation, whilst showing no significant impact on reporting accuracy, did show that visual search, in terms of interpretation time and the number of visual fixations per image, was significantly changed w...

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“…20 It states that the results of a study may be affected by the case mix, particularly when study and clinical populations have different proportions of negative cases. 21 In our study, the prevalence rate of cervical spine fracture was 52%, considerably greater than in clinical practice.…”

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confidence: 99%

Fracture Detection in the Cervical Spine with Multidetector CT: 1-mm versus 3-mm Axial Images

Phal¹,

Riccelli²,

Wang³

et al. 2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Multidetector CT imaging of the cervical spine performed with submillimeter collimation allows for the production of excellent quality multiplanar reformations and reconstructed axial images at any chosen section thickness. Currently there is no consensus on what images need to be reviewed for accurate diagnosis of cervical spine fractures. Our study assesses whether 1-mm axial images provide any diagnostic advantage over 3-mm images in detection of cervical spine fractures when read in conjunction with multiplanar reformations.

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From the laboratory to the clinic

Cited by 24 publications

References 8 publications

Observer Performance in Computed Tomography Head Reporting

Observer Performance in Computed Tomography Head Reporting

Assessing the effect of a true-positive recall case in screening mammography: does perceptual priming alter radiologists' performance?

Fracture Detection in the Cervical Spine with Multidetector CT: 1-mm versus 3-mm Axial Images

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