Radiographers as film readers in screening mammography: an assessment of competence under test and screening conditions

Pauli, Regina; Hammond, Seán; Cooke, Julie; Ansell, Janet

doi:10.1259/0007-1285-69-817-10

Cited by 53 publications

(35 citation statements)

References 11 publications

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“…Yet when one considers that these radiographers have not had any formal training when reporting on images, it can be surmised that these rates could increase following an organised training program 38 leading to less FPs. With a high NPV, it is clear the radiographers were confident in determining negative images.…”

Section: Resultsmentioning

confidence: 99%

Radiographers' ability to perceive and classify abnormalities on mammographic images — results of a pilot project

Holt

Pollard

2010

Radiographer

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Purpose: The literature indicates that image interpretation as a developing role for radiographers is becoming more popular overseas. However, little is known about the ability of Australian radiographers to interpret radiographic images. The aim of this study is to provide pilot data to determine how well radiographers, without formal image interpretation training, can read mammograms. Methods: Twelve radiographers employed by the BreastScreen Queensland screening service were divided into two equal groups based on years of mammographic imaging experience. Each participant was asked to interpret a purposive image set containing 60 two-view primary screening bilateral mammographic images. The participants were asked to determine if an abnormality was perceived, indicate the location on a breast diagram and then classify the image set according to a 5 point scale; no specific finding, benign finding, probably benign finding, probably malignant finding, highly suggestive of malignancy. Sensitivity and specificity rates for each group was calculated and compared. Results: Compared to the "Gold Standard" outcomes, the sensitivity of Group A in detecting abnormalities which had resulted in a positive screening result was 82.6% as compared to Group B at 77.5%. Specificity demonstrated Group B higher than A: 79.6% compared to 75.4 %. These results were minimally lower than those found in overseas studies. Conclusion: The results indicate that further work in this area is justified to support the training and role development of radiographers in the formal reporting role of screening mammograms.

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Section: Resultsmentioning

confidence: 99%

Radiographers' ability to perceive and classify abnormalities on mammographic images — results of a pilot project

Holt

Pollard

2010

Radiographer

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“…In the setting of an increased workload for radiologists, this alternative working practice, known as skill mixing, has been explored in many studies [16][17][18][19][20][21]. A systematic review showed that technologists could be as sensitive as radiologists in detecting breast malignancies, but with higher false-positive rates [22].…”

Section: Introductionmentioning

confidence: 99%

Computer-aided detection in full-field digital mammography in a clinical population: performance of radiologist and technologists

Biggelaar

Kessels

Engelshoven

et al. 2009

Breast Cancer Res Treat

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The purpose of the study was to evaluate the impact of a computer-aided detection (CAD) system on the performance of mammogram readers in interpreting digital mammograms in a clinical population. Furthermore, the ability of a CAD system to detect breast cancer in digital mammography was studied in comparison to the performance of radiologists and technologists as mammogram readers. Digital mammograms of 1,048 consecutive patients were evaluated by a radiologist and three technologists. Abnormalities were recorded and an imaging conclusion was given as a BI-RADS score before and after CAD analysis. Pathology results during 12 months follow up were used as a reference standard for breast cancer. Fifty-one malignancies were found in 50 patients. Sensitivity and specificity were computed before and after CAD analysis and provided with 95% CIs. In order to assess the detection rate of malignancies by CAD and the observers, the pathological locations of these 51 breast cancers were matched with the locations of the CAD marks and the mammographic locations that were considered to be suspicious by the observers. For all observers, the sensitivity rates did not change after application of CAD. A mean sensitivity of 92% was found for all technologists and 84% for the radiologist. For two technologists, the specificity decreased (from 84 to 83% and from 77 to 75%). For the radiologist and one technologist, the application of CAD did not have any impact on the specificity rates (95 and 83%, respectively). CAD detected 78% of all malignancies. Five malignancies were indicated by CAD without being noticed as suspicious by the observers. In conclusion, the results show that systematic application of CAD in a clinical patient population failed to improve the overall sensitivity of mammogram interpretation by the readers and was associated with an increase in false-positive results. However, CAD marked five malignancies that were missed by the different readers.

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“…(1) Hillman et al (2) in the USA were the first to suggest using non-medical personnel to supplement the mammography image interpretation (MII) workforce and in the UK pilot schemes to train radiographers to interpret and report screening mammograms were first initiated in the 1990s. (3)(4)(5)(6) Radiographers in the UK have now been involved in MII for over 20 years. In 1995 they had a formal MII role in 6% (6/103) National Health Service Breast Screening Programme (NHSBSP) units (7) and by 2008, 205 (69.7%) of the 10 consultant and 284 (260 qualified and 24 trainee) advanced practitioner radiographers working in the NHSBSP interpreted mammography images.…”

Section: Introductionmentioning

confidence: 99%

Radiographer involvement in mammography image interpretation: A survey of United Kingdom practice

Culpan

2016

Radiography

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Breast cancer is most often diagnosed using x-ray mammography. Traditionally mammography images have been interpreted and reported by medically qualified practitioners -radiologists. Due to radiologist workforce shortages in recent years some nonmedical practitioners, radiographers, now interpret and report mammography images. The aims of this survey were to describe the characteristics and practices of radiographers who interpret and report mammography images in NHS hospitals in the UK, and in particular to establish the extent of their practice beyond low-risk asymptomatic screening cases.This service evaluation demonstrated that UK radiographers are interpreting and reporting images across the full spectrum of clinical indications for mammography including: low-risk population screening, symptomatic, annual surveillance, family history and biopsy / surgical cases. The survey revealed that radiographers are involved in a diverse range of single and double reading practices where responsibility for diagnostic decision making is shared or transferred between radiologists and / or other radiographers. Comparative analysis of subgroup data suggested that there might be differences in the characteristics and practices of radiographers who interpret only low-risk screening mammograms and those who interpret and report a wider range of cases.The findings of this survey provide a platform for further research to investigate how and why the roles and responsibilities of radiographers who interpret and report mammograms vary between organisations, between practitioners and across different examinations. Further research is also needed to explore the implications of variation in practice for patients, practitioners and service providers. Highlights UK radiographers interpret mammograms across the full spectrum of clinical indications  UK radiographers are involved in a wide range of single / double mammography reading practices  Characteristics required for screen reading may differ from those for interpreting other cases  Further research is required to explore variation in practice across organisations and individuals  Further research is required to identify patient and service consequences of variation in practice

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Radiographers as film readers in screening mammography: an assessment of competence under test and screening conditions

Cited by 53 publications

References 11 publications

Radiographers' ability to perceive and classify abnormalities on mammographic images — results of a pilot project

Radiographers' ability to perceive and classify abnormalities on mammographic images — results of a pilot project

Computer-aided detection in full-field digital mammography in a clinical population: performance of radiologist and technologists

Radiographer involvement in mammography image interpretation: A survey of United Kingdom practice

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