Survey of Radiology Residents: Breast Imaging Training and Attitudes

Bassett, Lawrence W.; Monsees, Barbara; Smith, Robert A.; Wang, Lily; Hooshi, Parizad; Farria, Dione M.; Sayre, James W.; Feig, Stephen A.; Jackson, Valerie P.

doi:10.1148/radiol.2273020046

Cited by 78 publications

(49 citation statements)

References 10 publications

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“…The focus group selected eight factors considered to be the most significant. In this case, the scale ranged from (1) "Totally irrelevant" to (5) "Highly relevant".…”

Section: Methodsmentioning

confidence: 99%

“…Litigation as a stress factor for physicians was identified as early as the end of the 1980s by US researchers [2]. Recent studies have shown how the fear of litigation can influence physicians' behaviour and their professional decisions [3][4][5]. We therefore felt the need to perform a study in Italy regarding the consequences that compensation claims for civil liability and criminal proceedings have on the well-being and professional conduct of radiologists.…”

Section: Introductionmentioning

confidence: 99%

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Malpractice stress syndrome in radiologists and radiotherapists: perceived causes and consequences

Fileni

Magnavita

Mammì³

et al. 2007

Radiol med

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“…The focus group selected eight factors considered to be the most significant. In this case, the scale ranged from (1) "Totally irrelevant" to (5) "Highly relevant".…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Malpractice stress syndrome in radiologists and radiotherapists: perceived causes and consequences

Fileni

Magnavita

Mammì³

et al. 2007

Radiol med

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“…7 Concern of malpractice liability is also a presence among Canadian radiologists, as 72% of a population of surveyed radiology residents expressed a strong concern of mammography-specific malpractice risk when compared with other imaging examinations. 51 Elmore et al 7 surveyed 124 US radiologists in an effort to assess the relationship between radiologists experience with diagnosisspecific malpractice in the mammography setting and their recall rates subsequent to those experiences. Prior involvement in a mammography-related medical malpractice case did not increase the recall rate or FP rate above that observed in those who were not involved in prior litigation claims.…”

Section: Screening Protocolmentioning

confidence: 99%

Is the false-positive rate in mammography in North America too high?

Le¹,

Mothersill²,

Seymour³

et al. 2016

BJR

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The practice of investigating pathological abnormalities in the breasts of females who are asymptomatic is primarily employed using X-ray mammography. The importance of breast screening is reflected in the mortality-based benefits observed among females who are found to possess invasive breast carcinoma prior to the manifestation of clinical symptoms. It is estimated that population-based screening constitutes a 17% reduction in the breast cancer mortality rate among females affected by invasive breast carcinoma. In spite of the significant utility that screening confers in those affected by invasive cancer, limitations associated with screening manifest as potential harms affecting individuals who are free of invasive disease. Disease-free and benign tumour-bearing individuals who are subjected to diagnostic work-up following a screening examination constitute a population of cases referred to as false positives (FPs). This article discusses factors contributing to the FP rate in mammography and extends the discussion to an assessment of the consequences associated with FP reporting. We conclude that the mammography FP rate in North America is in excess based upon the observation of overtreatment of in situ lesions and the disproportionate distribution of detriment and benefit among the population of individuals recalled for diagnostic work-up subsequent to screening. To address the excessive incidence of FPs in mammography, we investigate solutions that may be employed to remediate the current status of the FP rate. Subsequently, it can be suggested that improvements in the breast-screening protocol, medical litigation risk, image interpretation software and the implementation of image acquisition modalities that overcome superimposition effects are promising solutions.

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“…The more screening exams a radiologist interprets, the more accurate she is likely to be [8], but one survey of radiology residents found that they desired to spend less than one-quarter of their time on breast imaging [9]. The high rate of litigation and lower rate of compensation associated with this area of the specialty have been offered as possible reasons for decreased interest in breast imaging [4].…”

Section: Personnelmentioning

confidence: 99%

Mammography Quality Standards Act: Gains and Losses in Women's Health Care

2007

AMA Journal of Ethics

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Mammography is one of the best ways to detect breast cancer early enough that treatment can be expected to lead to good outcomes. And because breast cancer is the leading non-skin cancer in women and the second most common cause of cancerrelated mortality in women [1], encouraging regular mammograms is an excellent preventive strategy.At least in part because of the increased demand for breast imaging, the federal government has taken a marked interest in mammography services. Congress passed the Mammography Quality Standards Act (MQSA) in 1992 to better regulate the field of breast imaging. Specifically, the act sought to correct four areas of concern: (1) poor quality equipment, (2) a lack of quality assurance procedures, (3) poorly trained radiologic technologists and interpreting physicians, and (4) a lack of facility inspections or consistent governmental oversight [2].Whether or not the MQSA has succeeded in resolving these problems in mammography remains an open question-there have been clear gains and losses in breast imaging as a result of the act. This commentary will discuss several of these. Standards and AccessPrior to the implementation of the MQSA, the quality of breast imaging varied greatly by geography. Accreditation programs at the time were strictly voluntary; only half of all mammography facilities had applied for accreditation by 1991, and only half of those that applied had earned accreditation [3]. Many of the failures had to do with substandard equipment that produced images that were difficult to interpret correctly. As a result of the MQSA, equipment had to be upgraded or replaced to meet federal standards for image quality. Ensuring a high-quality image reduces the number of scans women must endure and enables physicians to report findings more accurately. Therefore, many believe that the MQSA improved the standard of care for women having mammograms.Of course, an increase in the standard did not come without cost. Mammography facilities that could not meet the equipment or personnel requirements were forced to close or merge with others. Often financial considerations drove these changes. There is some evidence of long wait times for patients to access mammography services [4], but it is not clear whether there was a significant decrease in overall

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Survey of Radiology Residents: Breast Imaging Training and Attitudes

Abstract: Residency training in breast imaging has improved in terms of time and curriculum. However, a majority of the residents would not consider a fellowship and did not want to interpret mammograms in their future practices.

Cited by 78 publications

References 10 publications

Malpractice stress syndrome in radiologists and radiotherapists: perceived causes and consequences

Malpractice stress syndrome in radiologists and radiotherapists: perceived causes and consequences

Is the false-positive rate in mammography in North America too high?

Mammography Quality Standards Act: Gains and Losses in Women's Health Care

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