The influence of clinical information on the accuracy of diagnostic mammography

Houssami, Nehmat; Irwig, Les; Simpson, Judy M.; McKessar, Merran; Blome, Steven; Noakes, Jennie

doi:10.1023/b:brea.0000025416.66632.84

Cited by 41 publications

(35 citation statements)

References 8 publications

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“…For instance, collateral clinical information may not be available for out-of-network patients whose medical data do not reside in the institutional electronic health record. Studies have demonstrated that insufficient clinical data available to the interpreting radiologist (ie, either cryptic or incorrect information) at the point of care increases the likelihood of a diagnostic miss [16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Harvey

Tomov²,

Babayan³

et al. 2016

Journal of the American College of Radiology

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Section: Discussionmentioning

confidence: 99%

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Harvey

Tomov²,

Babayan³

et al. 2016

Journal of the American College of Radiology

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“…Sites received institutional review board approval for study activities and for protection of the identities of women, to understanding variability in the interpretive performance of diagnostic mammography in community-based settings. Despite studies in which researchers considered characteristics at the level of the woman and mammogram ( 1,(3)(4)(5)(6)(7)(8), radiologist ( 9,10 ), and facility ( 11-13 ), broad unexplained variation remains in the performance of diagnostic mammography ( 1,9 ).…”

Section: Discussionmentioning

confidence: 99%

Mammographic Interpretive Volume and Diagnostic Mammogram Interpretation Performance in Community Practice

Haneuse¹,

Buist²,

Miglioretti³

et al. 2012

Radiology

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Purpose:To investigate the association between radiologist interpretive volume and diagnostic mammography performance in community-based settings. Materials and Methods:This study received institutional review board approval and was HIPAA compliant. A total of 117 136 diagnostic mammograms that were interpreted by 107 radiologists between 2002 and 2006 in the Breast Cancer Surveillance Consortium were included. Logistic regression analysis was used to estimate the adjusted effect on sensitivity and the rates of false-positive fi ndings and cancer detection of four volume measures: annual diagnostic volume, screening volume, total volume, and diagnostic focus (percentage of total volume that is diagnostic). Analyses were stratifi ed by the indication for imaging: additional imaging after screening mammography or evaluation of a breast concern or problem. Results:Diagnostic volume was associated with sensitivity; the odds of a true-positive fi nding rose until a diagnostic volume of 1000 mammograms was reached; thereafter, they either leveled off ( P , .001 for additional imaging) or decreased ( P = .049 for breast concerns or problems) with further volume increases. Diagnostic focus was associated with false-positive rate; the odds of a false-positive fi nding increased until a diagnostic focus of 20% was reached and decreased thereafter ( P , .024 for additional imaging and P , .001 for breast concerns or problems with no selfreported lump). Neither total volume nor screening volume was consistently associated with diagnostic performance. Conclusion:Interpretive volume and diagnostic performance have complex multifaceted relationships. Our results suggest that diagnostic interpretive volume is a key determinant in the development of thresholds for considering a diagnostic mammogram to be abnormal. Current volume regulations do not distinguish between screening and diagnostic mammography, and doing so would likely be challenging.q RSNA, 2011 Supplemental material: http://radiology.rsna.org/lookup /suppl

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“…A false-negative (FN) diagnosis due to a perception or cognitive error is a recognised problem [1]. Evidence from earlier eye-tracking experiments using chest images reveals that most radiologists do not follow a systematic search strategy [2,3], and interpretation of these images can be influenced significantly by the clinical information provided by referrers [4][5][6][7]. Clinical information is provided as a guide for patient diagnosis and can be disease specific, symptom specific, location specific or a combination of these.…”

Section: Introductionmentioning

confidence: 99%

Does Expectation of Abnormality Affect the Search Pattern of Radiologists When Looking for Pulmonary Nodules?

et al. 2016

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This experiment investigated whether there might be an effect on the visual search strategy of radiologists during image interpretation of the same adult chest radiographs when given different clinical information. Each of 17 experienced radiologists was asked to interpret a set of 57 (10 abnormal) posteroanterior chest images to identify the presence of pulmonary lesions using differing clinical information (leading to unknown, low and high expectations of prevalence). Eye position metrics (search time, dwell time and time to first fixation) were compared for normal and abnormal images, as well as between conditions. For all images, there was a significantly longer search time at high prevalence expectation compared to low prevalence expectation (W = 75.19, P = <0.0001). Mann-Whitney analysis of the abnormal images demonstrated that the dwell time on correctly identified lesions was significantly shorter at low prevalence expectation compared to both unknown (U = 364.5, P = 0.02) and high prevalence expectation (U = 397.0, P = 0.0002). Visual search patterns of radiologists appear to be affected by changing a priori information where such information fosters an expectation of abnormality.

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The influence of clinical information on the accuracy of diagnostic mammography

Abstract: Our findings support the provision of clinical information relating to patients' presentation to radiologists reporting diagnostic mammography.

Cited by 41 publications

References 8 publications

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Radiology Malpractice Claims in the United States From 2008 to 2012: Characteristics and Implications

Mammographic Interpretive Volume and Diagnostic Mammogram Interpretation Performance in Community Practice

Does Expectation of Abnormality Affect the Search Pattern of Radiologists When Looking for Pulmonary Nodules?

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