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

S J Lewis; C R Mello-Thoms; P C Brennan; W Lee; A Tan; M F McEntee; M Evanoff; M Pietrzyk; W M Reed

doi:10.1259/bjr.20140029

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

Journal article

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

S J Lewis, C R Mello-Thoms, P C Brennan, W Lee, A Tan, M F McEntee, M Evanoff, M Pietrzyk and W M Reed

British journal of radiology, Vol.87(1039), pp.20140029-20140029

07/2014

DOI: 10.1259/bjr.20140029

PMCID: PMC4075586

PMID: 24814694

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Abstract

To measure the effect of the insertion of less-difficult malignant cases on subsequent breast cancer detection by breast imaging radiologists. 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. 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 = -2.532; p = 0.0114) and location sensitivity (z = -2.128; p = 0.0333) between the first and second halves of Set A and a marginal improvement in jackknife free-response ROC figure of merit (z = -1.89; p = 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. 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. 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.

Clinical Competence

Mental Recall

Diagnostic Errors - prevention & control

Humans

Mammography - standards

Sensitivity and Specificity

Repetition Priming

Female

Perception

ROC Curve

Breast Neoplasms - diagnostic imaging

Task Performance and Analysis

Details

Title: Subtitle: Assessing the effect of a true-positive recall case in screening mammography: does perceptual priming alter radiologists' performance?
Creators: S J Lewis - 1 Medical Imaging Optimisation and Perception Group (MIOPeG), Discipline of Medical Radiation Sciences, Lidcombe, Faculty of Health Science, The University of Sydney, NSW, Australia
C R Mello-Thoms
P C Brennan
W Lee
A Tan
M F McEntee
M Evanoff
M Pietrzyk
W M Reed
Resource Type: Journal article
Publication Details: British journal of radiology, Vol.87(1039), pp.20140029-20140029
DOI: 10.1259/bjr.20140029
PMID: 24814694
PMCID: PMC4075586
NLM abbreviation: Br J Radiol
ISSN: 0007-1285
eISSN: 1748-880X
Publisher: England
Language: English
Date published: 07/2014
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984051597102771

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