Observer Variability in Breast Cancer Diagnosis between Countries with and without Breast Screening

Delgermaa Demchig; Claudia Mello-Thoms; Warwick Lee; Khulan Khurelsukh; Asai Ramish; Patrick Brennan

doi:10.1016/j.acra.2018.03.003

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Observer Variability in Breast Cancer Diagnosis between Countries with and without Breast Screening

Journal article

Peer reviewed

Observer Variability in Breast Cancer Diagnosis between Countries with and without Breast Screening

Delgermaa Demchig, Claudia Mello-Thoms, Warwick Lee, Khulan Khurelsukh, Asai Ramish and Patrick Brennan

Academic radiology, Vol.26(1), pp.62-68

01/2019

DOI: 10.1016/j.acra.2018.03.003

PMID: 29580792

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Abstract

Image reporting is a vital component of patient management depending on individual radiologists' performance. Our objective was to explore mammographic diagnostic efficacy in a country where breast cancer screening does not exist. Two mammographic test sets were used: a typical screening (TS) and high-difficulty (HD) test set. Nonscreening (NS) radiologists (n = 11) read both test sets, while 52 and 49 screening radiologists read the TS and HD test sets, respectively. The screening radiologists were classified into two groups: a less experienced (LE) group with ≤5 years' experience and a more experienced (ME) group with ≥5 years' experience. A Kruskal–Wallis and Tukey–Kramer post hoc test were used to compare reading performance among reader groups, and the Wilcoxon matched pairs tests was used to compare TS and ND test sets for the NS radiologists. Across the three reader groups, there were significant differences in case sensitivity (χ2 [2] = 9.4, P = .008), specificity (χ2 [2] = 10.3, P = .006), location sensitivity (χ2 [2] = 19.8, P < .001), receiver operating characteristics, area under the curve (χ2 [2] = 19.7, P < .001) and jack-knife free-response receiver operating characteristics (JAFROCs) (χ2 [2] = 18.1, P < .001). NS performance for all measured scores was significantly lower than those for the ME readers (P < .006), while only location sensitivity was lower (χ2 [2] = 17.5, P = .026) for the NS compared to the LE group. No other significant differences were observed. Large variations in mammographic performance exist between radiologists from screening and nonscreening countries.

Breast cancer

observer variability

developing country

reader performance

mammographic screening

Details

Title: Subtitle: Observer Variability in Breast Cancer Diagnosis between Countries with and without Breast Screening
Creators: Delgermaa Demchig - Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia
Claudia Mello-Thoms - Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia
Warwick Lee - Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia
Khulan Khurelsukh - Department of Diagnostic Radiology, The Intermed Hospital, Ulaanbaatar, Mongolia
Asai Ramish - Department of Diagnostic Radiology, National Cancer Center of Mongolia, Ulaanbaatar, Mongolia
Patrick Brennan - Medical Image Perception and Optimization Group (MIOPeG), Medical Radiation Science, Faculty of Health Science, The University of Sydney, PO Box 170, Lidcombe, NSW 2141, Australia
Resource Type: Journal article
Publication Details: Academic radiology, Vol.26(1), pp.62-68
Publisher: Elsevier Inc
DOI: 10.1016/j.acra.2018.03.003
PMID: 29580792
ISSN: 1076-6332
eISSN: 1878-4046
Language: English
Date published: 01/2019
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984051726902771

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