TY - JOUR
T1 - Optimizing the Pairs of Radiologists That Double Read Screening Mammograms
AU - Gommers, Jessie J.J.
AU - Abbey, Craig K.
AU - Strand, Fredrik
AU - Taylor-Phillips, Sian
AU - Jenkinson, David J.
AU - Larsen, Marthe
AU - Hofvind, Solveig
AU - Sechopoulos, Ioannis
AU - Broeders, Mireille J.M.
N1 - Funding Information:
This research is supported by KWF Kankerbestrijding and NWO Domain AES, as part of their joint strategic research program Technology for Oncology II. The collaboration project is co-funded by the PPP Allowance made available by Health-Holland, Top Sector Life Sciences & Health, to stimulate public-private partnerships. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by Cancer Registry of Norway is intended nor should be inferred.
Funding Information:
Acknowledgements: The CSAW data set was provided by Fredrik Strand, MD, PhD, and has been approved by the regional ethical review board for research. The CO-OPS data set, funded by an NIHR Postdoctoral Fellowship and an NIHR Career Development Fellowship (CDF-2016-09-018), was provided by Sian Taylor-Phillips, PhD, and David Jenkinson, PhD. The data set from BreastScreen Norway was disclosed with legal bases in the Cancer Registry of Norway regulations and provided by Solveig Hofvind, PhD, and Marthe Larsen, MSc.
Funding Information:
Disclosures of conflicts of interest: J.J.J.G. No relevant relationships. C.K.A. Consultant at Canon Medical; advisory board member for Izotropic. F.S. Payment for lectures from Lunit; president of the Research and Education Committee of the Swedish Society of Breast Imaging. S.T.P. Funded by an NIHR Postdoctoral Fellowship and an NIHR Career Development Fellowship (CDF-2016-09-018). D.J.J. Grants from the National Institute of Health and Care Research. M.L. No relevant relationships. S.H. Head of BreastScreen Norway. I.S. Grants or grants pending from Siemens Healthcare, Canon Medical, ScreenPoint Medical, Sectra Benelux, Hologic, Volpara Solutions, Lunit, and iCAD; payment for lectures including service on speakers’ bureaus from Siemens Healthcare; member of the scientific advisory board of Koning; member of the Radiology editorial board. M.J.M.B. Grants or grants pending from ScreenPoint Medical, Sectra Benelux, Hologic, Volpara Solutions, Lunit, and iCAD; personal speaker fees from Hologic and Siemens Healthcare.
Publisher Copyright:
© RSNA, 2023.
PY - 2023/10
Y1 - 2023/10
N2 - Despite variation in performance characteristics among radiologists, the pairing of radiologists for the double reading of screening mammograms is performed randomly. It is unknown how to optimize pairing to improve screening performance. Purpose: To investigate whether radiologist performance characteristics can be used to determine the optimal set of pairs of radiologists to double read screening mammograms for improved accuracy. Materials and Methods: This retrospective study was performed with reading outcomes from breast cancer screening programs in Sweden (2008-2015), England (2012-2014), and Norway (2004-2018). Cancer detection rates (CDRs) and abnormal interpretation rates (AIRs) were calculated, with AIR defined as either reader flagging an examination as abnormal. Individual readers were divided into performance categories based on their high and low CDR and AIR. The performance of individuals determined the classification of pairs. Random pair performance, for which any type of pair was equally represented, was compared with the performance of specific pairing strategies, which consisted of pairs of readers who were either opposite or similar in AIR and/or CDR. Results: Based on a minimum number of examinations per reader and per pair, the final study sample consisted of 3 592 414 examinations (Sweden, n = 965 263; England, n = 837 048; Norway, n = 1 790 103). The overall AIRs and CDRs for all specific pairing strategies (Sweden AIR range, 45.5-56.9 per 1000 examinations and CDR range, 3.1-3.6 per 1000; England AIR range, 68.2-70.5 per 1000 and CDR range, 8.9-9.4 per 1000; Norway AIR range, 81.6-88.1 per 1000 and CDR range, 6.1-6.8 per 1000) were not significantly different from the random pairing strategy (Sweden AIR, 54.1 per 1000 examinations and CDR, 3.3 per 1000; England AIR, 69.3 per 1000 and CDR, 9.1 per 1000; Norway AIR, 84.1 per 1000 and CDR, 6.3 per 1000). Conclusion: Pairing a set of readers based on different pairing strategies did not show a significant difference in screening performance when compared with random pairing.
AB - Despite variation in performance characteristics among radiologists, the pairing of radiologists for the double reading of screening mammograms is performed randomly. It is unknown how to optimize pairing to improve screening performance. Purpose: To investigate whether radiologist performance characteristics can be used to determine the optimal set of pairs of radiologists to double read screening mammograms for improved accuracy. Materials and Methods: This retrospective study was performed with reading outcomes from breast cancer screening programs in Sweden (2008-2015), England (2012-2014), and Norway (2004-2018). Cancer detection rates (CDRs) and abnormal interpretation rates (AIRs) were calculated, with AIR defined as either reader flagging an examination as abnormal. Individual readers were divided into performance categories based on their high and low CDR and AIR. The performance of individuals determined the classification of pairs. Random pair performance, for which any type of pair was equally represented, was compared with the performance of specific pairing strategies, which consisted of pairs of readers who were either opposite or similar in AIR and/or CDR. Results: Based on a minimum number of examinations per reader and per pair, the final study sample consisted of 3 592 414 examinations (Sweden, n = 965 263; England, n = 837 048; Norway, n = 1 790 103). The overall AIRs and CDRs for all specific pairing strategies (Sweden AIR range, 45.5-56.9 per 1000 examinations and CDR range, 3.1-3.6 per 1000; England AIR range, 68.2-70.5 per 1000 and CDR range, 8.9-9.4 per 1000; Norway AIR range, 81.6-88.1 per 1000 and CDR range, 6.1-6.8 per 1000) were not significantly different from the random pairing strategy (Sweden AIR, 54.1 per 1000 examinations and CDR, 3.3 per 1000; England AIR, 69.3 per 1000 and CDR, 9.1 per 1000; Norway AIR, 84.1 per 1000 and CDR, 6.3 per 1000). Conclusion: Pairing a set of readers based on different pairing strategies did not show a significant difference in screening performance when compared with random pairing.
KW - n/a OA procedure
KW - NLA
UR - http://www.scopus.com/inward/record.url?scp=85175128110&partnerID=8YFLogxK
U2 - 10.1148/radiol.222691
DO - 10.1148/radiol.222691
M3 - Article
C2 - 37874241
AN - SCOPUS:85175128110
SN - 0033-8419
VL - 309
SP - e222691
JO - Radiology
JF - Radiology
IS - 1
M1 - e222691
ER -
