We propose to expand upon a national survey of the interpretations given to mammograms. The previous study considered the interpretation of screening mammograms. The proposed study will examine the diagnostic interpretation of mammograms. As in the previous study, the proposed study will precisely estimate determinants of the variability in, and the accuracy of, radiologists' diagnostic interpretation of mammograms. The proposed study is a natural and logical extension of the screening study. Based on the study results, and with the participation of a distinguished national advisory panel, we will attempt to develop recommendations for potential public health interventions and intervention targets to improve the effectiveness of diagnostic mammogram interpretation. The study will use mammography films randomly sampled from a typical screening program with disease status determined before sampling by biopsy or long-term follow-up. Some of these films were read in the survey of screening mammogram interpretation. The films and additional work-up will be interpreted by the same radiologists who participated in the survey of screening interpretation. These radiologists had been randomly sampled from facilities accredited by the FDA as of January 1998. Regression models for ROC curves will be used to relate variability in interpretation and diagnostic accuracy as functions of radiologist and case characteristics. Using the paired data from both surveys, we will test whether skill in screening mammogram interpretation equates to skill in diagnostic mammogram interpretation. We will also estimate the improvement in accuracy that is generated by additional work-up. Our sampling design and statistical methods will minimize and control for possible biases coming from self-selection by radiologists.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
2R01CA074110-06
Application #
6132509
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Gohagan, John K
Project Start
1997-05-07
Project End
2001-07-31
Budget Start
2000-06-16
Budget End
2001-04-30
Support Year
6
Fiscal Year
2000
Total Cost
$538,548
Indirect Cost
Name
Medical College of Wisconsin
Department
Radiation-Diagnostic/Oncology
Type
Schools of Medicine
DUNS #
073134603
City
Milwaukee
State
WI
Country
United States
Zip Code
53226
Beam, Craig A; Conant, Emily F; Sickles, Edward A et al. (2003) Evaluation of proscriptive health care policy implementation in screening mammography. Radiology 229:534-40
Beam, Craig A; Conant, Emily F; Sickles, Edward A (2003) Association of volume and volume-independent factors with accuracy in screening mammogram interpretation. J Natl Cancer Inst 95:282-90