The goal of this research is to identify reasons for variability in the interpretation of mammograms. Though previous studies have shown marked interpretive variation, they did not explain why it occurs and they used test sets that do not necessarily reflect what occurs in day-to-day community practices. This community-based, multicenter observational study will utilize a unique collaboration among three geographically distinct breast cancer surveillance programs in the states of Washington, New Hampshire, and Colorado. This collaboration will allow the investigators to accumulate breast cancer outcome and interpretive data on more than 500,000 mammograms from 91 facilities and 279 radiologists. The investigators will evaluate potential factors influencing the accuracy and recall rates of mammography using a structured conceptual framework that separates characteristics of the radiologists from those of the facility and community environment. The investigators hypothesize that the fiscal, legal, and community practice environment and personal characteristics of the radiologist influence variability in the accuracy of mammography and the likelihood of having patients recalled for additional evaluation. Gaining a better understanding of how individual radiologists and their practice environment account for variation will help identify ways to improve mammography.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Project (R01)
Project #
5R01HS010591-03
Application #
6528218
Study Section
Health Care Technology and Decision Science (HTDS)
Program Officer
Benns, Jenae
Project Start
2000-09-01
Project End
2005-08-31
Budget Start
2002-09-01
Budget End
2005-08-31
Support Year
3
Fiscal Year
2002
Total Cost
Indirect Cost
Name
University of Washington
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
135646524
City
Seattle
State
WA
Country
United States
Zip Code
98195
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Haneuse, Sebastien; Buist, Diana S M; Miglioretti, Diana L et al. (2012) Mammographic interpretive volume and diagnostic mammogram interpretation performance in community practice. Radiology 262:69-79
Cook, Andrea J; Elmore, Joann G; Miglioretti, Diana L et al. (2010) Decreased accuracy in interpretation of community-based screening mammography for women with multiple clinical risk factors. J Clin Epidemiol 63:441-51
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Jackson, Sara L; Taplin, Stephen H; Sickles, Edward A et al. (2009) Variability of interpretive accuracy among diagnostic mammography facilities. J Natl Cancer Inst 101:814-27
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Aiello Bowles, Erin J; Miglioretti, Diana L; Sickles, Edward A et al. (2008) Accuracy of short-interval follow-up mammograms by patient and radiologist characteristics. AJR Am J Roentgenol 190:1200-8
Puggioni, Gavino; Gelfand, Alan E; Elmore, Joann G (2008) Joint modeling of sensitivity and specificity. Stat Med 27:1745-61
Taplin, Stephen; Abraham, Linn; Barlow, William E et al. (2008) Mammography facility characteristics associated with interpretive accuracy of screening mammography. J Natl Cancer Inst 100:876-87
Carney, Patricia A; Yi, Joyce P; Abraham, Linn A et al. (2007) Reactions to uncertainty and the accuracy of diagnostic mammography. J Gen Intern Med 22:234-41

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