RATIONALE AND OBJECTIVES: The Mammography Quality Standards Act requires practices to measure limited aspects of their performance. The authors conducted this study to calculate the differences in measurements of sensitivity and specificity due only to differences in the definitions used in the analysis. This included definitions for case inclusion. MATERIALS AND METHODS: Data from the New Mexico Mammography Project for January 1991 to December 1995 on 136,540 women who underwent screening mammography were analyzed. A starting definition was created for each performance measure. The components of the definition were varied, and estimates of sensitivity and specificity for the different definitions were calculated. RESULTS: Sensitivity was lower and specificity was higher when assessed on the basis of the results of all imaging performed in the screening work-up rather than on the initial screening examination alone. Sensitivity was higher and specificity was lower in women who did not undergo rather than in women who did recently undergo a previous examination. When the definition of a positive examination included cases that were recommended for short-term follow-up, the work-up sensitivity was slightly higher and the work-up specificity was considerably lower. Longer follow-up times for determining the diagnosis of cancer were associated with decreasing sensitivity, particularly when the follow-up period extended beyond 12 months. CONCLUSION: Variations in the operational definitions for measures of mammographic performance affect these estimates. To facilitate valid comparisons, reports need to be explicit regarding the definitions and methods used.
RATIONALE AND OBJECTIVES: The Mammography Quality Standards Act requires practices to measure limited aspects of their performance. The authors conducted this study to calculate the differences in measurements of sensitivity and specificity due only to differences in the definitions used in the analysis. This included definitions for case inclusion. MATERIALS AND METHODS: Data from the New Mexico Mammography Project for January 1991 to December 1995 on 136,540 women who underwent screening mammography were analyzed. A starting definition was created for each performance measure. The components of the definition were varied, and estimates of sensitivity and specificity for the different definitions were calculated. RESULTS: Sensitivity was lower and specificity was higher when assessed on the basis of the results of all imaging performed in the screening work-up rather than on the initial screening examination alone. Sensitivity was higher and specificity was lower in women who did not undergo rather than in women who did recently undergo a previous examination. When the definition of a positive examination included cases that were recommended for short-term follow-up, the work-up sensitivity was slightly higher and the work-up specificity was considerably lower. Longer follow-up times for determining the diagnosis of cancer were associated with decreasing sensitivity, particularly when the follow-up period extended beyond 12 months. CONCLUSION: Variations in the operational definitions for measures of mammographic performance affect these estimates. To facilitate valid comparisons, reports need to be explicit regarding the definitions and methods used.
Authors: William E Barlow; Chen Chi; Patricia A Carney; Stephen H Taplin; Carl D'Orsi; Gary Cutter; R Edward Hendrick; Joann G Elmore Journal: J Natl Cancer Inst Date: 2004-12-15 Impact factor: 13.506
Authors: Nicole Urban; Gary M Longton; Andrea D Crowe; Mariann J Drucker; Constance D Lehman; Susan Peacock; Kimberly A Lowe; Steve B Zeliadt; Marcia A Gaul Journal: Acad Radiol Date: 2007-09 Impact factor: 3.173
Authors: Bonnie C Yankaskas; Sebastien Haneuse; Julie M Kapp; Karla Kerlikowske; Berta Geller; Diana S M Buist Journal: J Natl Cancer Inst Date: 2010-05-03 Impact factor: 13.506
Authors: Bonnie C Yankaskas; Ryan C May; Jeanine Matuszewski; J Michael Bowling; Molly P Jarman; Bruce F Schroeder Journal: Radiology Date: 2011-10-26 Impact factor: 11.105
Authors: Diana S M Buist; Hongyuan Gao; Melissa L Anderson; Tracy Onega; Susan Brandzel; Melissa A Rabelhofer; Susan Carol Bradford; Erin J Aiello Bowles Journal: Prev Med Date: 2017-06-24 Impact factor: 4.018
Authors: Diana S M Buist; Linn A Abraham; William E Barlow; Arun Krishnaraj; Regan C Holdridge; Edward A Sickles; Patricia A Carney; Karla Kerlikowske; Berta M Geller Journal: Breast Cancer Res Treat Date: 2010-08-11 Impact factor: 4.872
Authors: Erin J Aiello Bowles; Diana L Miglioretti; Edward A Sickles; Linn Abraham; Patricia A Carney; Bonnie C Yankaskas; Joann G Elmore Journal: AJR Am J Roentgenol Date: 2008-05 Impact factor: 3.959