OBJECTIVE: Federal regulations mandate that radiologists receive regular albeit limited feedback regarding their interpretive accuracy in mammography. We sought to determine whether radiologists who regularly receive more extensive feedback can report their actual performance in screening mammography accurately. SUBJECTS AND METHODS: Radiologists (n = 105) who routinely interpret screening mammograms in three states (Washington, Colorado, and New Hampshire) completed a mailed survey in 2001. Radiologists were asked to estimate how frequently they recommended additional diagnostic testing after screening mammography and the positive predictive value of their recommendations for biopsy (PPV2). We then used outcomes from 336,128 screening mammography examinations interpreted by the radiologists from 1998 to 2001 to ascertain their true rates of recommendations for diagnostic testing and PPV2. RESULTS: Radiologists' self-reported rate of recommending immediate additional imaging (11.1%) exceeded their actual rate (9.1%) (mean difference, 1.9%; 95% confidence interval [CI], 0.9-3.0%). The mean self-reported rate of recommending short-interval follow-up was 6.2%; the true rate was 1.8% (mean difference, 4.3%; 95% CI, 3.6-5.1%). Similarly, the mean self-reported and true rates of recommending immediate biopsy or surgical evaluation were 3.2% and 0.6%, respectively (mean difference, 2.6%; 95% CI, 1.8-3.4%). Conversely, radiologists' mean self-reported PPV2 (18.3%) was significantly less than their mean true PPV2 (27.6%) (mean difference, -9.3%; 95% CI, -12.4% to -6.2%). CONCLUSION: Despite regular performance feedback, community radiologists may overestimate their true rates of recommending further evaluation after screening mammography and underestimate their true positive predictive value.
OBJECTIVE: Federal regulations mandate that radiologists receive regular albeit limited feedback regarding their interpretive accuracy in mammography. We sought to determine whether radiologists who regularly receive more extensive feedback can report their actual performance in screening mammography accurately. SUBJECTS AND METHODS: Radiologists (n = 105) who routinely interpret screening mammograms in three states (Washington, Colorado, and New Hampshire) completed a mailed survey in 2001. Radiologists were asked to estimate how frequently they recommended additional diagnostic testing after screening mammography and the positive predictive value of their recommendations for biopsy (PPV2). We then used outcomes from 336,128 screening mammography examinations interpreted by the radiologists from 1998 to 2001 to ascertain their true rates of recommendations for diagnostic testing and PPV2. RESULTS: Radiologists' self-reported rate of recommending immediate additional imaging (11.1%) exceeded their actual rate (9.1%) (mean difference, 1.9%; 95% confidence interval [CI], 0.9-3.0%). The mean self-reported rate of recommending short-interval follow-up was 6.2%; the true rate was 1.8% (mean difference, 4.3%; 95% CI, 3.6-5.1%). Similarly, the mean self-reported and true rates of recommending immediate biopsy or surgical evaluation were 3.2% and 0.6%, respectively (mean difference, 2.6%; 95% CI, 1.8-3.4%). Conversely, radiologists' mean self-reported PPV2 (18.3%) was significantly less than their mean true PPV2 (27.6%) (mean difference, -9.3%; 95% CI, -12.4% to -6.2%). CONCLUSION: Despite regular performance feedback, community radiologists may overestimate their true rates of recommending further evaluation after screening mammography and underestimate their true positive predictive value.
Authors: Stephen H Taplin; Laura E Ichikawa; Karla Kerlikowske; Virginia L Ernster; Robert D Rosenberg; Bonnie C Yankaskas; Patricia A Carney; Berta M Geller; Nicole Urban; Mark B Dignan; William E Barlow; Rachel Ballard-Barbash; Edward A Sickles Journal: Radiology Date: 2002-02 Impact factor: 11.105
Authors: R Ballard-Barbash; S H Taplin; B C Yankaskas; V L Ernster; R D Rosenberg; P A Carney; W E Barlow; B M Geller; K Kerlikowske; B K Edwards; C F Lynch; N Urban; C A Chrvala; C R Key; S P Poplack; J K Worden; L G Kessler Journal: AJR Am J Roentgenol Date: 1997-10 Impact factor: 3.959
Authors: R E Myers; T Hyslop; M Gerrity; N Schlackman; N Hanchak; J Grana; B J Turner; D Weinberg; W W Hauck Journal: Cancer Epidemiol Biomarkers Prev Date: 1999-07 Impact factor: 4.254
Authors: Rebecca Smith-Bindman; Philip W Chu; Diana L Miglioretti; Edward A Sickles; Roger Blanks; Rachel Ballard-Barbash; Janet K Bobo; Nancy C Lee; Matthew G Wallis; Julietta Patnick; Karla Kerlikowske Journal: JAMA Date: 2003-10-22 Impact factor: 56.272
Authors: Joann G Elmore; Connie Y Nakano; Thomas D Koepsell; Laurel M Desnick; Carl J D'Orsi; David F Ransohoff Journal: J Natl Cancer Inst Date: 2003-09-17 Impact factor: 13.506
Authors: Patricia A Carney; Andrea J Cook; Diana L Miglioretti; Stephen A Feig; Erin Aiello Bowles; Berta M Geller; Karla Kerlikowske; Mark Kettler; Tracy Onega; Joann G Elmore Journal: J Clin Epidemiol Date: 2011-10-15 Impact factor: 6.437
Authors: Bin Zheng; Dror Lederman; Jules H Sumkin; Margarita L Zuley; Michelle Z Gruss; Linda S Lovy; David Gur Journal: Acad Radiol Date: 2010-12-03 Impact factor: 3.173
Authors: Bin Zheng; Margarita L Zuley; Jules H Sumkin; Victor J Catullo; Gordon S Abrams; Grace Y Rathfon; Denise M Chough; Michelle Z Gruss; David Gur Journal: Med Phys Date: 2008-07 Impact factor: 4.071
Authors: Andrea J Cook; Joann G Elmore; Weiwei Zhu; Sara L Jackson; Patricia A Carney; Chris Flowers; Tracy Onega; Berta Geller; Robert D Rosenberg; Diana L Miglioretti Journal: AJR Am J Roentgenol Date: 2012-09 Impact factor: 3.959