Margarita Posso1, Teresa Puig2, Misericòrdia Carles3, Montserrat Rué4, Carlos Canelo-Aybar5, Xavier Bonfill6. 1. Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), Barcelona, Spain; Iberoamerican Cochrane Centre, Barcelona, Spain. Electronic address: mposso@cochrane.es. 2. Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain. Electronic address: tpuig@santpau.cat. 3. Economics Department and CREIP, Universitat Rovira i Virgili, Reus, Spain. Electronic address: misericordia.carles@urv.cat. 4. Basic Medical Sciences Department, Biomedical Research Institut of Lleida (IRBLLEIDA), Universitat de Lleida, Lleida, Spain. Electronic address: montse.rue@cmb.udl.cat. 5. Iberoamerican Cochrane Centre, Barcelona, Spain; School of Medicine, Peruvian University of Applied Sciences, Lima, Peru. Electronic address: ccanelo@santpau.cat. 6. Department of Clinical Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau (IIB Sant Pau), Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Iberoamerican Cochrane Centre, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Spain. Electronic address: xbonfill@santpau.cat.
Abstract
PURPOSE: Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes. METHODS: We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804. RESULTS: Of 1473 potentially relevant hits, four high-quality studies were included. The pooled cancer detection rate of double reading was 6.01 per 1000 screens (CI: 4.47‰-7.77‰), and it was 5.65 per 1000 screens (CI: 3.95‰-7.65‰) for single reading (P=0.76). The pooled proportion of false-positives of double reading was 47.03 per 1000 screens (CI: 39.13‰-55.62‰) and it was 40.60 per 1000 screens (CI: 38.58‰-42.67‰) for single reading (P=0.12). One study reported, for double reading, an ICER (Incremental Cost-Effectiveness Ratio) of 16,684 Euros (24,717 US$ PPP; 2015 value) per detected cancer. Single reading+CAD (computer-aided-detection) was cost-effective in Japan. CONCLUSION: The evidence of benefit for double reading compared to single reading for digital mammography interpretation is scarce. Double reading seems to increase operational costs, have a not significantly higher false-positive rate, and a similar cancer detection rate.
PURPOSE: Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes. METHODS: We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804. RESULTS: Of 1473 potentially relevant hits, four high-quality studies were included. The pooled cancer detection rate of double reading was 6.01 per 1000 screens (CI: 4.47‰-7.77‰), and it was 5.65 per 1000 screens (CI: 3.95‰-7.65‰) for single reading (P=0.76). The pooled proportion of false-positives of double reading was 47.03 per 1000 screens (CI: 39.13‰-55.62‰) and it was 40.60 per 1000 screens (CI: 38.58‰-42.67‰) for single reading (P=0.12). One study reported, for double reading, an ICER (Incremental Cost-Effectiveness Ratio) of 16,684 Euros (24,717 US$ PPP; 2015 value) per detected cancer. Single reading+CAD (computer-aided-detection) was cost-effective in Japan. CONCLUSION: The evidence of benefit for double reading compared to single reading for digital mammography interpretation is scarce. Double reading seems to increase operational costs, have a not significantly higher false-positive rate, and a similar cancer detection rate.
Authors: Sian Taylor-Phillips; David Jenkinson; Chris Stinton; Matthew G Wallis; Janet Dunn; Aileen Clarke Journal: Radiology Date: 2018-04-10 Impact factor: 11.105
Authors: Olena Mandrik; Obinna Ikechukwu Ekwunife; Filip Meheus; Johan L Hans Severens; Stefan Lhachimi; Carin A Uyl-de Groot; Raul Murillo Journal: Cancer Med Date: 2019-09-30 Impact factor: 4.452