J Brown1, S Bryan, R Warren. 1. Health Economics Research Group, Brunel University, Uxbridge, Middlesex.
Abstract
OBJECTIVE: To compare mammography reading by one radiologist with independent reading by two radiologists. DESIGN: An observational non-randomised trial at St Margaret's Hospital, Epping. SUBJECTS: 33 734 consecutive attenders for breast screening in the main trial and a sample of 132 attenders for assessment who provided data on private costs. INTERVENTIONS: Three reporting policies were compared: single reading, consensus double reading, and non-consensus double reading. MAIN OUTCOME MEASURES: Numbers of cancers detected, recall rates, screening and assessment costs, and cost effectiveness ratios. RESULTS: A policy of double reading followed by consensus detected an additional nine cancers per 10 000 women screened (95% confidence interval 5 to 13) compared with single reading. A non-consensus double reading policy detected an additional 10 cancers per 10 000 women screened (95% confidence interval 6 to 14). The difference in numbers of cancers detected between the consensus and non-consensus double reading policies was not significant (95% confidence interval -0.2 to 2.2). The proportion of women recalled for assessment after consensus double reading was significantly lower than after single reading (difference 2.7%; 95% confidence interval 2.4% to 3.0%). The recall rate with the non-consensus policy was significantly higher than with single reading (difference 3.0%; 2.5% to 3.5%). Consensus double reading cost less than single reading (saving 4853 pounds per 10 000 women screened). Non-consensus double reading cost more than single reading (difference 19 259 pounds per 10 000 women screened). CONCLUSIONS: In the screening unit studied a consensus double reading policy was more effective and less costly than a single reading policy.
OBJECTIVE: To compare mammography reading by one radiologist with independent reading by two radiologists. DESIGN: An observational non-randomised trial at St Margaret's Hospital, Epping. SUBJECTS: 33 734 consecutive attenders for breast screening in the main trial and a sample of 132 attenders for assessment who provided data on private costs. INTERVENTIONS: Three reporting policies were compared: single reading, consensus double reading, and non-consensus double reading. MAIN OUTCOME MEASURES: Numbers of cancers detected, recall rates, screening and assessment costs, and cost effectiveness ratios. RESULTS: A policy of double reading followed by consensus detected an additional nine cancers per 10 000 women screened (95% confidence interval 5 to 13) compared with single reading. A non-consensus double reading policy detected an additional 10 cancers per 10 000 women screened (95% confidence interval 6 to 14). The difference in numbers of cancers detected between the consensus and non-consensus double reading policies was not significant (95% confidence interval -0.2 to 2.2). The proportion of women recalled for assessment after consensus double reading was significantly lower than after single reading (difference 2.7%; 95% confidence interval 2.4% to 3.0%). The recall rate with the non-consensus policy was significantly higher than with single reading (difference 3.0%; 2.5% to 3.5%). Consensus double reading cost less than single reading (saving 4853 pounds per 10 000 women screened). Non-consensus double reading cost more than single reading (difference 19 259 pounds per 10 000 women screened). CONCLUSIONS: In the screening unit studied a consensus double reading policy was more effective and less costly than a single reading policy.
Authors: L Tabár; C J Fagerberg; A Gad; L Baldetorp; L H Holmberg; O Gröntoft; U Ljungquist; B Lundström; J C Månson; G Eklund Journal: Lancet Date: 1985-04-13 Impact factor: 79.321
Authors: Raúl Ramos-Pollán; Miguel Angel Guevara-López; Cesar Suárez-Ortega; Guillermo Díaz-Herrero; Jose Miguel Franco-Valiente; Manuel Rubio-Del-Solar; Naimy González-de-Posada; Mario Augusto Pires Vaz; Joana Loureiro; Isabel Ramos Journal: J Med Syst Date: 2011-04-09 Impact factor: 4.460
Authors: Elisabeth G Klompenhouwer; Adri C Voogd; Gerard J den Heeten; Luc J A Strobbe; Vivianne C Tjan-Heijnen; Mireille J M Broeders; Lucien E M Duijm Journal: Eur Radiol Date: 2015-04-18 Impact factor: 5.315
Authors: E G Klompenhouwer; L E M Duijm; A C Voogd; G J den Heeten; J Nederend; F H Jansen; M J M Broeders Journal: Eur Radiol Date: 2014-02-06 Impact factor: 5.315
Authors: Solveig Hofvind; Pamela M Vacek; Joan Skelly; Donald L Weaver; Berta M Geller Journal: J Natl Cancer Inst Date: 2008-07-29 Impact factor: 13.506