Radiology, Vol 184, 619-622, Copyright © 1992 by Radiological Society of North America

ARTICLES

Reading and decision aids for improved accuracy and standardization of mammographic diagnosis

CJ D'Orsi, DJ Getty, JA Swets, RM Pickett, SE Seltzer and BJ McNeil
Department of Radiology, University of Massachusetts Medical Center, Worcester 01655.

Image-reading and decision aids were designed to improve the accuracy of mammogram interpretation. The reading aid was a list of diagnostic radiographic features and scales for quantification of each feature. The decision aid, a computer program, converted the reader's scaled values, weighted for predictive power, into an advisory estimate of the probability of malignancy. The features were identified and their importance was assigned in four steps: (a) interviews of five expert readers to establish an initial set of features, (b) perceptual tests to refine the feature set, (c) a consensus meeting to refine this set and establish nomenclature and scales, and (d) the expert's scaling of each feature in a set of 150 mammograms. Those scaled judgments were analyzed to provide the final list of features and their relative importance and to program the computer decision aid. To test the enhancement effect, six other radiologists interpreted a different set of mammograms without, and later with, the two aids. Receiver operating characteristic analysis showed a gain of approximately 0.05 in sensitivity or specificity when the other value remained at 0.85. In a subset of the more difficult cases, the enhancement effect was approximately 0.15 in either sensitivity or specificity.

This article has been cited by other articles:

				J. G. Elmore, C. Y. Nakano, T. D. Koepsell, L. M. Desnick, C. J. D'Orsi, and D. F. Ransohoff International Variation in Screening Mammography Interpretations in Community-Based Programs J Natl Cancer Inst, September 17, 2003; 95(18): 1384 - 1393. [Abstract] [Full Text] [PDF]

				W. A. Berg, C. J. D'Orsi, V. P. Jackson, L. W. Bassett, C. A. Beam, R. S. Lewis, and P. E. Crewson Does Training in the Breast Imaging Reporting and Data System (BI-RADS) Improve Biopsy Recommendations or Feature Analysis Agreement with Experienced Breast Imagers at Mammography? Radiology, September 1, 2002; 224(3): 871 - 880. [Abstract] [Full Text] [PDF]

				C. Lehman, S. Holt, S. Peacock, E. White, and N. Urban Use of the American College of Radiology BI-RADS Guidelines by Community Radiologists: Concordance of Assessments and Recommendations Assigned to Screening Mammograms Am. J. Roentgenol., July 1, 2002; 179(1): 15 - 20. [Abstract] [Full Text] [PDF]

				W. A. Berg, C. Campassi, P. Langenberg, and M. J. Sexton Breast Imaging Reporting and Data System: Inter- and Intraobserver Variability in Feature Analysis and Final Assessment Am. J. Roentgenol., June 1, 2000; 174(6): 1769 - 1777. [Abstract] [Full Text]

				H.-P. Chan, B. Sahiner, M. A. Helvie, N. Petrick, M. A. Roubidoux, T. E. Wilson, D. D. Adler, C. Paramagul, J. S. Newman, and S. Sanjay-Gopal Improvement of Radiologists' Characterization of Mammographic Masses by Using Computer-aided Diagnosis: An ROC Study Radiology, September 1, 1999; 212(3): 817 - 827. [Abstract] [Full Text]

				W. Silen, T. A. Gaskin, C. J. D'Orsi, J. A. Swets, F. M. Hall, J. G. Elmore, C. K. Wells, and A. R. Feinstein Variability in the Interpretation of Mammograms N. Engl. J. Med., April 27, 1995; 332(17): 1171 - 1173. [Full Text]

				W. A. Berg, C. L. Arnoldus, E. Teferra, and M. Bhargavan Biopsy of Amorphous Breast Calcifications: Pathologic Outcome and Yield at Stereotactic Biopsy Radiology, November 1, 2001; 221(2): 495 - 503. [Abstract] [Full Text] [PDF]