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Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome
Objectives To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments. Methods We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a...
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| Published in: | European radiology 2015-10, Vol.25 (10), p.2821-2829 |
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| creator | Klompenhouwer, Elisabeth G. Voogd, Adri C. den Heeten, Gerard J. Strobbe, Luc J. A. Tjan-Heijnen, Vivianne C. Broeders, Mireille J. M. Duijm, Lucien E. M. |
| description | Objectives
To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments.
Methods
We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a third screening radiologist. Two years’ follow-up was performed.
Results
Discrepant readings comprised 57.2 % (830/1452) and 29.1 % (346/1188) of recalls at blinded and non-blinded double readings, respectively. At blinded double reading, arbitration would have decreased recall rate (3.4 to 2.2 %, p |
| doi_str_mv | 10.1007/s00330-015-3711-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1710653336</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3799842901</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-18c71d7bd3efe59e9a65c8a0a3e353f3c871b885939cc79b3c7c56e74d8f1ed63</originalsourceid><addsrcrecordid>eNp1kc9uFSEUh4nR2Gv1AdwYEjdusHAZBnBn6r8mTdzUNWHgzO00A4zALPoefWCZ3laNiSsOnI_vEH4IvWb0PaNUnhVKOaeEMkG4ZIz0T9COdXxPGFXdU7Sjmisite5O0ItSbiilmnXyOTrZC6W7Ztihu09TcRkWGyveCohTPOBgQ0iHbJfrW2xLgVICxFqwrXiYp-jBYxs9jimSx71P6zADzmB9M3zAU1isqziN2OZhqtnWKUU8NB-u11P29yRk3A7_zE1rdSnAS_RstHOBVw_rKfrx5fPV-Tdy-f3rxfnHS-K6bl8JU04yLwfPYQShQdteOGWp5cAFH7lTkg1KCc21c1IP3EknepCdVyMD3_NT9O7oXXL6uUKpJrTfgHm2EdJaDJOM9oJzvqFv_0Fv0ppje12jqNa90JI2ih0pl1MpGUaz5CnYfGsYNVtk5hiZaZGZLTKzmd88mNchgP994zGjBuyPQGmteID81-j_Wn8BCDyj1g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1709965970</pqid></control><display><type>article</type><title>Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome</title><source>Springer Nature</source><creator>Klompenhouwer, Elisabeth G. ; Voogd, Adri C. ; den Heeten, Gerard J. ; Strobbe, Luc J. A. ; Tjan-Heijnen, Vivianne C. ; Broeders, Mireille J. M. ; Duijm, Lucien E. M.</creator><creatorcontrib>Klompenhouwer, Elisabeth G. ; Voogd, Adri C. ; den Heeten, Gerard J. ; Strobbe, Luc J. A. ; Tjan-Heijnen, Vivianne C. ; Broeders, Mireille J. M. ; Duijm, Lucien E. M.</creatorcontrib><description>Objectives
To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments.
Methods
We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a third screening radiologist. Two years’ follow-up was performed.
Results
Discrepant readings comprised 57.2 % (830/1452) and 29.1 % (346/1188) of recalls at blinded and non-blinded double readings, respectively. At blinded double reading, arbitration would have decreased recall rate (3.4 to 2.2 %, p < 0.001) and programme sensitivity (83.2 to 76.0 %, p = 0.013), would not have influenced the cancer detection rate (CDR; 7.5 to 6.8 per 1,000 screens, p = 0.258) and would have increased the positive predictive value of recall (PPV; 22.3 to 31.2 %, p < 0.001). At non-blinded double reading, arbitration would have decreased recall rate (2.8 to 2.3 %, p < 0.001) and increased PPV (23.2 to 27.5 %, p = 0.021), but would not have affected CDR (6.6 to 6.3 per 1,000 screens, p = 0.604) and programme sensitivity (76.0 to 72.7 %, p = 0.308).
Conclusion
Arbitration of discrepant screening mammography assessments is a good tool to improve recall rate and PPV, but is not desirable as it reduces the programme sensitivity at blinded double reading.
Key points
•
Blinded double reading results in higher programme sensitivity than non-blinded reading.
•
Discrepant readings occur more often at blinded compared to non-blinded reading.
•
Arbitration of discrepant readings reduces the recall rate and PPV.
•
Arbitration would reduce the programme sensitivity at blinded double reading.</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-015-3711-6</identifier><identifier>PMID: 25894007</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Arbitration ; Breast ; Breast cancer ; Breast Neoplasms - diagnostic imaging ; Decision making ; Delayed Diagnosis ; Diagnostic Radiology ; Double-Blind Method ; Early Detection of Cancer - methods ; Early Detection of Cancer - standards ; Female ; Hospitals ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Mammography ; Mammography - methods ; Mammography - standards ; Mass Screening - methods ; Medical screening ; Medicine ; Medicine & Public Health ; Middle Aged ; Negotiating ; Neuroradiology ; Observer Variation ; Oncology ; Radiology ; Retrospective Studies ; Ultrasound ; Womens health</subject><ispartof>European radiology, 2015-10, Vol.25 (10), p.2821-2829</ispartof><rights>European Society of Radiology 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-18c71d7bd3efe59e9a65c8a0a3e353f3c871b885939cc79b3c7c56e74d8f1ed63</citedby><cites>FETCH-LOGICAL-c442t-18c71d7bd3efe59e9a65c8a0a3e353f3c871b885939cc79b3c7c56e74d8f1ed63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25894007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klompenhouwer, Elisabeth G.</creatorcontrib><creatorcontrib>Voogd, Adri C.</creatorcontrib><creatorcontrib>den Heeten, Gerard J.</creatorcontrib><creatorcontrib>Strobbe, Luc J. A.</creatorcontrib><creatorcontrib>Tjan-Heijnen, Vivianne C.</creatorcontrib><creatorcontrib>Broeders, Mireille J. M.</creatorcontrib><creatorcontrib>Duijm, Lucien E. M.</creatorcontrib><title>Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments.
Methods
We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a third screening radiologist. Two years’ follow-up was performed.
Results
Discrepant readings comprised 57.2 % (830/1452) and 29.1 % (346/1188) of recalls at blinded and non-blinded double readings, respectively. At blinded double reading, arbitration would have decreased recall rate (3.4 to 2.2 %, p < 0.001) and programme sensitivity (83.2 to 76.0 %, p = 0.013), would not have influenced the cancer detection rate (CDR; 7.5 to 6.8 per 1,000 screens, p = 0.258) and would have increased the positive predictive value of recall (PPV; 22.3 to 31.2 %, p < 0.001). At non-blinded double reading, arbitration would have decreased recall rate (2.8 to 2.3 %, p < 0.001) and increased PPV (23.2 to 27.5 %, p = 0.021), but would not have affected CDR (6.6 to 6.3 per 1,000 screens, p = 0.604) and programme sensitivity (76.0 to 72.7 %, p = 0.308).
Conclusion
Arbitration of discrepant screening mammography assessments is a good tool to improve recall rate and PPV, but is not desirable as it reduces the programme sensitivity at blinded double reading.
Key points
•
Blinded double reading results in higher programme sensitivity than non-blinded reading.
•
Discrepant readings occur more often at blinded compared to non-blinded reading.
•
Arbitration of discrepant readings reduces the recall rate and PPV.
•
Arbitration would reduce the programme sensitivity at blinded double reading.</description><subject>Aged</subject><subject>Arbitration</subject><subject>Breast</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Decision making</subject><subject>Delayed Diagnosis</subject><subject>Diagnostic Radiology</subject><subject>Double-Blind Method</subject><subject>Early Detection of Cancer - methods</subject><subject>Early Detection of Cancer - standards</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Mammography</subject><subject>Mammography - methods</subject><subject>Mammography - standards</subject><subject>Mass Screening - methods</subject><subject>Medical screening</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Negotiating</subject><subject>Neuroradiology</subject><subject>Observer Variation</subject><subject>Oncology</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Ultrasound</subject><subject>Womens health</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><recordid>eNp1kc9uFSEUh4nR2Gv1AdwYEjdusHAZBnBn6r8mTdzUNWHgzO00A4zALPoefWCZ3laNiSsOnI_vEH4IvWb0PaNUnhVKOaeEMkG4ZIz0T9COdXxPGFXdU7Sjmisite5O0ItSbiilmnXyOTrZC6W7Ztihu09TcRkWGyveCohTPOBgQ0iHbJfrW2xLgVICxFqwrXiYp-jBYxs9jimSx71P6zADzmB9M3zAU1isqziN2OZhqtnWKUU8NB-u11P29yRk3A7_zE1rdSnAS_RstHOBVw_rKfrx5fPV-Tdy-f3rxfnHS-K6bl8JU04yLwfPYQShQdteOGWp5cAFH7lTkg1KCc21c1IP3EknepCdVyMD3_NT9O7oXXL6uUKpJrTfgHm2EdJaDJOM9oJzvqFv_0Fv0ppje12jqNa90JI2ih0pl1MpGUaz5CnYfGsYNVtk5hiZaZGZLTKzmd88mNchgP994zGjBuyPQGmteID81-j_Wn8BCDyj1g</recordid><startdate>20151001</startdate><enddate>20151001</enddate><creator>Klompenhouwer, Elisabeth G.</creator><creator>Voogd, Adri C.</creator><creator>den Heeten, Gerard J.</creator><creator>Strobbe, Luc J. A.</creator><creator>Tjan-Heijnen, Vivianne C.</creator><creator>Broeders, Mireille J. M.</creator><creator>Duijm, Lucien E. M.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20151001</creationdate><title>Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome</title><author>Klompenhouwer, Elisabeth G. ; Voogd, Adri C. ; den Heeten, Gerard J. ; Strobbe, Luc J. A. ; Tjan-Heijnen, Vivianne C. ; Broeders, Mireille J. M. ; Duijm, Lucien E. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-18c71d7bd3efe59e9a65c8a0a3e353f3c871b885939cc79b3c7c56e74d8f1ed63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Arbitration</topic><topic>Breast</topic><topic>Breast cancer</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Decision making</topic><topic>Delayed Diagnosis</topic><topic>Diagnostic Radiology</topic><topic>Double-Blind Method</topic><topic>Early Detection of Cancer - methods</topic><topic>Early Detection of Cancer - standards</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Mammography</topic><topic>Mammography - methods</topic><topic>Mammography - standards</topic><topic>Mass Screening - methods</topic><topic>Medical screening</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Negotiating</topic><topic>Neuroradiology</topic><topic>Observer Variation</topic><topic>Oncology</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Ultrasound</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klompenhouwer, Elisabeth G.</creatorcontrib><creatorcontrib>Voogd, Adri C.</creatorcontrib><creatorcontrib>den Heeten, Gerard J.</creatorcontrib><creatorcontrib>Strobbe, Luc J. A.</creatorcontrib><creatorcontrib>Tjan-Heijnen, Vivianne C.</creatorcontrib><creatorcontrib>Broeders, Mireille J. M.</creatorcontrib><creatorcontrib>Duijm, Lucien E. 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A.</au><au>Tjan-Heijnen, Vivianne C.</au><au>Broeders, Mireille J. M.</au><au>Duijm, Lucien E. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2015-10-01</date><risdate>2015</risdate><volume>25</volume><issue>10</issue><spage>2821</spage><epage>2829</epage><pages>2821-2829</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To determine the value of adding a third reader for arbitration of discrepant screening mammography assessments.
Methods
We included a consecutive series of 84,927 digital screening mammograms, double read in a blinded or non-blinded fashion. Arbitration was retrospectively performed by a third screening radiologist. Two years’ follow-up was performed.
Results
Discrepant readings comprised 57.2 % (830/1452) and 29.1 % (346/1188) of recalls at blinded and non-blinded double readings, respectively. At blinded double reading, arbitration would have decreased recall rate (3.4 to 2.2 %, p < 0.001) and programme sensitivity (83.2 to 76.0 %, p = 0.013), would not have influenced the cancer detection rate (CDR; 7.5 to 6.8 per 1,000 screens, p = 0.258) and would have increased the positive predictive value of recall (PPV; 22.3 to 31.2 %, p < 0.001). At non-blinded double reading, arbitration would have decreased recall rate (2.8 to 2.3 %, p < 0.001) and increased PPV (23.2 to 27.5 %, p = 0.021), but would not have affected CDR (6.6 to 6.3 per 1,000 screens, p = 0.604) and programme sensitivity (76.0 to 72.7 %, p = 0.308).
Conclusion
Arbitration of discrepant screening mammography assessments is a good tool to improve recall rate and PPV, but is not desirable as it reduces the programme sensitivity at blinded double reading.
Key points
•
Blinded double reading results in higher programme sensitivity than non-blinded reading.
•
Discrepant readings occur more often at blinded compared to non-blinded reading.
•
Arbitration of discrepant readings reduces the recall rate and PPV.
•
Arbitration would reduce the programme sensitivity at blinded double reading.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25894007</pmid><doi>10.1007/s00330-015-3711-6</doi><tpages>9</tpages></addata></record> |
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| ispartof | European radiology, 2015-10, Vol.25 (10), p.2821-2829 |
| issn | 0938-7994 1432-1084 |
| language | eng |
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| source | Springer Nature |
| subjects | Aged Arbitration Breast Breast cancer Breast Neoplasms - diagnostic imaging Decision making Delayed Diagnosis Diagnostic Radiology Double-Blind Method Early Detection of Cancer - methods Early Detection of Cancer - standards Female Hospitals Humans Imaging Internal Medicine Interventional Radiology Mammography Mammography - methods Mammography - standards Mass Screening - methods Medical screening Medicine Medicine & Public Health Middle Aged Negotiating Neuroradiology Observer Variation Oncology Radiology Retrospective Studies Ultrasound Womens health |
| title | Discrepant screening mammography assessments at blinded and non-blinded double reading: impact of arbitration by a third reader on screening outcome |
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