Single reading with computer-aided detection for screening mammography.
Background: The sensitivity of screening mammography for the detection of small breast cancers is higher when the mammogram is read by two readers rather than by a single reader. We conducted a trial to determine whether the performance of a single reader using a computer-aided detection system woul...
| Published in: | New England Journal of Medicine Vol. 359; no. 16; pp. 1675 - 1685 |
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| Main Authors: | , , , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
New England Journal of Medicine
10/16/2008
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105967505&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105967505 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00284793 NEJ jtl: New England Journal of Medicine issn: 00284793 maglogo: N pubinfo: dt: 10/16/2008 vid: 359 iid: 16 pid: 388 pub: New England Journal of Medicine place: Waltham, Massachusetts artinfo: ui: 105967505 NLM18832239 2010071997 10.1056/NEJMoa0803545 NLM18832239 105967505 ppf: 1675 ppct: 10 formats: tig: atl: Single reading with computer-aided detection for screening mammography. aug: au: Gilbert FJ Astley SM Gillan MGC Agbaje OF Wallis MG James J Boggis CRM Duffy SW Gilbert, Fiona J Astley, Susan M Gillan, Maureen G C Agbaje, Olorunsola F Wallis, Matthew G James, Jonathan Boggis, Caroline R M Duffy, Stephen W affil: Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, Scotland, United Kingdom sug: subj: Breast Neoplasms Diagnosis Diagnosis, Computer Assisted Equivalence Evaluation Mammography Adult Aged Breast Neoplasms Epidemiology Comparative Studies Confidence Intervals Cost Benefit Analysis Descriptive Statistics Digital Imaging Education, Continuing (Credit) England Female McNemar's Test Middle Age Multicenter Studies Power Analysis Prospective Studies Random Assignment Sample Size Determination Sensitivity and Specificity United Kingdom Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female ab: Background: The sensitivity of screening mammography for the detection of small breast cancers is higher when the mammogram is read by two readers rather than by a single reader. We conducted a trial to determine whether the performance of a single reader using a computer-aided detection system would match the performance achieved by two readers. Methods: The trial was designed as an equivalence trial, with matched-pair comparisons between the cancer-detection rates achieved by single reading with computer-aided detection and those achieved by double reading. We randomly assigned 31,057 women undergoing routine screening by film mammography at three centers in England to double reading, single reading with computer-aided detection, or both double reading and single reading with computer-aided detection, at a ratio of 1:1:28. The primary outcome measures were the proportion of cancers detected according to regimen and the recall rates within the group receiving both reading regimens. Results: The proportion of cancers detected was 199 of 227 (87.7%) for double reading and 198 of 227 (87.2%) for single reading with computer-aided detection (P=0.89). The overall recall rates were 3.4% for double reading and 3.9% for single reading with computer-aided detection; the difference between the rates was small but significant (P<0.001). The estimated sensitivity, specificity, and positive predictive value for single reading with computer-aided detection were 87.2%, 96.9%, and 18.0%, respectively. The corresponding values for double reading were 87.7%, 97.4%, and 21.1%. There were no significant differences between the pathological attributes of tumors detected by single reading with computer-aided detection alone and those of tumors detected by double reading alone. Conclusions: Single reading with computer-aided detection could be an alternative to double reading and could improve the rate of detection of cancer from screening mammograms read by a single reader. (ClinicalTrials.gov number, NCT00450359.) pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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