OAK BROOK, Ill. – When double reading screening mammograms, radiographers (technologists) trained for the task perform as well as radiologists in key areas, according to a study published in Radiology, a journal of the Radiological Society of North America (RSNA).
Double reading, the process of interpreting a radiological image with two or more sets of eyes, is the standard of care throughout Europe and it has been shown to improve cancer detection rates while simultaneously keeping recall rates low. The National Health Service Breast Screening Program (NHSBSP) in the United Kingdom (U.K.) has over 80 screening centers in England, where over 2 million women are screened annually.
To mitigate the strains put on the healthcare system due to increased workload and radiologist shortages, the NHSBSP has been utilizing non-radiologists as part of double reading since the 1990s. While the traditional role of radiographers is to perform the mammogram, the NHSBSP recruits radiographers who undergo extensive additional postgraduate training to interpret the mammograms. They also participate in the same quality assurance standards as radiologists.
"With the production of reliable individual reader performance data in recent years, it has been possible to produce a robust comparison of the performance of our radiologist and non-radiologist readers in England," said study lead author Yan Chen, Ph.D., associate professor of cancer screening at the University of Nottingham School of Medicine in the U.K.
For this study, researchers analyzed a year's worth of performance data collected from 224 radiologists and 177 radiographers from the NHSBSP. Readers who also took part in the External Quality Assurance (EQA) scheme known as the Personal Performance in Mammographic Screening (PERFORMS) were eligible for this study, and they also gave consent for their individual real-life breast screening performance data to be accessed from the Breast Screening Information System.
Performance metrics that were analyzed were cancer detection rate, recall rate—the percentage of patients called back for follow-up testing—and positive predictive value of recall based on biopsy-proven pathological findings. Positive predictive value reflects the percentage of cancers found among exams for which biopsy was recommended or performed.
Each metric was analyzed according to the reader profession, years of experience and any interaction between them using analysis of variance. Analysis of variance is a statistical formula used to compare variances across the means (or average) of different groups.