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Proficiency test for screening mammography: results for 117 volunteer Italian radiologists
S Ciatto1, D Ambrogetti, S Catarzi
1Department of Diagnostic Imaging, Centro per lo Studio e la Prevenzione Oncologica, Florence, Italy.
Objective:
To analyse the performance of a large sample of Italian radiologists undergoing a proficiency test for screening mammography.
Design:
Evaluation of performance indicators according to reference standards determined by a panel of experts (sensitivity (reference standard > or = 80%), recall rate (reference standard < or = 15%)).
Setting:
117 Italian radiologists of varying experience (years of practice 0.5-18, average 5.9; mammograms read 500-51,000, average 13,000), all currently reporting clinical mammography and planning to take part in screening in the near future.
Results:
Eighty four of 117 (72%) radiologists reached the standard for sensitivity, 88 (75%) reached the standard for recall rate, and only 59 (50%) reached both standards and passed the proficiency test. The probability of passing the test was significantly correlated with mammographic practice (p = 0.015), mammograms read (p = 0.024), and mammograms read/year (p = 0.043).
Discussion:
The performance of a large sample of Italian radiologists currently reporting clinical mammography was disappointing, indicating the need for proper training of at least 50% of the tested subjects. When implementing organised screening the health authority should set up a proper process for training and accrediting radiologists, and a proficiency test should be part of such a process.