Professional mammographic quality assessment program for a community hospital

The evaluation of mammographic interpretations is a difficult challenge for a professional quality assessment program. As most images are read by a single observer and pathologic proof is obtained only if prompted by the report or if clinical symptoms warrant surgical intervention, it is difficult to construct a meaningful quality assessment program. The authors designed a program on the basis of a mammographic coding system that allows both individual physicians and practice groups to be evaluated. The program examines mammographic reports to determine the consistency of reporting by each physician and by the entire group. In addition, the program facilitated periodic evaluation of physicians with use of test cases. The coding system provided an easy method of correlating the mammographic reports with pathology reports from biopsy specimens, allowing a more thorough examination of possible systematic errors in the evaluation of the examinations, as well as enabling calculation of the positive predictive value for the diagnosis of cancer. The professional quality assessment program can be easily implemented in a busy clinical setting to evaluate whether mammograms were read consistently and "correctly" and to provide a method of continuing education for the physicians.