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Related Experiment Videos

Screening mammography. A risk versus risk decision.

E R Ritenour1, W R Hendee

  • 1University of Colorado Health Sciences Center, Department of Radiology, Denver.

Investigative Radiology
|January 1, 1989
PubMed
Summary

Comparing the risk of medical imaging procedures with the risk of not having them offers a clearer perspective. For screening mammography, the risks of the procedure are significantly lower than the risks of undiagnosed breast cancer.

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Area of Science:

  • Radiology
  • Medical Imaging Analysis
  • Risk Assessment

Background:

  • Traditional risk vs. benefit analysis in radiology presents challenges due to the disparate nature of risk and benefit.
  • Comparing fundamentally different quantities leads to contextual difficulties in understanding and communication among stakeholders.
  • Existing frameworks may not fully capture the nuanced decision-making process for diagnostic procedures.

Purpose of the Study:

  • To introduce a novel risk analysis framework: comparing the risk of undergoing a procedure versus the risk of foregoing it.
  • To reframe risk assessment in medical imaging by focusing on comparative risks rather than absolute benefit.
  • To provide a more intuitive and actionable method for evaluating the necessity of radiologic examinations.

Main Methods:

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  • Proposed a conceptual shift from risk vs. benefit to risk vs. risk analysis.
  • Applied this framework to screening mammography for women over 50 as a case study.
  • Quantitatively compared the risks associated with annual mammography against the risks of delayed breast cancer diagnosis.

Main Results:

  • The risk associated with annual screening mammography was found to be less than 1/10th the risk of early death from undetected breast cancer.
  • This risk vs. risk analysis demonstrated a favorable comparison for the diagnostic procedure.
  • The findings highlight the utility of this approach in evaluating screening and diagnostic pathways.

Conclusions:

  • The risk vs. risk analysis provides a more coherent and practical method for evaluating radiologic procedures.
  • This approach yields valuable data for complex diagnostic decision-making, particularly in screening programs.
  • It enhances understanding of the comparative risks involved in medical imaging choices.