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Mammogram interpretation by physician assistants
B J Hillman1, L L Fajardo, T B Hunter
1Department of Radiology, University of Arizona College of Medicine, Tucson.
AJR. American Journal of Roentgenology
|November 1, 1987
Summary
Physician assistants (PAs) can interpret mammograms effectively, matching radiologist accuracy while reducing costs and interpretation time. This study supports PAs in mammography screening under radiologist supervision for quality, low-cost care.
Area of Science:
- Radiology
- Medical Imaging
- Oncology
Background:
- Health maintenance organizations (HMOs) seek cost-effective, high-quality mammography services.
- Physician assistants (PAs) are increasingly integrated into healthcare teams.
- The role of PAs in specialized diagnostic interpretation requires evaluation.
Purpose of the Study:
- To assess the efficacy of physician assistants (PAs) in interpreting mammograms.
- To compare PA mammogram interpretation performance against radiologists.
- To evaluate the cost-effectiveness and time efficiency of PA-led mammography interpretation.
Main Methods:
- Four PAs underwent intensive training in mammographic interpretation.
- PAs interpreted a dataset of 727 mammograms, including normal cases, benign masses, and cancers.
- Performance was compared to six HMO radiologists using sensitivity, specificity, and receiver-operating-characteristic (ROC) curve analysis.
Main Results:
- PA interpretations demonstrated higher sensitivity and comparable specificity to radiologists.
- ROC curve analysis indicated superior performance by PAs compared to radiologists.
- PA interpretation was faster and less costly than radiologist interpretation, with similar clinical recommendations.
Conclusions:
- Properly trained, supervised, and evaluated PAs are capable of interpreting mammograms effectively.
- PA involvement in mammography can enhance efficiency and reduce costs.
- Radiologist supervision is crucial for optimal implementation of PAs in mammography interpretation.