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The Relationship between Mammography Readers' Real-Life Performance and Performance in a Test Set-based Assessment
Yan Chen1, Jonathan J James1, Eleanor J Cornford1
1Division of Cancer and Stem Cells, University of Nottingham, School of Medicine, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, England (Y.C.); Nottingham Breast Institute, Nottingham University Hospitals NHS Trust, Nottingham, England (J.J.J.); Department of Radiology, Cheltenham General Hospital, Cheltenham, England (E.J.C.); and Young Person and Adult Screening Programmes, Public Health England, Sheffield, England (J.J.).
Purpose:
To compare an individual's Personal Performance in Mammographic Screening (PERFORMS) score with their Breast Screening Information System (BSIS) real-life performance data and determine which parameters in the PERFORMS scheme offer the best reflection of BSIS real-life performance metrics.
Materials And Methods:
In this retrospective study, the BSIS real-life performance metrics of individual readers (n = 452) in the National Health Service Breast Screening Program (NHSBSP) in England were compared with performance in the test set-based assessment scheme over a 3-year period from 2013 to 2016. Cancer detection rate (CDR), recall rate, and positive predictive value (PPV) were calculated for each reader, for both real-life screening and the PERFORMS test. For each metric, real-life and test set versions were compared using a Pearson correlation. The real-life CDR, recall rate, and PPV of outliers were compared against other readers (nonoutliers) using analysis of variance.
Results:
BSIS real-life CDRs, recall rates, and PPVs showed positive correlations with the equivalent PERFORMS measures (P < .001, P = .002, and P < .001, respectively). The mean real-life CDR of PERFORMS outliers was 7.2 per 1000 women screened and was significantly lower than other readers (nonoutliers) where the real-life CDR was 7.9 (P = .002). The mean real-life screening PPV of PERFORMS outliers was 0.14% and was significantly lower than the nonoutlier group who had a mean PPV of 0.17% (P = .006).
Conclusion:
The use of test set-based assessment schemes in a breast screening program has the potential to predict and identify poor performance in real life.© RSNA, 2020Keywords: Breast, ScreeningSee also the commentary by Thigpen and Rapelyea in this issue.
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