Radiologist Characteristics Associated with Interpretive Performance of Screening Mammography: A National Mammography...

Area of Science:

• Radiology
• Medical Imaging
• Public Health

Background:

• Factors influencing radiologist performance in screening mammography are not well understood.
• Optimizing screening mammography interpretation is crucial for early cancer detection and patient outcomes.

Purpose of the Study:

• To identify specific radiologist characteristics associated with improved screening mammography interpretation performance.
• To analyze the impact of geographic location, subspecialization, and practice patterns on mammography quality metrics.

Main Methods:

• Retrospective analysis of 1223 radiologists from the National Mammography Database (2008-2019) linked to Medicare data.
• Evaluation of seven key performance metrics: recall rate (RR), cancer detection rate (CDR), positive predictive values (PPV1, PPV2, PPV3), invasive CDR, and percentage of ductal carcinoma in situ (DCIS).
• Multivariable logistic regression identified characteristics independently associated with acceptable performance across these metrics.

Main Results:

• Radiologists in the Midwest and West regions demonstrated higher odds of achieving acceptable RR, PPV1, PPV2, and CDR compared to the Northeast.
• Breast imaging subspecialists and those performing diagnostic mammography showed significantly better performance across multiple metrics (PPV1, invasive CDR, DCIS, CDR).
• Performing breast ultrasound was associated with lower performance in PPV1, PPV2, DCIS, and CDR.

Conclusions:

• Geographic location, breast imaging subspecialization, and performing diagnostic mammography are positively associated with superior screening mammography performance.
• The use of breast ultrasound in practice correlates with decreased performance in key mammography quality indicators.
• These findings highlight practice characteristics that can be leveraged to improve the quality of screening mammography interpretation.