Applying the "positive predictive value-recall diagram" to monitor performance and provide recommendations for screening radiologists
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View abstract on PubMed
Summary
This summary is machine-generated.Positive predictive value (PPV)-recall diagrams help audit teams identify variations in breast cancer screening performance. While recommendations often improved recall rates, further individual radiologist feedback may be needed for optimal results.
Area Of Science
- Radiology and Imaging
- Quality Assurance in Healthcare
- Biostatistics
Background
- Monitoring radiologist performance in breast cancer screening is crucial for optimizing detection rates and minimizing false positives.
- Variations in performance metrics like recall rate (RR), cancer detection rate (CDR), and positive predictive value (PPV) necessitate effective quality assurance tools.
- Existing methods may not fully capture the interrelationships between these key performance indicators across different reading units (RUs).
Purpose Of The Study
- To evaluate the utility of positive predictive value (PPV)-recall diagrams for monitoring and guiding performance improvements in RUs within a national breast cancer screening program.
- To assess the suitability of PPV-recall diagrams in identifying variations in screening performance over time and between different RUs.
- To determine the impact of audit recommendations, informed by PPV-recall diagrams, on RU performance.
Main Methods
- A retrospective analysis of triennial quality assurance audit data from the Dutch breast cancer screening program (2010-2019).
- PPV-recall diagrams were constructed using recall rate, cancer detection rate, and PPV for initial and subsequent screenings across 12 RUs.
- RU-specific diagrams were used to track performance variations and inform audit recommendations focused on adjusting recall rates.
Main Results
- Significant variations in RU performance were observed, with PPVs ranging widely (4.9-23.7% for initial, 21.2-54.3% for subsequent screening).
- Target values were less frequently met for initial screenings compared to subsequent screenings, leading to more recommendations for initial screening adjustments.
- Recommendations to adjust recall rates often resulted in the desired directional change (17/24 instances) but did not always achieve target values.
Conclusions
- PPV-recall diagrams provide valuable insights into performance variations and interrelationships between screening outcomes for RUs.
- These diagrams aid audit teams in formulating targeted recommendations for improving breast cancer screening performance.
- Feedback derived solely from PPV-recall diagrams may require supplementation with individual radiologist feedback for optimal performance enhancement.
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