検診用マンモグラフィの2度目の読み取りの同じか異なる順序の使用が乳がん検出率に与える影響:ランダム化臨床試験
Sian Taylor-Phillips1, Matthew G Wallis2, David Jenkinson1
1Warwick Medical School, the University of Warwick, Coventry, United Kingdom.
JAMA
|May 11, 2016
まとめ
英国の大規模な試験では,第2の読者に対するマンモグラフィの読み順の変更が乳がん検出率に有意な影響を及ぼさなかった. この研究では,がんの検出率やリコール率の違いは見つかりませんでした.
科学分野:
- 放射線科
- 腫瘍学
- 公衆衛生
背景:
- マンモグラフィのスクリーニング解釈は困難で,読者の警戒心が低下したため,癌と偽陽性が出る可能性があります.
- イギリスでは2人の読者が独立して マンモグラフィを評価し デジタルマモグラフィはバッチで読みます
研究 の 目的:
- 2番目の読者のバッチ読み順の変更が乳がん検出率に影響するかどうかを評価する.
主な方法:
- イギリスの46のスクリーニングセンターで360人の読者を対象とした多センター,ダブルブラインド,クラスターランダム化試験です.
- 介入群の読者はマモグラフィのバッチを 反対の順番で検査し,対照群は同じ順番で検査した.
主要な成果:
- 介入群と対照群の間では,がん検出率 (0. 88% 対 0. 87%) で有意な差はありません.
- 同様のリコール率 (4. 14% 対 4. 17%) と読者による意見の相違 (3. 43% 対 3. 48%) が観察された.
- この研究では 1,194,147件のスクリーニングマンモグラフィを分析した.
結論:
- マンモグラフィー・バッチの読み取り順番が異なるのは 乳がんの検出率を大きく変えない.
- この結果は,現在のバッチ読み取りプロトコルが読者順序に関して堅牢であることを示唆しています.
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