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イギリスのNHSの乳腺スクリーニングプログラムにおけるマンモグラフィーの読者間のリコール決定の観察者間変動:観察者間変動の測定値の比較
Laura Quinn1, David Jenkinson2, Sian Taylor-Phillips3
1Department of Applied Health Sciences, University of Birmingham, Birmingham, UK; NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK.
European journal of radiology
|February 14, 2026
まとめ
マンモグラフィーのリコール決定における観察者間の変動性は,最初のスクリーニングでは低いが,その後のスクリーニングでは高い. コエンのカッパは,有病率のバイアスのため,低有病率スクリーニングには適していません.
科学分野:
- 放射線学とイメージング
- バイオ統計学 バイオ統計学
- 公衆衛生は公衆衛生である.
背景:
- マンモグラフィックスクリーニングは,乳がんの早期発見に不可欠です.
- マンモグラフィの解釈における観察者間の変動は,スクリーニングの有効性に影響を与える可能性があります.
- 英国の国立保健サービス (NHS) の乳腺スクリーニングプログラムは,スクリーニングの質を標準化することを目的としています.
研究 の 目的:
- NHSの乳腺スクリーニングプログラムにおけるマンモグラフリーダーのリコール決定との一致を評価する.
- 観察者間の変動性の異なる統計的測定値のパフォーマンスを比較する.
主な方法:
- 22のNHSセンターで401,682人の女性のデータを分析した.
- 2人の読者によるマンモグラフィの独立した解釈.
- パーセント合意,流行率調整バイアス調整カッパ (PABAK),Gwetの合意係数 (GwetのAC),Cohenのカッパの計算と比較.
- スクリーニングのタイプ (最初 vs 後),癌の診断,読者のリコール率,および年齢層による階層化された分析.
主要な成果:
- 後のスクリーニングと比較して,最初のスクリーニングでより低い合意 (パーセント合意,GwetのAC,PABAK) が観察されました.
- 癌が検出され,読者がより高いリコール率を持っていた場合,合意の測定値は低い.
- コエンのカッパは不一致なパターンを示し,リコール頻度に大きく影響され,低頻度設定には適さない.
結論:
- パーセント合意,GwetのAC,およびPABAKは,マンモグラフィのスクリーニングにおける観察者間の変動性を評価するためのより信頼できる尺度です.
- コエンのカッパは,有病率バイアスの感受性があるため,低有病率スクリーニングシナリオには不適切です.
- 観察者間の変動性を理解し対処することは,乳がんスクリーニングプログラムの最適化に不可欠です.
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