Evidence map›Paper›PMID 33630161›Full record

ArticleEuropean radiology2021

Optimum screening mammography reading volumes: evidence from the NHS Breast Screening Programme.

Eleanor Cornford, Shan Cheung, Mike Press, Olive Kearins, Sian Taylor-Phillips

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In one paragraph

Article in European radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Eleanor CornfordThirlestaine Breast Unit, Cobalt House, Gloucestershire Hospitals NHS Foundation Trust, Thirlestaine Road, Cheltenham, Gloucestershire, GL53 7AS, UK. Eleanor.cornford@nhs.net.ORCID http://orcid.org/0000-0002-3139-356X
Shan CheungPublic Health England, 5 St Philips Place, Birmingham, B3 2PW, UK.
Mike PressScreening QA Service (South) Public Health England, Birmingham, UK.
Olive KearinsNational Lead Breast Screening Research & Data, Screening Division, Public Health England, Birmingham, UK.
Sian Taylor-PhillipsDivision of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7A, UK.

Funding

National Institute for Health Research NIHR-CDF-2016-09-018
6 · The paper itself

Abstract

objectivesMinimum caseload standards for professionals examining breast screening mammograms vary from 480 (US) to 5000 (Europe). We measured the relationship between the number of women's mammograms examined per year and reader performance.

methodsWe extracted routine records from the English NHS Breast Screening Programme for readers examining between 1000 and 45,000 mammograms between April 2014 and March 2017. We measured the relationship between the volume of cases read and screening performance (cancer detection rate, recall rate, positive predictive value of recall (PPV) and discrepant cancers) using linear logistic regression. We also examined the effect of reader occupational group on performance.

resultsIn total, 759 eligible mammography readers (445 consultant radiologists, 235 radiography advanced practitioners, 79 consultant radiographers) examined 6.1 million women's mammograms during the study period. PPV increased from 12.9 to 14.4 to 17.0% for readers examining 2000, 5000 and 10000 cases per year respectively. This was driven by decreases in recall rates from 5.8 to 5.3 to 4.5 with increasing volume read, and no change in cancer detection rate (from 7.6 to 7.6 to 7.7). There was no difference in cancer detection rate with reader occupational group. Consultant radiographers had higher recall rate and lower PPV compared to radiologists (OR 1.105, p = 0.012; OR 0.874, p = 0.002, unadjusted).

conclusionPositive predictive value of screening increases with the total volume of cases examined per reader, through decreases in numbers of cases recalled with no concurrent change in numbers of cancers detected. KEY POINTS: • In the English Breast Screening Programme, readers who examined a larger number of cases per year had a higher positive predictive value, because they recalled fewer women for further tests but detected the same number of cancers. • Reader type did not affect cancer detection rate, but consultant radiographers had a higher recall rate and lower positive predictive value than consultant radiologists, although this was not adjusted for length of experience.

Indexed as

Breast NeoplasmsMammographyEarly Detection of CancerFemaleHumansMass ScreeningSensitivity and SpecificityState MedicineBreastBreast cancerMammographyMass screening

Identifiers

PMID33630161

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.