ArticleEuropean journal of radiology2026
Interobserver variability of recall decisions between mammography readers in the English NHS breast screening programme: A comparison of interobserver variability measures.
Article in European journal of radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate interobserver variability between mammogram readers' recall decisions in the English NHS breast screening programme, comparing different variability measures.
methodsData from 401,682 women in 22 NHS centres who underwent mammographic screening interpreted independently by two mammogram readers were included. Percentage agreement, prevalence-adjusted bias-adjusted-kappa (PABAK), Gwet's agreement coefficient (Gwet's AC) and Cohen's kappa were reported with 95% confidence intervals. Analyses were performed separately for women at first and subsequent screening appointments, by cancer diagnosis, reader recall rates and age group.
resultsOf 86,287 women at first screening, 6,491 (7.5%) were recalled, compared to 9,488 (3.0%) of 315,395 at subsequent screenings. Percentage agreement, Gwet's AC, and PABAK were lower for first screening than subsequent (93.6%, 95%CI: 93.4-93.7 vs 97.2%, 95%CI: 97.2-97.3), (92.3, 95%CI:92.1 to 92.5 vs 97.0, 95% CI: 97.0 to 97.1) and (87.2, 95%CI: 86.9-87.4 vs 94.4, 95%CI: 94.3-94.5), whereas Cohen's kappa, which is biased downwards when prevalence of recall is lower, did not change (61.6, 95%CI: 60.7-62.5 vs 61.8, 95%CI: 61.0-62.5). Percentage agreement, Gwet's AC, and PABAK were lower for women with cancer detected than without, but Cohen's kappa showed the opposite pattern, driven by prevalence bias. Percentage agreement, Gwet's AC, and PABAK were lower when one/both readers had high recall rates, but Cohen's kappa showed no important pattern.
conclusionsPercentage agreement, Gwet's AC, and PABAK showed lower agreement for interpreting the more challenging first screen, without assistance of previous mammograms, when women had cancer and when one/both readers had a high recall rate. Cohen's kappa was heavily distorted by outcome prevalence. Despite widespread use, Cohen's kappa is inappropriate for low prevalence settings such as screening, or making comparisons when prevalence varies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.