Quality/Medical Errors

Radiologists with more experience reading mammograms aren't necessarily more accurate in interpreting them

Radiologists differ in their ability to interpret screening mammograms accurately. However, accuracy is not associated with volume of mammograms read or years of experience. In fact, more experienced radiologists are more likely to call a mammogram positive than they are to have a keener ability to detect cancer, according to a study supported by the Agency for Healthcare Research and Quality (HS10591).

Training prior to practice may be the most important component of accuracy in mammogram interpretation. However, this conclusion requires further study, according to William E. Barlow, Ph.D., of the University of Washington, Seattle. Dr. Barlow and his colleagues investigated the relationship of radiologist characteristics to the accuracy of mammogram interpretation from 1996 to 2001.

They linked nearly 500,000 screening mammograms interpreted by 124 radiologists with breast cancer outcomes data. The radiologists completed a survey on demographics, malpractice concerns, years of experience interpreting mammograms, and number of mammograms read annually. Within 1 year of mammography, 2,402 breast cancers were identified, a rate of 5.12 per 1,000 screening mammograms.

There was no significant association between accuracy and years interpreting mammograms or mammography volume, after adjusting for variables that affect the threshold for calling a mammogram positive (cancer). The researchers conclude that increasing volume requirements is unlikely to improve overall mammography accuracy.

See "Accuracy of screening mammography interpretation by characteristics of radiologists," by Dr. Barlow, Chen Chi, M.S., Patricia A. Carney, Ph.D., and others in the December 15, 2004, Journal of the National Cancer Institute 96(24), pp. 1840-1850.

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