Cancer Control Research
5R01HS010591-03
Elmore, Joann G.
UNDERSTANDING VARIABILITY IN COMMUNITY MAMMOGRAPHY
Abstract
The goal of this research is to identify reasons for variability in the
interpretation of mammograms. Though previous studies have shown
marked interpretive variation, they did not explain why it occurs and they
used test sets that do not necessarily reflect what occurs in day-to-day
community practices. This community-based, multicenter observational study
will utilize a unique collaboration among three geographically distinct breast
cancer surveillance programs in the states of Washington, New Hampshire, and
Colorado. This collaboration will allow the investigators to accumulate
breast cancer outcome and interpretive data on more than 500,000 mammograms
from 91 facilities and 279 radiologists. The investigators will evaluate
potential factors influencing the accuracy and recall rates of mammography
using a structured conceptual framework that separates characteristics of the
radiologists from those of the facility and community environment. The
investigators hypothesize that the fiscal, legal, and community practice
environment and personal characteristics of the radiologist influence
variability in the accuracy of mammography and the likelihood of having
patients recalled for additional evaluation. Gaining a better understanding
of how individual radiologists and their practice environment account for
variation will help identify ways to improve mammography.
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