Factors that impact upon interpretation efficacy of radiography advanced practitioners who interpret mammograms

Objectives

In the United Kingdom (UK) Radiography advanced practitioners (RAPs) report mammographic images, however unlike other professional groupings who read mammograms, no data are available describing factors that impact reading performance. This preliminary study explores whether or not factors such as experience, mind set, access to prior images encountered by RAPs could impact upon their performance.

Methods

The performance of 15 RAPs interpreting a test set of 60 mammographic cases with known reading outcomes was assessed. Twenty of these 60 cases contained a cancer, whilst the remaining cases were normal or benign. Sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) and free response operating characteristic (AFROC) values were established for each RAP and Student-T and Mann Whitney tests were used to identify specific features that had a significant impact on accuracy.

Results

In terms of ROC values, higher values (p = 0.0042) were seen in those readers who: had less than [10 years experience] (0.93), compared to readers with greater than 10 years of experience (0.84); read greater than [100 cases/week] (0.93), compared to those who read less than 100 cases per week (0.87) (p = 0.0358) as well as readers who believed that emotional mind-set impacted their image interpretation (0.91) compared to those who did not (0.84) (p = 0.0272). Similar higher ROC values were noted in readers who consistently relied on [prior imaging](0.94), compared to those who occasionally relied on prior projections (0.89) (p = 0.0231).

Conclusion

This preliminary work suggests that factors may impact upon the diagnostic performance of RAPs when reading mammograms. These early results from a small sample size demonstrate that further explorations are required to optimise RAP reporting.