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J Clin Epidemiol. 2012 Feb;65(2):219-30. doi: 10.1016/j.jclinepi.2011.06.010. Epub 2011 Oct 15.

Use of clinical history affects accuracy of interpretive performance of screening mammography.

Author information

  • 1Department of Family Medicine, Oregon Health & Science University, Portland, OR 97239-3098, USA. carneyp@ohsu.edu

Abstract

OBJECTIVE:

To examine how use of clinical history affects radiologist's interpretation of screening mammography.

STUDY DESIGN AND SETTING:

Using a self-administered survey and actual interpretive performance, we examined associations between use of clinical history and sensitivity, false-positive rate, recall rate, and positive predictive value, after adjusting for relevant covariates using conditional logistic regression.

RESULTS:

Of the 216 radiologists surveyed (63.4%), most radiologists reported usually or always using clinical history when interpreting screening mammography. Compared with radiologists who rarely use clinical history, radiologists who usually or always use it had a higher false-positive rate with younger women (10.7 vs. 9.7), denser breast tissue (10.1 for heterogeneously dense to 10.9 for extremely dense vs. 8.9 for fatty tissue), or longer screening intervals (> prior 5 years) (12.5 vs. 10.5). Effect of current hormone therapy (HT) use on false-positive rate was weaker among radiologists who use clinical history compared with those who did not (P=0.01), resulting in fewer false-positive examinations and a nonsignificant lower sensitivity (79.2 vs. 85.2) among HT users.

CONCLUSION:

Interpretive performance appears to be influenced by patient age, breast density, screening interval, and HT use. This influence does not always result in improved interpretive performance.

Copyright © 2012 Elsevier Inc. All rights reserved.

PMID:
22000816
[PubMed - indexed for MEDLINE]
PMCID:
PMC3253253
Free PMC Article

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