Design of a study to improve accuracy in reading mammograms

Journal of Clinical Epidemiology
M S PepeG Longton

Abstract

This paper is concerned with the design and analysis of mammography reading studies. In particular we consider studies aimed at evaluating interventions to improve the accuracy with which mammograms are read. A simple randomized design is suggested in which a relatively large group of readers read sets of mammograms before and after an intervention phase. We propose solutions to three difficult statistical issues that arise in the context of such studies: (i) the choice of primary outcome measure; (ii) the data analysis technique to be employed; and (iii) the methodology for calculating sample sizes for readers and images to be read. First, we argue in favor of using sensitivity and specificity as the primary outcome measures rather than receiver operating characteristic (ROC) curves in mammography studies, although the latter are considered state of the art for many types of radiology reading studies. We argue that sensitivity and specificity are more clinically relevant and conceptually more straightforward than ROC curves. Second, we suggest a bivariate approach to data analysis for evaluating intervention effects on sensitivity and specificity. This accommodates the correlations inherent between these measures and allows fo...Continue Reading

References

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Citations

Mar 3, 2005·Journal of the National Cancer Institute·Rebecca Smith-BindmanKarla Kerlikowske
Nov 23, 2006·AJR. American Journal of Roentgenology·Stephen H TaplinConstance D Lehman
Jul 23, 2005·AJR. American Journal of Roentgenology·Nancy A Obuchowski
Aug 9, 2005·Journal of Clinical Epidemiology·Berta M GellerSusan C Harvey
Feb 28, 2004·The British Journal of Radiology·P M TaylorK Johnston
Jun 18, 2002·Medical Care·Nicole Urban

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