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J W Partridge G, Darker I, J James J, Satchithananda K, Sharma N, Valencia A, Teh W, Khan H, Muscat E, J Michell M, Chen Y. How long does it take to read a mammogram? Investigating the reading time of digital breast tomosynthesis and digital mammography. Eur J Radiol 2024; 177:111535. [PMID: 38852330 DOI: 10.1016/j.ejrad.2024.111535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/16/2024] [Accepted: 05/27/2024] [Indexed: 06/11/2024]
Abstract
PURPOSE To analyse digital breast tomosynthesis (DBT) reading times in the screening setting, compared to 2D full-field digital mammography (FFDM), and investigate the impact of reader experience and professional group on interpretation times. METHOD Reading time data were recorded in the PROSPECTS Trial, a prospective randomised trial comparing DBT plus FFDM or synthetic 2D mammography (S2D) to FFDM alone, in the National Health Service (NHS) breast screening programme, from January 2019-February 2023. Time to read DBT+FFDM or DBT+S2D and FFDM alone was calculated per case and reading times were compared between modalities using dependent T-tests. Reading times were compared between readers from different professional groups (radiologists and radiographer readers) and experience levels using independent T-tests. The learning curve effect of using DBT in screening on reading time was investigated using a Kruskal-Wallis test. RESULTS Forty-eight readers interpreted 1,242 FFDM batches (34,210 FFDM cases) and 973 DBT batches (13,983 DBT cases). DBT reading time was doubled compared to FFDM (2.09 ± 0.64 min vs. 0.98 ± 0.30 min; p < 0.001), and DBT+S2D reading was longer than DBT + FFDM (2.24 ± 0.62 min vs. 2.04 ± 0.46 min; p = 0.006). No difference was identified in reading time between radiologists and radiographers (2.06 ± 0.71 min vs. 2.14 ± 0.46 min, respectively; p = 0.71). Readers with five or more years of experience reading DBT were quicker than those with less experience (1.86 ± 0.56 min vs. 2.37 ± 0.65 min; p = 0.008), and DBT reading time decreased after less than 9 months accrued screening experience (p = 0.01). CONCLUSIONS DBT reading times were double those of FFDM in the screening setting, but there was a short learning curve effect with readers showing significant improvements in reading times within the first nine months of DBT experience. CLINICALTRIALS gov Identifier: NCT03733106.
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Affiliation(s)
- George J W Partridge
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, United Kingdom
| | - Iain Darker
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, United Kingdom
| | - Jonathan J James
- Nottingham University Hospitals NHS Trust, Nottingham Breast Institute, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, United Kingdom
| | - Keshthra Satchithananda
- Department of Breast Radiology and National Breast Screening Training Centre, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom
| | - Nisha Sharma
- Leeds Breast Screening Unit, Leeds Teaching Hospital, York Road, Leeds, LS14 6UH, United Kingdom
| | - Alexandra Valencia
- Avon Breast Screening, Bristol Breast Care Centre, Bristol, BS10 5NB, United Kingdom
| | - William Teh
- North London Breast Screening Service, Edgware Community Hospital, London, HA8 9BA, United Kingdom
| | - Humaira Khan
- City, Sandwell and Walsall Breast Screening Service, Birmingham City Hospital, B18 7QH, United Kingdom
| | - Elizabeth Muscat
- South West London Breast Screening Service, St George's Hospital, London, SW17 0QT, United Kingdom
| | - Michael J Michell
- Department of Breast Radiology and National Breast Screening Training Centre, King's College Hospital, Denmark Hill, London SE5 9RS, United Kingdom
| | - Yan Chen
- University of Nottingham, School of Medicine, Translational Medical Sciences, Clinical Sciences Building, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB, United Kingdom.
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Jones LI, Marshall A, Geach R, Elangovan P, O'Flynn E, Timlin T, McKeown-Keegan S, Rose J, Vinnicombe S, Taylor-Phillips S, Halling-Brown M, Dunn JA. Optimising the diagnostic accuracy of First post-contrAst SubtracTed breast MRI (FAST MRI) through interpretation-training: a multicentre e-learning study, mapping the learning curve of NHS Breast Screening Programme (NHSBSP) mammogram readers using an enriched dataset. Breast Cancer Res 2024; 26:85. [PMID: 38807211 PMCID: PMC11134713 DOI: 10.1186/s13058-024-01846-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 05/18/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Abbreviated breast MRI (FAST MRI) is being introduced into clinical practice to screen women with mammographically dense breasts or with a personal history of breast cancer. This study aimed to optimise diagnostic accuracy through the adaptation of interpretation-training. METHODS A FAST MRI interpretation-training programme (short presentations and guided hands-on workstation teaching) was adapted to provide additional training during the assessment task (interpretation of an enriched dataset of 125 FAST MRI scans) by giving readers feedback about the true outcome of each scan immediately after each scan was interpreted (formative assessment). Reader interaction with the FAST MRI scans used developed software (RiViewer) that recorded reader opinions and reading times for each scan. The training programme was additionally adapted for remote e-learning delivery. STUDY DESIGN Prospective, blinded interpretation of an enriched dataset by multiple readers. RESULTS 43 mammogram readers completed the training, 22 who interpreted breast MRI in their clinical role (Group 1) and 21 who did not (Group 2). Overall sensitivity was 83% (95%CI 81-84%; 1994/2408), specificity 94% (95%CI 93-94%; 7806/8338), readers' agreement with the true outcome kappa = 0.75 (95%CI 0.74-0.77) and diagnostic odds ratio = 70.67 (95%CI 61.59-81.09). Group 1 readers showed similar sensitivity (84%) to Group 2 (82% p = 0.14), but slightly higher specificity (94% v. 93%, p = 0.001). Concordance with the ground truth increased significantly with the number of FAST MRI scans read through the formative assessment task (p = 0.002) but by differing amounts depending on whether or not a reader had previously attended FAST MRI training (interaction p = 0.02). Concordance with the ground truth was significantly associated with reading batch size (p = 0.02), tending to worsen when more than 50 scans were read per batch. Group 1 took a median of 56 seconds (range 8-47,466) to interpret each FAST MRI scan compared with 78 (14-22,830, p < 0.0001) for Group 2. CONCLUSIONS Provision of immediate feedback to mammogram readers during the assessment test set reading task increased specificity for FAST MRI interpretation and achieved high diagnostic accuracy. Optimal reading-batch size for FAST MRI was 50 reads per batch. Trial registration (25/09/2019): ISRCTN16624917.
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Affiliation(s)
- Lyn I Jones
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK.
| | - Andrea Marshall
- Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK
| | - Rebecca Geach
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK
| | - Premkumar Elangovan
- Scientific Computing Department, Royal Surrey NHS Foundation Trust, Guildford, Surrey, GU2 7XX, UK
| | - Elizabeth O'Flynn
- St George's University Hospitals Foundation Trust, London, SW17 0QT, UK
| | - Tony Timlin
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK
| | - Sadie McKeown-Keegan
- North Bristol NHS Trust, Southmead Hospital, Southmead Road, Westbury on Trym, Bristol, BS10 5NB, UK
| | - Janice Rose
- Independent Cancer Patients' Voice, London, EC1R 0LL, UK
| | - Sarah Vinnicombe
- Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, GL53 7AS, UK
| | | | - Mark Halling-Brown
- Scientific Computing Department, Royal Surrey NHS Foundation Trust, Guildford, Surrey, GU2 7XX, UK
| | - Janet A Dunn
- Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK
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Catania D, Giannotti N, Roletto A, Ryan ML. Opinions on advanced practice among diagnostic and therapeutic radiographers: Survey results of an European congress of radiology study. Radiography (Lond) 2024; 30:806-812. [PMID: 38513333 DOI: 10.1016/j.radi.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/12/2024] [Accepted: 03/03/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION The exploration of Advanced Practice (AP) in both diagnostic and therapeutic radiography has become a prominent topic of discussion within the radiographic community, prompting an investigation into radiographers' perceptions and the current global status of advanced roles. This study aimed collect data on radiography and radiation therapy AP career paths, and understand radiographers' perceptions of advanced practice at the European Congress of Radiology (ECR) 2020. METHODS A concise, 15-question web-based survey was distributed through the EFRS Research Hub during ECR 2020. Topics covered included respondents' demographics, educational background, current radiography skills, the landscape of AP in radiography, potential progression avenues in their countries, and key benefits linked to role advancement. RESULTS The survey garnered responses from 83 radiographers, with a predominant 79.5% (n = 66) representing Europe. Information on the total number of participants approached during the ECR and thus the resulting response rate is not available. Among the findings, a meaningful portion (30%, n = 25) of participants indicated the absence of AP opportunities in their respective country. Notably, an overwhelming majority (97.5%, n = 81) expressed a personal willingness to embrace AP roles. Areas of particular interest to the respondents included radiography reporting (38.6%, n = 32), performing ultrasound examination (13.2%, n = 11), conducting interventional procedures (13.2%, n = 11) and engaging in radiography research (10.8%, n = 9). CONCLUSION The study indicates a keen interest among surveyed radiographers in pursuing AP, emphasizing the necessity for role recognition. Education, research and job satisfaction emerged as pivotal for AP progression. Despite this, AP availability in Europe is limited. IMPLICATION FOR PRACTICE There is a need to recognize and address barriers, provide targeted education and training, and promote job satisfaction to facilitate the development of AP in radiography.
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Affiliation(s)
- D Catania
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
| | - N Giannotti
- Medical Imaging Sciences, School of Health Sciences, The University of Sydney, Australia.
| | - A Roletto
- Department of Radiology, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - M-L Ryan
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Ireland.
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Dodelzon K, Milch HS, Mullen LA, Dialani V, Jacobs S, Parikh JR, Grimm LJ. Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review. JOURNAL OF BREAST IMAGING 2024; 6:124-132. [PMID: 38330442 DOI: 10.1093/jbi/wbad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Indexed: 02/10/2024]
Abstract
Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
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Affiliation(s)
- Katerina Dodelzon
- Department of Radiology, Weill Cornell Medicine at NewYork-Presbyterian, New York, NY, USA
| | - Hannah S Milch
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lisa A Mullen
- Division of Breast Imaging, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Vandana Dialani
- Division of Breast Imaging, Department of Radiology, Beth Israel Lahey Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Jacobs
- New Ulm Medical Center Radiology, Allina Health, New Ulm, MN, USA
| | - Jay R Parikh
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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Bradley D, Harrison J, Goodall M, Dobrashian R. Are Advanced Clinical Practitioners perfectly placed to re-report neuroimages to support clinical diagnosis of dementia? INTERNATIONAL JOURNAL FOR ADVANCING PRACTICE 2023; 1:146-150. [PMID: 38229770 PMCID: PMC7615529 DOI: 10.12968/ijap.2023.1.3.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
With the ageing population, the prevalence of dementia is increasing worldwide. There is an emphasis on early, timely diagnosis and treatment options for people with a dementia yet wait times from referral to diagnosis have increased. Neuroimaging performed by radiologists is utilised to support dementia diagnosis and some patients will already have a CT scan from a pre-existing condition such as stroke. The purpose of this commentary is to consider whether ACPs who specialise in dementia, are perfectly placed to re-report on pre-existing neuroimages to support the clinical diagnosis of dementia.
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Affiliation(s)
| | - Joanna Harrison
- Synthesis Economic Evaluation and Decision Science (SEEDS) Group, University of Central Lancashire
| | - Mark Goodall
- Institute of Population Health, University of Liverpool
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