Inter-observer variability in mammography screening and effect of type and number of readers on screening outcome

Inter-observer variability in mammography screening and effect of type and number of readers on screening outcome
L E M Duijm, M W J Louwman, J H Groenewoud, L V van de Poll-Franse, J Fracheboud & J W Coebergh
Br J Cancer 2009 100: 901-907

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Twenty-one screening mammography radiographers and eight screening radiologists participated. A total of 106 093 screening mammograms were double-read by two radiographers and, in turn, by two radiologists. Initially, radiologists were blinded to the referral opinion of the radiographers. A woman was referred if she was considered positive at radiologist double-reading with consensus interpretation or referred after radiologist review of positive cases at radiographer double-reading.

We conclude that screener performance significantly varied at single-reading. Double-reading increased sensitivity by a relative 7.3%. When there is a shortage of screening radiologists, triple reading by one radiologist and two radiographers may replace radiologist double-reading.