Paper Info
Title
Blinding of the second reader in mammography screening: impact on behaviour and cancer detection.
Abstract
Background: The policy of the NHS Breast Cancer Screening Programme is for each woman's mammograms to be examined by two separate readers, working independently. In practice, sometimes the second reader (reader 2) can see the decision of the first reader (reader 1). The National Breast Screening Service (NB SS) computer software automatically records whether the second reader can see the decision of the first reader or whether they are 'blinded'. This study aimed to determine the effect of blinding the second reader on the recall rate and cancer detection rate of reader 2. Methods: Data were from eight screening centres based in the Midlands area in England participating in the 'Changing Case Order to Optimise Patterns of Performance in Screening (CO-OPS)' clinical trial. A three-level Markov Chain Monte Carlo multilevel model was fitted to determine the effect of blinding reader 2 on recall rate and cancer detection. Results: 207,595 women were included in the analysis, of whom 1,796 had cancer detected. Reader 2 was blinded to reader l's decisions for 54.5% (113,029/207,595) cases. If reader 2 is blinded, there is a high probability that they are more likely to recall than if they were not blinded for a prevalent case but less likely to recall an incident case. The interaction effects on reader 2's cancer detection rate were not significant. Conclusion: If the second reader is not blinded to the decision of the first reader, they appear to be influenced by the first reader's decision suggesting that reading is not independent.
Year
DOI
Venue
2019
10.1117/12.2512090
Proceedings of SPIE
Keywords
Field
DocType
Breast Screening,Radiologist,Double reading,Mammography,Cohort,Performance,Blinded Decision Making
Mammography,Blinding,Cancer detection,Medical physics,Medicine
Conference
Volume
ISSN
Citations 
10952
0277-786X
0
PageRank 
References 
Authors
0.34
0
3
Name
Order
Citations
PageRank
Jennifer Anne Cooper100.34
David Jenkinson200.34
Sian Taylor-Phillips320.81