Radiologists' perceptions of computer aided detection versus double reading for mammography interpretation

Abstract

Rationale and objectives: The aim of this study was to examine radiologists' use and perceptions of computer-aided detection (CAD) and double reading for screening mammography interpretation.

Materials and methods: A mailed survey of 257 community radiologists participating in the national Breast Cancer Surveillance Consortium was used to assess perceptions and practices related to CAD and double reading. Latent class analysis was used to classify radiologists' overall perceptions of CAD and double reading on the basis of their agreement or disagreement with specific statements about CAD and double reading.

Results: Most radiologists (64%) reported using CAD for more than half the screening mammograms they interpreted, but only <5% reported double reading that much. More radiologists perceived that double reading improved cancer detection rates compared to CAD (74% vs 55% reported), whereas fewer radiologists thought that double reading decreased recall rates compared to CAD (50% vs 65% reported). Radiologists with the most favorable perceptions of CAD were more likely to think that CAD improved cancer detection rates without taking too much time compared to radiologists with the most unfavorable overall perceptions. In latent class analysis, an overall favorable perception of CAD was significantly associated with the use of CAD (81%), a higher percentage of workload in screening mammography (80%), academic affiliation (71%), and fellowship training (58%). Perceptions of double reading that were most favorable were associated with academic affiliation (98%).

Conclusions: Radiologists' perceptions were more favorable toward double reading by a second clinician than by a computer, although fewer used double reading in their own practice. The majority of radiologists perceived both CAD and double reading at least somewhat favorably, although for largely different reasons.

Figure 1

Self-reported use of CAD for mammogram interpretation among U.S. community radiologists (n=257).

Figure 2

Self-reported use of double reading for mammogram interpretation among U.S. community radiologists (n=257).

Figure 3

Perception about CAD (Fig. 3a) and double reading (Fig. 3b) on individual survey questions among radiologists who were classified as most favorable vs. most unfavorable by latent class analyses.

Figure 4

Correspondence of latent class perceptions of CAD with double reading perceptions for individual radiologists (N=236) expressed as probabilities.