A self-directed learning intervention for radiographers rating mammographic breast density |
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| Affiliation: | 1. Faculty of Health Sciences, The University of Sydney, Discipline of Medical Radiation Sciences, Cumberland Campus, 75 East Street, Lidcombe, NSW 2141, Australia;2. Faculty of Health Sciences, University of Calabar, Department of Radiography and Radiological Sciences, PMB 1115 Calabar, Nigeria;3. Directorate of Radiography, Center for Health Science Research, University of Salford, UK;4. Center for Health Science Research, Karolinska Institute, Stockholm, Sweden;1. Department of Orthopaedic Surgery, Clinical Orthopedic Research Hvidovre, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark;2. Functional and Diagnostic Imaging Department, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark;3. Clinical Research Center, Copenhagen University Hospital Hvidovre, Kettegaard Alle 30, Hvidovre, 2650, Copenhagen, Denmark;1. University of Salford, Salford, UK;2. Liverpool Vascular & Endovascular Service, Liverpool, UK;3. Royal Liverpool & Broadgreen University Hospital, Liverpool, UK;1. Department of Imaging Technology & Sonography, University of Cape Coast, Cape Coast, Central Region, Ghana;2. Corston Health System Ltd, P.O. Box GP 4560, Accra, Ghana |
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| Abstract: | PurposeSubjective methods of mammographic breast density (MBD) assessment are prone to inter-reader variability. This work aims to assess the impact of a short self-directed, experiential learning intervention on radiographers' reproducibility of MBD assessment.MethodThe study used two sets of images (test and learning intervention) containing left craniocaudal and left mediolateral oblique views. The test set had MBD ratings from Volpara™ and radiologists using the fourth edition Breast Imaging and Data Systems (BI-RADS®). Seven radiographers rated the MBD of the test set before and after a self-directed learning intervention using the percentage descriptors in the fourth edition BI-RADS® Atlas. The inter-reader agreement, the agreement between radiographers and Volpara™ as well as radiologists, was assessed using a Weighted Kappa (кw).ResultsOverall, radiographers' inter-reader agreement (кw) was substantial (0.79; 95% CI: 0.70–0.87) before the intervention and almost perfect (0.84; 95% CI: 0.77–0.90) after the intervention. Before the intervention, radiographers demonstrated fair agreement with radiologists (0.24; 95% CI: −0.46–0.61) and Volpara™ (0.24; 95% CI: −0.41–0.59). A fair but slightly improved agreement was also observed between radiographers and radiologists (0.31; 95% CI: −0.33–0.64) as well as Volpara™ (0.28; 95% CI: −0.34–0.61) after the intervention.ConclusionFindings demonstrate that a short duration self-directed, experiential learning intervention reduces inter-reader differences in MBD classification, but has a negligible impact on improving the agreement between inexperienced and expert readers. |
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| Keywords: | Training Mammography Volumetric assessment Volpara™ Inter-reader variability |
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