'Batch reading' mammograms lowers recall rates

September 06, 2005

Batch reading, the process of interpreting screening mammograms during a set-aside block of time in a quiet environment that prevents interruption or distraction, can significantly reduce the number of patients who have to return for additional mammograms--although few hospitals use it, say researchers from the University of Wisconsin.

For the study, the researchers analyzed the recall and cancer detection rates for 9,522 screening mammograms, 1,538 of which were interpreted by batch reading. They found that recall rates were 20.1% without batch reading and 16.2% with batch reading and that the accuracy of cancer detection was not adversely affected.

According to the authors, methods of reading screening mammograms can be categorized as batch reading or non-batch reading. Non-batch reading refers to reading screening mammograms in the midst of other duties such as diagnostic mammograms, phone calls, consultations with referring physicians or procedures--in other words, with continual interruptions.

"Experts in the field of breast imaging have long believed that batch reading not only improves performance but contributes to cost-effective breast cancer screening. In 1994, researchers surveyed 1,057 facilities and found that only 20% used batch reading," said Elizabeth S. Burnside, MD, lead author of the study.

It may make sense that interpreting mammograms in a quiet, distraction-free environment would improve performance, but, say the authors, there are many competing pressures in a busy practice. Referring physicians want immediate access to radiologists for consultation on patients who are present in clinic, anxious patients desire immediate interpretation of mammograms and consultation with the interpreting physicians and the shortage of breast imaging specialists require these services be provided by a shrinking pool of individuals. "It is tempting for efficiency sake to fit screening mammograms into the small bits of time between other clinical activities, but our research demonstrates that batch reading contributes to maintaining high cancer detection while decreasing false positive results," said Dr. Burnside.

"This should encourage both the medical community and patients to support this practice. Despite the trade-offs, uninterrupted, distraction-free batch reading appears to be an essential component to high quality, accurate interpretation of screening mammography," said Dr. Burnside.
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A PDF of the full study is available upon request to reporters.

The study appears in the September 2005 issue of the American Journal of Roentgenology.

The American Journal of Roentgenology (AJR) is a highly respected peer-reviewed monthly radiology journal published by the American Roentgen Ray Society (ARRS). For almost 100 years, the AJR has been recognized as one of the best specialty journals in the world. The ARRS and AJR are named after Wilhelm Röentgen, who discovered the x-ray in 1895. For more information, visit www.arrs.org.

American College of Radiology

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