干旱区生态环境知识资源中心

Rationale and Objectives: The purpose of this study was to better understand the concept of mammography difficulty and how it affects radiology resident performance.

Materials and:Methods: Seven radiology residents and three expert breast imagers reviewed 100 mammograms, consisting of bilateral medial lateral oblique and craniocaudal views, using a research workstation. The cases consisted of normal, benign, and malignant findings. Participants identified abnormalities and scored the difficulty and malignant potential for each case: Resident performance (sensitivity, specificity, and area under the receiver operating characteristic curve [AUC]) was calculated for Self- and expert-assessed high and low difficulties.

Results: For cases classified by self-assessed difficulty, the resident AUCs were 0.667 for high difficulty and 0.771 for low difficulty cases (P = .010). Resident sensitivities were 0.707 for high and 0.614 for low difficulty cases P = .113). Resident Specificities were 0.583 for high and 0.905 for low difficulty cases (P < .001). For Oases classified by expert-assessed difficulty, the resident AUCs were 0.583 for high and 0.783 for low difficulty cases P = .001). Resident sensitivities Were 0.558 for high and 0.796 for low difficulty cases (P < .001). Resident specificities were 0.714 for high and 0.740 for low difficulty-cases (P = .807).

Conclusions: Increased self- and expert-assessed difficulty is associated with a decrease in resident performance in mammography. However, while this lower performance is due to a decrease in specificity for self-assessed difficulty, it is due to a decrease in sensitivity for expert-assessed difficulty: These tends. suggest that educators should provide a mix of self- and expert-assessed difficult cases in educational materials to maximize the effect of training on resident performance and confidence.