The effect of prevalence of disease on performance of residents and fellows during training for interpreting DBT in a test-train-test observer study

Christiane M. Hakim; Lauren Chang Sen; Andrew Degnan; Joseph Delic; Sarah Pai; Hersh Sagreiya; Mark Sparrow; Ernestine Thomas; Michael Yannes; David Gur

doi:10.1117/12.2249341

10 March 2017 The effect of prevalence of disease on performance of residents and fellows during training for interpreting DBT in a test-train-test observer study

Christiane M. Hakim, Lauren Chang Sen, Andrew Degnan, Joseph Delic, Sarah Pai, Hersh Sagreiya, Mark Sparrow, Ernestine Thomas, Michael Yannes, David Gur

Author Affiliations +

Proceedings Volume 10136, Medical Imaging 2017: Image Perception, Observer Performance, and Technology Assessment; 1013603 (2017) https://doi.org/10.1117/12.2249341
Event: SPIE Medical Imaging, 2017, Orlando, Florida, United States

Abstract

There are no data on the effect of disease prevalence during training for interpreting digital breast tomosynthesis (DBT) based screening examinations on the performance of residents and fellows. We assessed the performance of six residents (four after one breast imaging rotation and two after two rotations) and two fellows in breast imaging when interpreting DBT screening examinations in a multi-case, mode balanced, test- train-test retrospective reader study (127 training and 160 testing cases). Half were trained with feedback of verified truth after reviewing each case with low prevalence of disease (13/127) and half with high prevalence (52/128). The pre- and post- training dataset was the same. Performance measures were compared (sensitivity, specificity and AUC). Readers trained with the low prevalence set decreased the overall recall rate of non-cancer cases (FPF from 0.21 to 0.13, <0.001), and of cases with known malignancies (TPF from 0.70 to 0.61, p=0.004, due primarily to one clearly outlier reader). Readers trained with the high prevalence increased the overall recall rate (albeit, not statistically significant) of non-cancer cases (FPF from 0.16 to 0.18, p=0.07), and a borderline significant increase of cancer cases (TPF from 0.61 to 0.66, p=0.04). Fellows post six months of specialty training in each group had no significant changes in sensitivity, specificity, or AUC after training (smallest p>0.07). Both residents with two rotations experience had significant changes in sensitivity and specificity (highest p<0.028), but not in AUC. Early training with low disease prevalence of “what not to recall” should be included during training.

Conference Presentation

Citation Download Citation

Christiane M. Hakim, Lauren Chang Sen, Andrew Degnan, Joseph Delic, Sarah Pai, Hersh Sagreiya, Mark Sparrow, Ernestine Thomas, Michael Yannes, and David Gur "The effect of prevalence of disease on performance of residents and fellows during training for interpreting DBT in a test-train-test observer study", Proc. SPIE 10136, Medical Imaging 2017: Image Perception, Observer Performance, and Technology Assessment, 1013603 (10 March 2017); https://doi.org/10.1117/12.2249341

ACCESS THE FULL ARTICLE

INSTITUTIONAL
Select your institution to access the SPIE Digital Library.

SELECT YOUR INSTITUTION

PERSONAL
Sign in with your SPIE account to access your personal subscriptions or to use specific features such as save to my library, sign up for alerts, save searches, etc.

PERSONAL SIGN IN

No SPIE Account? Create one

;

PURCHASE THIS CONTENT

SUBSCRIBE TO DIGITAL LIBRARY

50 downloads per 1-year subscription

Members: $195

Non-members: $335 ADD TO CART

25 downloads per 1 - year subscription

Members: $145

Non-members: $250 ADD TO CART

PURCHASE SINGLE ARTICLE