Mammography recall rates of 4.9% to 5.5% achieve the best trade-off between sensitivity and positive predictive value, according to research published in the latest issue of the American Journal of Roentgenology.
To measure the effect of rising recall rates on sensitivity and positive predictive value (PPV), researchers from the University of North Carolina at Chapel Hill evaluated mammography and pathology data contained in the Carolina Mammography Registry (AJR, September 2001, Vol.177:3, pp. 543-549).
The registry collects prospective mammography data from mammography facilities, and links the data to a breast pathology database that includes benign and malignant breast pathology records, according to the team.
The study covered 215,665 screening mammograms from women, age 40 and over, who received screening mammography between January 1994 and June 1998. Women in the oldest age group (over 70) had a recall rate of 4.9% with a PPV of 12.7%, while those aged 60-69 had a recall rate of 5.8% with a PPV of 8.2%.
"When grouping practices by volume, we found that an increase in mean volume of mammograms was associated with a decrease in recall rate for screening volumes of more than 200 per month with no difference in sensitivity and an increase in PPV," the authors wrote.
The researchers performed regression analyses, which showed that practices with recall rates of 4.4% or less had lower sensitivity than practices that had recall rates of 4.8% or greater. However, the study team did not find a statistically significant increase in sensitivity among the practices after a recall rate of 4.8% was reached.
In addition, a decline in PPV was observed with increasing recall rates for practices with recall rates of 8.9% or greater, and to a lesser extent, for practices with recall rates of 5.9% to 8.7%, according to the researchers.
"Combining these findings, we conclude that practices with recall rates between 4.9% and 5.5% achieve the best trade-off of sensitivity and PPV," they concluded.
By Erik L. RidleyAuntMinnie.com staff writer
October 4, 2001
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