In a report released this week, the Institute of Medicine (IOM) has offered its take on how to overhaul U.S. breast cancer screening programs -- greater regulation of screening programs.
The committee of the National Cancer Policy Board declares that "current (Mammography Quality Standards Act) medical audit requirements are inadequate for measuring or improving the quality of image interpretation." The committee proposes "enhanced" medical audits, both mandatory and voluntary.
The mandatory portion would involve the collection of three core measures from each facility:
- Positive predictive value 2 (PPV2)
- Cancer detection rate per 1,000 women
- Abnormal interpretation rate
The voluntary part would also mean the collection of patient characteristics and tumor-staging reports.
In addition to revising the audit component of the MQSA, the organization recommends instituting a pay-for-performance policy and considering centralized cancer screening programs.
The report, titled "Improving Breast Imaging Quality Standards," also addresses the value of interpretive tools, such as computer-aided detection (CAD) and double-reading, as well as the manpower shortage in the specialty. Prorated malpractice insurance premiums and increasing the role of radiologist assistants (RA) are two options detailed in the report.
Although the IOM paper does not directly call for any increases in breast cancer screening reimbursement, it does state that rates should be increased if new audit procedures are implemented.
Click here to access the executive summary of the 84-page report.
By AuntMinnie.com staff writers
May 27, 2005
Related Reading
PPV alone not enough to assess mammo screening program, May 23, 2005
Breast imaging trends show longer waits for screening mammo, more biopsies, May 6, 2005
Breast biopsy costs big bucks, but so does cancer screening, January 19, 2005
IOM calls for increase in mammography services, access, June 11, 2004
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