Assessment of Jordanian Radiologist Performance in the Detection of Breast Cancers

This study aims to monitor diagnostic accuracy amongst Jordanian mammography readers and identify parameters linked to higher levels of performance. In this study, we have used the Breast Screen Reader Assessment Strategy (BREAST) platform to facilitate 27 radiologists in reading a case set of 60 digital mammograms, 20 of which included cancers. Each case consisted of the four standard cranio-caudal (CC) and medio-lateral oblique (MLO) projections. All radiologists were registered to read mammograms at their workplace by the Jordanian Ministry of Health. Each reader was asked to locate any malignancies, provide a confidence rating using a scale of 1 - 5, and identify the type of appearance. All images were displayed using 8 MP monitor, supported by radiology workstations with full image manipulation facilities. Results were evaluated using Jackknife Alternative Free-Response Receiver Operating Characteristic (JAFROC). Demographics obtained from each radiologist regarding their experience, qualifications and breast-reading activities were correlated against JAFROC scores using Spearman techniques. The results showed that the mean JAFROC score was 0. 52 (95% confidence interval (CI): 0.46, 0.58); location sensitivity score was 0. 41 (95% CI: 0.41, 0.56); specificity score was 0.73 (95% CI: 0.68, 0.83). Higher performance in term of JAFROC scores was directly related to number of years since professional qualification (r = 0.433; p = 0.024), number of years reading breast images (r = 0.62; r = 0.001) and number of mammography images read per year (r = 0.69; p = 0.001). On the other hand, higher performance was inversely linked to the frequency of reading other modalities per week (r = -0.48; p = 0.010). No other statistical differences were significant. Finally, higher radiologists’ performance in cancer detection is correlated with increasing the number of mammograms reads per week.