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medpundit |
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Thursday, April 05, 2007A highly promoted and widely used computerized system for examining mammograms is leading to less accuracy, not more, a new study finds. The system, known as computer-aided detection, or CAD, did not find more breast cancer, researchers are reporting today. But it did lead to many more false alarms that resulted in additional testing and biopsies for spots on mammograms that turned out to be harmless. I have noticed this in my practice since the computer aided detection was adopted by the mammography centers around here. There are significantly more women undergoing breast biopsies and repeat mammograms in my practice, but there isn't more breast cancer. Nice to see the observation confirmed by the study: Seven facilities (16%) implemented computer-aided detection during the study period. Diagnostic specificity decreased from 90.2% before implementation to 87.2% after implementation...., the positive predictive value decreased from 4.1% to 3.2% (P=0.01), and the rate of biopsy increased by 19.7%..... The increase in sensitivity from 80.4% before implementation of computer-aided detection to 84.0% after implementation was not significant..... The change in the cancer-detection rate (including invasive breast cancers and ductal carcinomas in situ) was not significant (4.15 cases per 1000 screening mammograms before implementation and 4.20 cases after implementation...). Analyses of data from all 43 facilities showed that the use of computer-aided detection was associated with significantly lower overall accuracy than was nonuse.... Like lung cancer screening and CT scans, this seems counter-intuitive. How could double-checking a result be less accurate than a single reading? Perhaps the human eye isn't so bad at detecting the true cancer, at least when that eye is connected to a discerning and well-trained brain. Or maybe breast cancer, like lung cancer, is one of those cancers that does not lend itself well to screening. Is there any reason to think that MRI's will be more accurate? posted by Sydney on 4/05/2007 08:32:00 PM 0 comments 0 Comments: |
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