4 ms·

There is history of breast cancer in my family and anything that can be done to improve outcomes has to be highly commended. I did however have the same questio

There is history of breast cancer in my family and anything that can be done to improve outcomes has to be highly commended. I did however have the same question and this > to at least get a second opinion on their mammogram. for me makes a lot of sense, even in developed countries where you get a result but want extra assurances. It would be interesting to know (assuming you have the data, even anecdotally) if the second opinions using this overturned professional ones and from those how many were corrected an original false negative mistake.

ska 4y ago
Not speaking for coolwulf obviously but I can perhaps shed some light. Screening breast mammo has an occurrence rate problme. Something like less than 10 in 1000 studies will require further review; this means in practice as a radiologist you look at a lot of negative films before seeing a TP. It also means a typical read is done fast. Seconds-to-small minutes. This results in a couple of things. Reader variability based on experience/throughput, and false negatives. There were some double reader studies that caught something like 15% (going from memory here) of FN - but nobody can affort to have two radiologists read everything. So the profession is already conceptually used to the idea of using an algorithm as a "second read" and reconsidering. Typically this won't "overturn" anything here but rather say 'hey have another look', but the decision to proceed or not is still the clinicians. Having a positive from the algorithm makes them review carefully, but you have to watch the FP rate here or nobody would get anything else done. I have heard of health systems using algorithms as a first pass too (i.e. radiologist only see films that have had a postive in a tuned-to-be-senstive version), but that has it's own set of issues.

ska 4y ago

Not speaking for coolwulf obviously but I can perhaps shed some light. Screening breast mammo has an occurrence rate problme. Something like less than 10 in 1000 studies will require further review; this means in practice as a radiologist you look at a lot of negative films before seeing a TP. It also means a typical read is done fast. Seconds-to-small minutes. This results in a couple of things. Reader variability based on experience/throughput, and false negatives. There were some double reader studies that caught something like 15% (going from memory here) of FN - but nobody can affort to have two radiologists read everything. So the profession is already conceptually used to the idea of using an algorithm as a "second read" and reconsidering. Typically this won't "overturn" anything here but rather say 'hey have another look', but the decision to proceed or not is still the clinicians. Having a positive from the algorithm makes them review carefully, but you have to watch the FP rate here or nobody would get anything else done. I have heard of health systems using algorithms as a first pass too (i.e. radiologist only see films that have had a postive in a tuned-to-be-senstive version), but that has it's own set of issues.