This paper is concerned with the design and analysis of mammography reading studies.
In particular we consider studies aimed at evaluating interventions to improve the accuracy with which mammograms are read.
A simple randomized design is suggested in which a relatively large group of readers read sets of mammograms before and after an intervention phase.
We propose solutions to three difficult statistical issues that arise in the context of such studies :
(i) the choice of primary outcome measure ;
(ii) the data analysis technique to he employed ;
and (iii) the methodology for calculating sample sizes for readers and images to he read.
First, we argue in favor of using sensitivity and specificity as the primary outcome measures rather than receiver operating characteristic (ROC) curves in mammography studies, although the latter are considered state of the art for many types of radiology reading studies.
We argue that sensitivity and specificity are more clinically relevant and conceptually more straightforward than ROC curves.
Second, we suggest a bivariate approach to data analysis for evaluating intervention effects on sensitivity and specificity.
This accommodates the correlations inherent between these measures and allows for estimation of joint effects on them.
Finally we propose a method for power calculations that uses computer simulation techniques. (...)
Mots-clés Pascal : Mammographie, Précision, Interprétation image, Sensibilité, Spécificité, Méthode ROC, Etude comparative, Méthode statistique, Simulation ordinateur, Evaluation performance, Formation permanente, Formation professionnelle, Homme, Radiodiagnostic
Mots-clés Pascal anglais : Mammography, Accuracy, Image interpretation, Sensitivity, Specificity, Receiver operating characteristic curves, Comparative study, Statistical method, Computer simulation, Performance evaluation, Continuing education, Occupational training, Human, Radiodiagnosis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0403433
Code Inist : 002B24A08. Création : 25/01/1999.