Abstract:
BACKGROUND:Early detection with screening mammography can potentially reduce breast cancer mortality rates. To achieve an efficient screening, a peer review system provides a compensatory double-check reviewing, will hopefully to prevent the omission of detectable lesions and reduce unnecessary recall. METHODS:In 2009, 4643 initial mammographic screenings reported by 74 screening radiologists had negative results with a recall rate of less than 5%. In the same year, 2538 initial positives screened by 18 screening radiologists had a recall rate higher than 15%. Those 7181 randomized screenings were evenly distributed for reassessment by 39 reviewing radiologists. The disagreement of assessments between the reviewers and screening radiologists was recorded. The differential rate was defined as the number of the disagreements divided by the number of audited films reviewed by a screening radiologist. The equality of the differential rates for each screening radiologists with negative and positive assessments was compared by a Chi-square test. The performance of the 39 auditors was measured by the Kendall's tau statistic. P values less than 0.05 were considered statistically significant. RESULTS:The mean differential rate for screening radiologists of negative assessments was 6.7% (P = 0.588), while 35.0% for positive assessments were significant (P < 0.001). The result indicated that most of the initial negative assessments reported by the screening radiologists were generally accepted by the reviewers but not the positive assessments. With respect to the 39 reviewers, there was no significant evidence for the association of the difference rates between negative and positive assessments. Nine reviewers were found to have their differential rate for negative and positive assessments larger than the average of the population. Eleven reviewers were found to have their differential rates smaller than the average for both. Thirteen reviewers had their differential rates smaller than the average for negative assessments but larger than the average for positive assessments. The opposite condition was found for six reviewers. The Kendall's tau statistic was 0.038 (P = 0.735). CONCLUSIONS:Reviewers usually agreed with the opinion of the initial screening doctors who reported negative findings. Therefore, a 5% recall rate as the lower range of reviewing negatives may be still too high. The recall rate of more than 15% was significantly related to improper interpretation, especially when the differential rate is 25% or higher, a warning to the underperforming screening radiologist is recommended. An ideal reviewer should interpret films independently. Reviewers with tendencies to be followers or contrarians should not be enrolled in the reviewing system.
journal_name
Chin Med J (Engl)journal_title
Chinese medical journalauthors
Pan HB,Hsu GC,Yang TL,Huang JS,Chou CP,Liang HL,Lee SK,Chou YH,Li HJ,Wong KFsubject
Has Abstractpub_date
2013-01-01 00:00:00pages
68-71issue
1eissn
0366-6999issn
2542-5641journal_volume
126pub_type
杂志文章abstract:OBJECTIVE:To determine whether extraadrenal tissues synthesize aldosterone in addition to vascular tissue and brain. METHODS:Ex vivo kidney perfusion was performed in normal Wistar rats, ACEI pretreated and adrenalectomized rats prior to the perfusion experiment. After equilibration for 30 minutes, 120 ml of perfusate...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
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abstract:BACKGROUND:The usual transbronchial coagulation techniques include microwave, argon plasma coagulation (APC), electrocautery and cryotherapy. However, there are serious clinical problems in the safety of each. By analyzing the experimental data and clinical observations, we observed the variable effects of different co...
journal_title:Chinese medical journal
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abstract:BACKGROUND:Caspases are important in the signaling pathway of cellular apoptosis. Caspase-3 protein expression has been shown to increase and parallel to neuronal apoptosis in retinal ischemia injury. This study was to determine whether caspase-1 is involved in neuronal cell death or in retinal ischemia and reperfusion...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
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abstract:OBJECTIVE:To determine mutations of two common potassium channel subunit genes KCNQ1, KCNH2 causing long QT syndrome (LQTS) in the Chinese. METHODS:Thirty-one Chinese LQTS pedigrees were characterized for mutations in the two LQTS genes, KCNQ1 and KCNH2, by sequencing. RESULTS:Two novel KCNQ1 mutations, S277L in the ...
journal_title:Chinese medical journal
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doi:
更新日期:2003-09-01 00:00:00
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journal_title:Chinese medical journal
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doi:
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pub_type: 杂志文章
doi:10.4103/0366-6999.192782
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journal_title:Chinese medical journal
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pub_type: 杂志文章
doi:
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.4103/0366-6999.168056
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journal_title:Chinese medical journal
pub_type: 杂志文章,评审
doi:
更新日期:2011-11-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2004-11-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:1996-10-01 00:00:00
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journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridging (MB). Variable prevalence of MB has been described at autopsy and angiographic series with small and large sample size studies. In addition, no similar study was reported in Chinese population....
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2008-03-05 00:00:00
abstract:BACKGROUND:Four single nucleotide polymorphisms (SNPs) in the modulator recognition factor 2/AT-rich interaction domain 5B (MRF2/ARID5B) gene located at chromosome 10q21.2 have been shown to be associated with both type 2 diabetes mellitus (T2DM) and coronary artery disease in a Japanese cohort. This study aimed to inv...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.4103/0366-6999.204926
更新日期:2017-05-05 00:00:00
abstract::The solid pseudopapillary tumors of the pancreas (SPTP) are rare tumors, which are commonly found in adolescent women. Radical surgical resection of the primary tumor or metastases is the standard treatment for SPTP and could achieve long-term survival. We reported a case of a 20-year-old female with multiple liver me...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Cardiovascular diseases, especially coronary artery disease (CAD), are major causes of death in industrialized countries. Elevated concentrations of plasma homocysteine (Hcy) have been associated with an increased risk of CAD. Increased plasma levels of chemokine, characterized by their ability to induce mig...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Laser in situ keratomileusis (LASIK) has become an efficient and commonly performed procedure to reduce refractive errors. In order to further increase the postoperative visual quality, the wavefront-guided refractive surgery has been a research hotspot in customized surgery. This study was conducted to comp...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:
更新日期:2008-01-20 00:00:00
abstract:BACKGROUND:Transcatheter bronchial artery embolization (BAE) is widely used for the treatment of hemoptysis and the immediate success rate is high, but there are still some hemorrhage recurrences. One of the common reasons for failure of BAE is collateral branches as blood supply. The inferior phrenic artery (IPA) is o...
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doi:
更新日期:2009-03-05 00:00:00
abstract:BACKGROUND:Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), but the prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs as a prognostic factor in CLL. METHODS:This study retrospectively analyzed clinical data from 21...
journal_title:Chinese medical journal
pub_type: 杂志文章
doi:10.1097/CM9.0000000000000114
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abstract:BACKGROUND:Septicemia and inflammation-mediated septic shock caused by Vibrio vulnificus (VV) is strongly associated with chronic liver disease. This study examined the effects of antimicrobial therapy on expression of hepatic toll-like receptors and inflammatory cytokines in rats with alcohol-induced liver disease com...
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更新日期:2009-08-20 00:00:00
abstract::This paper reports the results of serological survey of 318,912 persons for nasopharyngeal carcinoma (NPC) in 21 cities and counties of south China. There were 8,441 persons with positive VCA-IgA antibody (single item positive) of EB virus (EBV), with a rate of 2.65%. In these VCA-IgA positive persons, 287 persons als...
journal_title:Chinese medical journal
pub_type: 杂志文章,多中心研究
doi:
更新日期:1995-04-01 00:00:00
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doi:
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abstract:OBJECTIVE:To investigate the influence of alveolar macrophages (AMs), fibroblasts and interstitial cells on development of lung fibrosis, and the interactions among TGF-beta 1 PDGF and IGF-1 and these cytokines-effects on lung fibrosis. MATERIAL AND METHODS:Expressions of TGF-beta 1, PDGF and IGF-1 mRNA in the lung ce...
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