Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T04:18:23.808Z Has data issue: false hasContentIssue false
  • English
  • Français

Costs and effects of using specialized breast technologists in prereading mammograms in a clinical patient population

Published online by Cambridge University Press:  22 October 2009

Frank J. H. M. van den Biggelaar ,
Alphons G. H. Kessels ,
Jos M. A. van Engelshoven  and
Karin Flobbe
Frank J. H. M. van den Biggelaar
Affiliation:
Maastricht University Medical Center
Alphons G. H. Kessels
Affiliation:
Maastricht University Medical Center
Jos M. A. van Engelshoven
Affiliation:
Maastricht University Medical Center
Karin Flobbe
Affiliation:
Maastricht University Medical Center
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The aim of this study was to assess the costs and effects of using specialized breast technologists in prereading mammograms to reduce the increasing workload of radiologists in daily clinical practice. Mammography is the most widely used imaging modality for early detection and diagnosis of breast cancer.

Methods: A total of 1389 mammograms of consecutive patients were evaluated by two technologists trained in mammogram interpretation. The costs and effects of four different experimental strategies of prereading mammograms by technologists were analyzed by decision analytic modeling and compared with the conventional strategy of standard evaluation by the radiologist on duty.

Results: Overall, the employment of technologists in this patient population resulted in a potential time saving up to 73 percent (1019/1389) for the radiologist. No additional false-negative imaging results were found as compared to the conventional strategy. The total diagnostic costs in the conventional strategy were determined at €150,602. The experimental strategies resulted in cost savings up to 17.2 percent (range, €122,494–€139,781).

Conclusions: The employment of technologists in prereading mammograms in a clinical patient population could be effective to reduce the workload of radiologists without jeopardizing the detection of malignancies. Furthermore, diagnostic costs can be reduced considerably.

Keywords

Breast cancerMammographyCostsEffectsCost-effectivenessRadiologistTechnologist
Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 25 , Issue 4 , October 2009 , pp. 505 - 513
Copyright
Copyright © Cambridge University Press 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1. Nederlandse Zorgautoriteit: National reimbursement rates. http://ctg.bit-ic.nl/Nzatarieven/top.do (accessed August 19, 2008).Google Scholar
2. D'Orsi, CJ, Bassett, LW, Berg, WA, et al. Breast imaging reporting and data system: ACR BI-RADS-mammography. 4th ed. Reston, VA: American College of Radiology (ACR); 2003.Google Scholar
3. Flobbe, K, Bosch, AM, Kessels, AG, et al. The additional diagnostic value of ultrasonography in the diagnosis of breast cancer. Arch Intern Med. 2003;163:1194–1199.CrossRefGoogle ScholarPubMed
4. Flobbe, K, Kessels, AG, Severens, JL, et al. Costs and effects of ultrasonography in the evaluation of palpable breast masses. Int J Technol Assess Health Care. 2004;20:440–448.CrossRefGoogle ScholarPubMed
5. Haiart, DC, Henderson, J. A comparison of interpretation of screening mammograms by a radiographer, a doctor and a radiologist: results and implications. Br J Clin Pract. 1991;45:43–45.CrossRefGoogle Scholar
6. Hardin, C, Pommier, S, Pommier, RF. The relationships among clinician delay of diagnosis of breast cancer and tumor size, nodal status, and stage. Am J Surg. 2006;192:506–508.CrossRefGoogle ScholarPubMed
7. Hillman, BJ, Fajardo, LL, Hunter, TB, et al. Mammogram interpretation by physician assistants. AJR Am J Roentgenol. 1987;149:907–912.CrossRefGoogle ScholarPubMed
8. Oostenbrink, J, Bouwmans, C, Koopmanschap, M, Rutten, F. Handleiding voor kostenonderzoek: methoden en standaard kostprijzen voor economische evaluaties in de gezondheidszorg. Diemen: College voor zorgverzekeringen; 2004.Google Scholar
9. Pauli, R, Hammond, S, Cooke, J, Ansell, J. Comparison of radiographer/radiologist double film reading with single reading in breast cancer screening. J Med Screen. 1996;3:18–22.CrossRefGoogle ScholarPubMed
10. Sainsbury, R, Johnston, C, Haward, B. Effect on survival of delays in referral of patients with breast-cancer symptoms: a retrospective analysis. Lancet. 1999;353:1132–1135.CrossRefGoogle ScholarPubMed
11. Tartter, PI, Pace, D, Frost, M, Bernstein, JL. Delay in diagnosis of breast cancer. Ann Surg. 1999;229:91–96.CrossRefGoogle ScholarPubMed
12. Tonita, JM, Hillis, JP, Lim, CH. Medical radiologic technologist review: effects on a population-based breast cancer screening program. Radiology. 1999;211:529–533.CrossRefGoogle ScholarPubMed
13. Van den Biggelaar, FJ, Nelemans, PJ, Flobbe, K. Performance of radiographers in mammogram interpretation: a systematic review. Breast. 2008;17:85–90.CrossRefGoogle ScholarPubMed
14. Vercauteren, LD, Kessels, AG, Van der Weijden, T, et al. Clinical impact of the use of additional ultrasonography in diagnostic breast imaging. Eur Radiol. 2008;18:2076–2084.CrossRefGoogle ScholarPubMed
15. Wivell, G, Denton, ER, Eve, CB, et al. Can radiographers read screening mammograms? Clin Radiol. 2003;58:63–67.CrossRefGoogle ScholarPubMed
16. Zonderland, HM, Van Veghel, T, Van Asperen, CJ, et al. Richtlijn Screening en diagnostiek van het mammacarcinoom. Utrecht: CBO; 2007.Google Scholar