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Mammographic interpretation in Vietnam : Tailored educational strategies are needed to increase clinicians’ expertise
Caspar, Felix Copps, Emily Diplas, Adrienne Hackney, Logan Jackson, Kyle Kearins, Imogen Lynch, Marcus McPherson, Dominique Pisconeri, Bellah Purkiss, Zara
Caspar, Felix
Copps, Emily
Diplas, Adrienne
Hackney, Logan
Jackson, Kyle
Kearins, Imogen
Lynch, Marcus
McPherson, Dominique
Pisconeri, Bellah
Purkiss, Zara
Abstract
Aim
Breast cancer incidence is rapidly increasing throughout South East Asia, highlighting the need for high-quality early diagnosis and treatment. This study aims to investigate the efficacy of mammography detection in Hanoi and Ho Chi Minh City (HCMC), Vietnam, using data from Australian radiologists as a benchmark; factors that influence performance will be highlighted.
Methods
A total of 53, 35 and 52 clinicians from Australia, HCMC and Hanoi, respectively, examined and diagnosed a test set of 60 mammograms, 20 of which contained cancers. Each clinician completed an accompanying questionnaire establishing demographic and experiential characteristics. The performance metrics of specificity, sensitivity, area under the receiver operating characteristic curve (AUC), location sensitivity and Jackknife free-response ROC (JAFROC) figure of merit were used to evaluate clinicians performance. Mann-Whitney and Kruskal-Wallis statistical methods were employed to establish significance.
Results
Vietnamese radiologists demonstrated significantly lower sensitivity, AUC, lesion sensitivity and JAFROC scores compared to Australian radiologists. There was no difference in performance between clinicians from Hanoi and HCMC. However, certain performance features (older and more experienced clinicians compared with their younger, less experienced counterparts, readers who read more compared with fewer mammograms per week, clinicians with greater radiological experience and clinicians that completed a fellowship) demonstrated significantly better performances.
Conclusions
The significant difference in diagnostic efficacy of mammograms between Vietnam and Australia identifies the need for improvements in breast radiology training, management and practice. Cost-effective solutions are available that can improve the reading efficacy of clinicians, and consequently health outcomes for Vietnamese women.
Keywords
breast cancer, diagnosis, experience, health equity, radiology
Date
2021
Type
Journal article
Journal
Asia-Pacific Journal of Clinical Oncology
Book
Volume
17
Issue
5
Page Range
e212-e216
Article Number
ACU Department
School of Education
Faculty of Education and Arts
Faculty of Education and Arts
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
All rights reserved
File Access
Controlled