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Title: Influencing clinicians and healthcare managers: can ROC be more persuasive?
Authors: Taylor-Phillips, Sian
Wallis, Matthew G.
Duncan, Alison
Gale, Alastair G.
Keywords: ROC methodology
Observer performance evaluation
Prior mammograms
Issue Date: 2010
Publisher: © 2010 Society of Photo-Optical Instrumentation Engineers
Citation: TAYLOR-PHILLIPS, S. ... et al., 2010. Influencing clinicians and healthcare managers: can ROC be more persuasive? IN: Medical Imaging 2010: Image Perception, Observer Performance, and Technology Assessment, edited by David J. Manning, Craig K. Abbey, Proc. SPIE 7627,76270X (2010).
Abstract: Receiver Operating Characteristic analysis provides a reliable and cost effective performance measurement tool, without using full clinical trials. However, when ROC analysis shows that performance is statistically superior in one condition than another it is difficult to relate this result to effects in practice, or even to determine whether it is clinically significant. In this paper we present two concurrent analyses: using ROC methods alongside single threshold recall rate data, and suggest that reporting both provides complimentary data. Four mammographers read 160 difficult cases (41% malignant) twice, with and without prior mammograms. Lesion location and probability of malignancy was reported for each case and analyzed using JAFROC. Concurrently each participant chose recall or return to screen for each case. JAFROC analysis showed that the presence of prior mammograms improved performance (p<.05). Single threshold data showed a trend towards a 26% increase in the number of false positive recalls without prior mammograms (p=.056). If this trend were present throughout the NHS Breast Screening Programme then discarding prior mammograms would correspond to an increase in recall rate from 4.6% to 5.3%, and 12,414 extra women recalled annually for assessment. Whilst ROC methods account for all possible thresholds of recall and have higher power, providing a single threshold example of false positive, false negative, and recall rates when reporting results could be more influential for clinicians. This paper discusses whether this is a useful additional method of presenting data, or whether it is misleading and inaccurate
Description: Copyright 2010 Society of Photo-Optical Instrumentation Engineers. One print or electronic copy may be made for personal use only. Systematic electronic or print reproduction and distribution, duplication of any material in this paper for a fee or for commercial purposes, or modification of the content of the paper are prohibited. This paper can also be found at: http://dx.doi.org/10.1117/12.843784
Version: Published
DOI: 10.1117/12.843784
URI: https://dspace.lboro.ac.uk/2134/6255
ISSN: 1605-7422
Appears in Collections:Conference Papers and Presentations (Computer Science)

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