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Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis

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Authors
Posso, Margarita
Puig, Teresa
Carles, Misericòrdia
Rué, Montserrat
Canelo-Aybar, Carlos
Bonfill, Xavier
Issue Date
2017-11
Keywords
Cost and cost analysis
Mammography
Mass screening
Cost and cost analysis
Systematic review
xmlui.metadata.dc.contributor.email
ccanelo@santpau.cat

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Citation
Effectiveness and cost-effectiveness of double reading in digital mammography screening: A systematic review and meta-analysis 2017, 96:40 European Journal of Radiology
Publisher
Elsevier Ireland Ltd
Journal
European Journal of Radiology
URI
http://hdl.handle.net/10757/622261
DOI
10.1016/j.ejrad.2017.09.013
Additional Links
http://linkinghub.elsevier.com/retrieve/pii/S0720048X17303716
Abstract
Purpose Double reading is the strategy of choice for mammogram interpretation in screening programmes. It remains, however, unknown whether double reading is still the strategy of choice in the context of digital mammography. Our aim was to determine the effectiveness and cost-effectiveness of double reading versus single reading of digital mammograms in screening programmes. Methods We performed a systematic review by searching the PubMed, Embase, and Cochrane Library databases up to April 2017. We used the QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies) tool and CHEERS (Consolidated Health Economic Evaluation Reporting Standards) checklist to assess the methodological quality of the diagnostic studies and economic evaluations, respectively. A proportion's meta-analysis approach, 95% Confidence Intervals (95% CI) and test of heterogeneity (P values) were used for pooled results. Costs are expressed US$ PPP (United States Dollar purchasing power parities). The PROSPERO ID of this Systematic Review's protocol is CRD42014013804. Results Of 1473 potentially relevant hits, four high-quality studies were included. The pooled cancer detection rate of double reading was 6.01 per 1000 screens (CI: 4.47‰–7.77‰), and it was 5.65 per 1000 screens (CI: 3.95‰–7.65‰) for single reading (P = 0.76). The pooled proportion of false-positives of double reading was 47.03 per 1000 screens (CI: 39.13‰–55.62‰) and it was 40.60 per 1000 screens (CI: 38.58‰–42.67‰) for single reading (P = 0.12). One study reported, for double reading, an ICER (Incremental Cost-Effectiveness Ratio) of 16,684 Euros (24,717 US$ PPP; 2015 value) per detected cancer. Single reading + CAD (computer-aided-detection) was cost-effective in Japan. Conclusion The evidence of benefit for double reading compared to single reading for digital mammography interpretation is scarce. Double reading seems to increase operational costs, have a not significantly higher false-positive rate, and a similar cancer detection rate. © 2017 Elsevier B.V.
Type
info:eu-repo/semantics/article
Rights
info:eu-repo/semantics/restrictedAccess
Language
eng
Description
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.
ISSN
0720048X
ae974a485f413a2113503eed53cd6c53
10.1016/j.ejrad.2017.09.013
Scopus Count
Collections
Medicina

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