Mammography Outcome Data: How much is enough?
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Tracking mammography outcome data has changed dramatically over the last 30 years. We used to simply ask… benign or malignant, how small and what type?
This level of generality in mammography screening is long gone. In its wake, we have dozens, even hundreds, of data points that can be assimilated into tracking reports… granular measurement of specificity, sensitivity, recall rate, number of biopsies, biopsy type, size and type of cancer, high-risk assessments and patient history, just to name a few—all tracked across different sites down to the individual radiologist.
Some facilities try to track everything, and many do. Others prefer to take a narrower approach, sticking to the minimum requirements in their particular country and/or state.
Which approach is better? What’s the right balance?
Unfortunately, there’s no single answer. It partially depends, of course, on the local/regional laws that apply to your health facility or imaging center and what type of interpretation you do (double read, double blind read, etc.)
That said, there are some best practices that work well for many sites I’ve worked with—regardless of location or screening type. Much of it comes down to your preferred workflow, the needs of your patient population and, most important, what metrics you’re trying to move the needle on. This should always include some level of detail around productivity requirements and documented goals for radiologists, technologists and other staff, balanced with quality metrics like recall rate, specificity and sensitivity. Adding other modalities besides mammography such as MRI, ultrasound and nuclear medicine only increases the number of metrics needed to follow.
Radiology Information Systems that are customized for mammography, such as CARESTREAM RIS, provide robust platforms for conveniently integrating patient data with ongoing tracking mechanisms that can be tailored for individual workflows. These systems automate many tasks that used to be handled manually, and bring the added benefit of keeping up with ongoing screening requirements that can change over time. Gone is the little black book listing your biopsy cases and pathology reports!
Based on their flexible nature, these systems enable you to establish a baseline for your facility, so you can focus on items that can actually drive better care and lower costs. This flexibility also lets you apply my golden rule… do what makes the most sense for your facility, based on your patients’ needs, and always use common sense.
What’s your golden rule?