OBSERVER VARIABILITY IN EARLY MAMMOGRAPHI C DIAGNOSIS - AN ROC ANALYSIS

As part of the German mammographic study, the participating doctors we re given test films of 30 histologically confirmed cases. Regarding th e indications for biopsy there was good sensitivity (the median amongs t 25 doctors was 0.87). Specificity (median 0.86) could be improved. C omparison of individual results with the majority showed considerable variability within the group of doctors performing mammography. ROC an alysis indicated that there was considerable observer variability whic h was independent from the speciality or praxis characteristics of the participants. The inclusion of mammography in an early diagnostic pro gramme requires continuing education of the participants in this techn ique. This should be supported by further methods of quality assurance .