Proficiency test for screening mammography: results for 117 volunteer Italian radiologists

Objective-To analyse the performance of a large sample of Italian radiologi sts undergoing a proficiency test for screening mammography. Design-Evaluation of performance indicators according to reference standard s determined by a panel of experts (sensitivity (reference standard greater than or equal to 80%), recall rate (reference standard less than or equal to 15%)). Setting-117 Italian radiologists of varying experience (years of practice 0 .5-18, average 5.9; mammograms read 500-51 000, average 13 000), all curren tly reporting clinical mammography and planning to take part in screening i n the near future. Results-Eighty four of 117 (72%) radiologists reached the standard for sens itivity, 88 (75%) reached the standard for recall rate, and only 59 (50%) r eached both standards and passed the proficiency test. The probability of p assing the test was significantly correlated with mammographic practice (p= 0.015), mammograms read (p=0.024), and mammograms read/year (p=0.043). Discussion-The performance of a large sample of Italian radiologists curren tly reporting clinical mammography was disappointing, indicating the need f or proper training of at least 50% of the tested subjects. When implementin g organised screening the health authority should set up a proper process f ar training and accrediting radiologists, and a proficiency test should be part of such a process.