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Popular Mammography Tool Not Effective for Finding Invasive Breast Cancer

By MedImaging International staff writers
Posted on 15 Aug 2011

Computer-aided detection (CAD) technology was shown to be ineffective in identifying breast tumors, and appears to increase a woman’s risk of being called back needlessly for further testing following mammography, a recent study has found.

The analysis of 1.6 million mammograms in seven states in the United States has delivered the most definitive findings to date on whether the popular mammography tool is effective in helping find breast cancer. “In real-world practice, CAD increases the chances of being unnecessarily called back for further testing because of false-positive results without clear benefits to women,” said Dr. Joshua Fenton, assistant professor in the University of California (UC) Davis (USA) department of family and community medicine. “Breast cancers were detected at a similar stage and size regardless of whether or not radiologists used CAD.”

The study examined screening mammograms performed on more than 680,000 women at 90 mammography facilities in seven US states, from 1998 to 2006. The false-positive rate normally increased from 8.1% before CAD to 8.6% after CAD was installed at the facilities in the study. Moreover, the detection rate of breast cancer and the stage and size of breast cancer tumors were similar regardless of CAD.

The study, was published online July 28, 2011, in the Journal of the National Cancer Institute and used data from the Breast Cancer Surveillance Consortium. Computer-aided detection software, approved by the US Food and Drug Administration (FDA) in 1998, analyzes the mammogram image and marks suspicious areas for radiologists to review. Its use has surged in recent years since Medicare began covering it in 2001. CAD is now applied to the large majority of screening mammograms in the United States with annual direct US Medicare costs exceeding US$30 million, according to a 2010 study in the Journal of the American College of Radiology.

According to 2009 Medicare data, insurers including Medicare typically paid approximately $12 per screening mammogram for CAD in addition to the costs of the mammogram (about $81 for film mammography and $130 for digital mammography), representing a 9% to 15% additional cost for CAD use.

The current study builds on Dr. Fenton’s initial assessment of the technology published in the New England Journal of Medicine (NEJM) in 2007. That report, which examined mammography-screening results in 43 facilities, including seven that utilized CAD, found that CAD was associated with reduced accuracy of interpretation of screening mammograms but no difference in the detection rate of invasive breast cancer.

Critics of the research findings in the NEJM said the study was based on use of an older kind of CAD technology, and so did not accurately reflect its usefulness. “In the current study, we evaluated newer technology in a larger sample and over a longer time period,” said Dr. Fenton. “We also looked for the first time at cancer stage and cancer size, which are critical for understanding how CAD may affect long-term breast cancer outcomes, such as mortality.”

The authors wrote that the results of real-world studies of CAD might differ from findings from preclinical studies. They suggest that these differences may arise because radiologists in clinical practice do not always adhere as strictly to use of the technology as designed, as have radiologists in protocol-driven studies.

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63 (!!!!! 3113.9850616455): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

64 (!!!!! 1441.9555664062): SELECT fid FROM jos_deeppockets WHERE id=294736576 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736576 AND published='1' LIMIT 1

65 (72.002410888672): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

66 (76.055526733398): select jos_twitters.link from jos_twitters where cat=10

67 (43.153762817383): select jos_facebook.link from jos_facebook where cat=10

68 (44.107437133789): select jos_google_plus.link from jos_google_plus where cat=10

69 (43.869018554688): select jos_linkedin.link from jos_linkedin where cat=10

70 (59.127807617188): SELECT fid FROM jos_deeppockets WHERE id=294736576 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294736576 AND published='1' LIMIT 1

71 (38.862228393555): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=216 ORDER BY `ordering`

72 (213.8614654541): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (138.99803161621): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (35.04753112793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

75 (578.16505432129): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 4076.9577026367): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (90.122222900391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (81.062316894531): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (40.054321289062): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (42.915344238281): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

92 (665.18783569336): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (64.849853515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (103.95050048828): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (48.87580871582): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (576.01928710938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

107 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

108 (72.002410888672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (63.180923461914): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (!!!!! 2197.0272064209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

111 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

112 (354.05158996582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (306.84471130371): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (61.03515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294736574 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (264.88304138184): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294736574 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (!!!!! 1884.937286377): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (!!!!! 7351.1600494385): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (!!!!! 7803.9169311523): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

119 (!!!!! 7990.1218414307): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

120 (!!!!! 7836.1034393311): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

121 (!!!!! 7995.1286315918): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

122 (!!!!! 7895.9465026855): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

123 (!!!!! 3803.014755249): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

124 (!!!!! 7876.8730163574): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 86467.027664185): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (!!!!! 11990.070343018): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

127 (!!!!! 8980.0357818604): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

128 (!!!!! 7934.0934753418): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736576 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736576 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 2354079.0081024): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (!!!!! 2229710.1020813): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (440.12069702148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (523.09036254883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (259.8762512207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (245.80955505371): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (238.89541625977): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (137.8059387207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (514.98413085938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (405.07316589355): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (38.862228393555): SELECT name FROM jos_deeppockets WHERE id=216

140 (26.941299438477): SELECT name FROM jos_deeppockets WHERE id=216

141 (537.87231445312): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (664.94941711426): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (!!!!! 7669.9256896973): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

144 (246.04797363281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

145 (!!!!! 20348.072052002): TRUNCATE TABLE jos_trademed_module

146 (168.0850982666): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 1305.8185577393): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294736576 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (!!!!! 1725.9120941162): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (92.983245849609): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

151 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

152 (!!!!! 1416.2063598633): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (275.1350402832): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

154 (95.844268798828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

155 (!!!!! 6376.0280609131): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294736576 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294736576 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (505.92422485352): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

157 (!!!!! 1256.9427490234): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

158 (114.91775512695): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (194.07272338867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

160 (88.930130004883): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294736576 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294736576 AND published='1' LIMIT 1

161 (101.08947753906): select jos_twitters.link from jos_twitters where cat=10

162 (55.789947509766): select jos_facebook.link from jos_facebook where cat=10

163 (48.160552978516): select jos_google_plus.link from jos_google_plus where cat=10

164 (46.968460083008): select jos_linkedin.link from jos_linkedin where cat=10

165 (361.91940307617): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 3473.0434417725): insert into jos_banners_delta values (14615,'2025-06-19 13:25:32','216.73.216.120','view'),(14202,'2025-06-19 13:25:32','216.73.216.120','view'),(14203,'2025-06-19 13:25:32','216.73.216.120','view')

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