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Risk Profiling Used with Mammography Diagnosis Should Reduce Number of Missed Tumors

By MedImaging International staff writers
Posted on 07 Jul 2014

A new approach to reading mammograms that takes into account a woman’s health risk profile would reduce the number of tumors missed, and in addition, decrease the number of false-positive findings, according to recent research.

The study’s findings were presented at a conference of the Institute for Operations Research and the Management Sciences (INFORMS; Catonsville, MD, USA), which took place June 16-18, 2014, at Georgetown University in Washington DC (USA). Mehmet U.S. Ayvaci, from the University of Texas Dallas (USA) presented his research group’s findings about the role of risk profiling in the interpretation of mammograms at Advances in Decision Analysis, a conference sponsored by the INFORMS Decision Analysis Society (DAS). Formed in 1980 with 1,000 current members, DAS supports the development and use of logical methods for improving decision-making in public and private enterprise.

The researchers found that providing radiologists with the patient’s risk profile information for breast cancer at the most advantageous time when examining the mammogram, together with statistical weighting based on profile risk, reduces false-negative results by 3.7%, thereby forewarning women whose cancer would have gone undiagnosed at an early stage, when treatment is most effective. It also reduces false-positive findings by 3.23%, thereby slashing superfluous healthcare costs and sparing patients’ needless worry.

Risk factors include family history, reproductive history, age, and ethnicity, and others forming the risk profile information. The researchers examined the complicated questions of whether providing risk profile data about women being screened for cancer biases radiologists and, if there is bias, whether this bias actually helps make readings more effective.

Historically, available clinical evidence has been inconclusive on the use of profile information when interpreting mammograms. One position is that profile information helps radiologists make better decisions and should be employed when reading mammograms. A contradictory position holds that profile information may bias the radiologists. However, whether bias always causes harm is unclear.

The investigators searched profile information and potential bias in mammography interpretation using a decision science technique called linear opinion pooling, which assigns weights to better aggregate probability estimates. They analyzed the decision performance of three groups: (1) a mammogram-only reading, with no risk profile information about the patient; (2) an unbiased reading, in which radiologists consult the risk profile after examining the mammogram; and (3) lastly, biased or “influenced” readings, in which radiologists consult a woman's risk profile as they examine the mammogram. Then they examined the conditions in which profile information could help improve biopsy decisions.

Numeric analysis using a clinical dataset from the Breast Cancer Surveillance Consortium revealed that use of profile data with an appropriate weight could reduce the false-positives and the number of missed tumors when compared to cases where profile information was not examined.

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69 (62.942504882812): 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=211 ORDER BY `ordering`

70 (299.93057250977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (149.01161193848): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (36.954879760742): 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`

73 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (23.841857910156): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (52.928924560547): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (35.04753112793): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 1837.0151519775): 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`

90 (!!!!! 2184.8678588867): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (76.770782470703): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (77.962875366211): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

106 (108.95729064941): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (65.088272094727): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (170.94612121582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

109 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

110 (!!!!! 1366.138458252): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (407.93418884277): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (662.08839416504): 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

113 (406.98051452637): 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

114 (116.10984802246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

115 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

116 (174.04556274414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

117 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

118 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

119 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

120 (360.96572875977): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 42758.941650391): 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

122 (256.06155395508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

123 (200.98686218262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

124 (!!!!! 2493.8583374023): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753382 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753382 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1726128.1013489): ( 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

126 (!!!!! 921398.87809753): ( 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

127 (473.97613525391): 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

128 (55.074691772461): 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

129 (273.22769165039): 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

130 (38.862228393555): 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

131 (203.13262939453): 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

132 (36.954879760742): 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

133 (238.18016052246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (257.01522827148): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (104.18891906738): SELECT name FROM jos_deeppockets WHERE id=211

136 (30.994415283203): SELECT name FROM jos_deeppockets WHERE id=211

137 (470.16143798828): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (373.84033203125): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (!!!!! 1026.1535644531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

140 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

141 (!!!!! 8016.1094665527): TRUNCATE TABLE jos_trademed_module

142 (590.08598327637): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (461.10153198242): 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=294753382 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (375.03242492676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

147 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

148 (!!!!! 1287.9371643066): 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

149 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

150 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

151 (422.00088500977): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294753382 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294753382 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (41.961669921875): 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=211 or channel_id is null)

153 (28.848648071289): 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=211 or channel_id is null)

154 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 1030.9219360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

156 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294753382 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294753382 AND published='1' LIMIT 1

157 (92.029571533203): select jos_twitters.link from jos_twitters where cat=10

158 (31.948089599609): select jos_facebook.link from jos_facebook where cat=10

159 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

160 (32.901763916016): select jos_linkedin.link from jos_linkedin where cat=10

161 (257.96890258789): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1199.9607086182): insert into jos_banners_delta values (14615,'2025-05-02 06:42:14','3.145.151.116','view'),(14202,'2025-05-02 06:42:14','3.145.151.116','view'),(14203,'2025-05-02 06:42:14','3.145.151.116','view')

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