Symptomatic and screening film-readers: a difference in reading style?

In the United Kingdom, screening personnel (radiologists, advanced practitioners, breast physicians/clinicians and registrars) read breast screening cases and symptomatic radiologists read cases that have been referred to them. Our previous PERFORMS research has suggested that there may be differences in reading styles between these two groups owing to such differences in their real-life practice. We set out to investigate whether such previously noted trends in reading style were predictive of current performance in 2006. Consequently, we examined the proficiency of the two groups on the recent PERFORMS set of mammograms. The performance for a group of 15 symptomatic readers was examined as compared with 15 screening personnel over a set of 60 difficult mammographic cases that contained a range of features and mammographic classification types. Both groups were matched, as far as possible, on real-life factors that may affect reporting skill – such as case volume and real-life reading experience. Concentrating on the groups' specificity and sensitivity measures identified whether current tendencies in radiological reading style were comparable with those previously noted. Results indicate that, on this scheme, the symptomatic readers' tendency to 'over-read' comparative with screeners may still be evident.