Digital mammography: the human factors implications

A change is underway, with conventional film-screen mammography being surpassed by the implementation of digital mammography and the associated soft-copy digital film reporting. However, there is an allied period of changeover with implementation that requires careful consideration to ensure optimal performance and efficiency of work tasks.

To examine the human factors implications, a combination of techniques (expert walkthroughs, verbal protocol analysis, workstation assessment) was applied to examine existing working practices during the implementation of digital mammography film reading. Radiologists and advanced practitioners within a UK NHS Breast Screening Unit participated to enable a thorough understanding to be gained of strategies adopted when using: routine conventional roller viewing of analogue (film) cases with analogue priors; routine soft-copy reporting with full-field digital mammography (FFDM) priors; trial FFDM with analogue priors viewed on a multiviewer; and trial FFDM with digitised analogue cases viewed digitally.

A variety of changes in working practices were recognised to have occurred with digital implementation. There was an impact upon performance and efficiency of digital soft-copy reporting when viewing analogue priors. Subsequent recommendations for workstation design, working practices and training were produced to assist in improved implementation of digital processes in mammography.