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Structured evaluation of the effectiveness of an interactive tool for developing interpretation skills in mammography


Lesion Zoo, a computer-based training tool, was developed to give trainee radiologists access to a wide range of possible mammographic appearances. Users describe lesions using terms from the BI-RADS lexicon and are given feedback on how their descriptions compare with those of by a panel of experts.


A zoo is a collection of lesions presented to a trainee, who is invited to ascribe features to the lesions and provide a confidence estimate. Trainees receive feedback on their progress, through a detailed comparison of their assessment with that of a panel of experts, and from a learning curve showing how their confidence changes. During this evaluation, two sets of test cases (masses and calcifications) were offered initially as a baseline assessment, followed by training on masses or calcifications, followed by a second assessment after which training was swapped (the group that had initially trained on masses was trained on calcifications and vice versa), and then a third assessment was carried out, allowing a test of the impact of the training on performance.


Analysis of variance shows significant two-way interaction: participants receiving training on calcifications improve more on calcifications than on masses and participants receiving training on masses improve more on masses.


Computer-based training tools provide a valuable addition to conventional training and allow trainees to get rapid access to experience with large numbers of cases. Well-designed tools that provide meaningful feedback on interpretation tasks are likely to be effective in improving performance.

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Correspondence to R Pietrosanu.

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Pietrosanu, R., Gay, H., Patel, A. et al. Structured evaluation of the effectiveness of an interactive tool for developing interpretation skills in mammography. Breast Cancer Res 14, P28 (2012).

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  • Cancer Research
  • Learning Curve
  • Baseline Assessment
  • Detailed Comparison
  • Valuable Addition