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PubMed2002

Nearly 4 years after an event: children's eyewitness memory and adults' perceptions of children's accuracy.

OBJECTIVE: The current study examined children's eyewitness memory nearly 4 years after an event and the ability of adults to evaluate such memory. METHOD: In Phase 1, 7- and 10-year olds were interviewed about a past event after a nearly 4-year delay. The interview included leading questions relevant to child abuse as well as statements designed to implicate the original confederate. In Phase 2, laypersons and professionals watched a videotaped interview (from Phase 1) that they were misled to believe was from an ongoing abuse investigation. Respondents then rated the child's accuracy and credibility, and the probability that the child had been abused. RESULTS: In Phase 1, few significant age differences in memory accuracy were found, perhaps owing in part to small sample size. Although children made a variety of commission errors, none claimed outright to have been abused. Nevertheless, some of the children's answers (e.g., saying that their picture had been taken, or that they had been in a bathtub) might cause concern in a forensic setting. In Phase 2, professional and nonprofessional respondents were unable to reliably estimate the overall accuracy of children's statements. However, respondents were able to reasonably estimate the accuracy of children's answers to abuse questions. Respondents were also more likely to think that 7-year olds compared to 10-year olds had been abused. Professionals were significantly less likely than nonprofessionals to believe that credible evidence of abuse existed. Professionals who indicated personal experience with child abuse or a close relationship with an abuse victim were more likely to rate children as abused. A gender bias to rate boys as more accurate than girls was apparent among laypersons but not professionals. CONCLUSIONS: Children were generally resistant to suggestions that abuse occurred during a long-ago generally forgotten event, but some potentially concerning errors were made. Both professionals and non-professionals had difficulty estimating the accuracy of children's reports, but adults were more likely to rate children as accurate if the children answered abuse-related questions correctly. Training and personal experience were associated with adults' ratings of children's reports. Implications for evaluations of child abuse reports are discussed.

Adult↗

PubMed1989

Effects of combined muscarinic and nicotinic blockade on choice accuracy in the radial-arm maze.

Acetylcholine (ACh) systems have been found to be crucial for the maintenance of accurate cognitive performance. A great variety of studies have shown that the muscarinic ACh receptor blocker scopolamine impairs choice accuracy in the radial-arm maze. Recently, it has been found that the nicotinic ACh receptor blocker mecamylamine also impairs radial-arm maze choice accuracy. In the present study, we investigated the effects of combined administration of these two ACh blockers. Scopolamine (0.15 mg/kg) and mecamylamine (10 mg/kg) each moderately impaired choice accuracy. Combined treatment with scopolamine and mecamylamine significantly decreased choice accuracy relative to either drug alone. This combination treatment lowered choice accuracy to chance levels. These data show that nicotinic and muscarinic blockade have at least additive effects in producing an anterograde memory deficit. Concurrent blockade of these two components of ACh systems may provide a better animal model of cognitive impairments due to the loss of cholinergic neurons, such as Alzheimer's disease.

Animals↗

PubMed1997

Analysis of accuracy in dose and position in calculations of a treatment planning system for blocked photon fields.

Accuracy in dose and position, defined as complementary criteria, was determined for blocked photon field calculations with a pencil beam based treatment planning system. The concept of field accuracy has been defined as a combination of deviations in dose and position. Absolute dose deviations were measured including the deviations in beam output (monitor units), depth doses and dose profiles. Based on this verification work it was concluded that the pencil beam model is capable of calculating dose distributions in blocked photon fields (6 MV and 25 MV) with a high degree of accuracy. The measurements and calculations mostly agreed within 3% or 3 mm, whichever was less, relative to a reference dose at 10 cm depth. Furthermore, the model behaves consistently because a substantial part of the discrepancies found could be ascribed to fundamental assumptions in the model related to electron contamination and primary block transmission. The concept 'field accuracy' allows an easy, quantitative and comprehensive comparison to common quality requirements giving, for example, equal weight to percent dose difference and to millimetre isodose distance. The method offers the possibility to focus on calculation accuracy which excludes some experimental sources of error.

Humans↗

PubMed1997

Reconstruction accuracy of a dedicated localiser for filmless planning in intra-operative brachytherapy.

BACKGROUND AND PURPOSE: With the use of HDR and PDR afterloaders containing a single stepping source, brachytherapy dose distributions can be optimised by varying the source dwell time. With the goal of implementing 'conformal brachytherapy', i.e. ensuring that the dose distribution conforms as accurately as possible to the target volume, we evaluated a set-up which enabled on-line implant localisation and dose planning during implantation. MATERIALS AND METHODS: The set-up, designated as an integrated brachytherapy unit (IBU), consists of a shielded operating room equipped with an HDR afterloader and a dedicated brachytherapy localiser connected to a treatment planning computer. The localiser is isocentric and has an extra degree of freedom in comparison to conventional simulators (i.e. an L-arm in combination with a C-arm) and enables viewing of the implant from any direction. A reconstruction algorithm which takes into account both rotation axes, i.e. the L-arm and C-arm angle, was developed for the localiser. The reconstruction procedure was tested by using the IBU localiser to measure the reconstruction accuracy with a phantom (containing 25 markers at well defined positions) and using reconstruction from radiographs. These results were compared to simulations where the accuracy of reconstruction was determined as a function of the reconstruction angle and the accuracy of read-outs of the localiser settings. On-line localisation and dose planning during implantation is based on filmless planning, i.e. fluoroscopy images and the corresponding localiser settings are imported into the treatment planning computer during implantation. The accuracy of filmless planning was determined using fluoroscopy images in the same set-up as for the experiments with the radiographs. The effect of reconstruction inaccuracies on the total irradiation time and the dose in target or normal tissue points was elucidated for clinically relevant implant geometries. The treatment plans of two phantoms based on reconstruction from films as well as fluoroscopy images were compared with plans for implants defined by exact co-ordinates. RESULTS: The average reconstruction error due to the accuracy of the read-out of the localiser settings varied between -0.18 and 0.24 mm, with a standard deviation (arising from digitisation errors) ranging from 0.11 to 0.22 mm. Using filmless reconstruction and the 10 inch field of view of the image intensifier (without applying correction for the geometric distortions) the average reconstruction error ranged from 0.01 to 0.65 mm, and the standard deviation ranged from 0.40 to 0.73 mm. These errors arose as a consequence of the finite pixel size and geometric distortions. These limited errors did not influence the treatment time for clinical implant geometries and had only a minor effect (<1%) on the dose in markers during filmless planning. CONCLUSION: This IBU set-up, with a dedicated brachytherapy localiser, allows for a rapid and accurate filmless planning procedure based on implant localisation from fluoroscopy images.

Brachytherapy↗

PubMed1999

Lumbosacral repositioning accuracy in standing posture: a combined electrogoniometric and videographic evaluation.

OBJECTIVE: To provide a new method of measuring repositioning accuracy in the lumbosacral spine in a standing position. DESIGN: A test-retest and parallel-forms reliability testing was performed. BACKGROUND: The contribution of proprioception to lumbar muscle function and to the stability of the lumbar spine is relatively unknown. METHOD: A piezoresistive electrogoniometer attached to the skin over the sacrum and a three-dimensional video analysis system with reflective markers on anatomical landmarks were both employed to measure the repositioning accuracy of pelvic tilting in standing. Eleven subjects without low back pain participated in this study. RESULTS: The overall mean repositioning accuracy was 1.87 degrees. Probability values from repeated measures ANOVA revealed no significant mean absolute error (AE) differences between sessions. Correlation coefficients between electrogoniometer and 3-D video analysis measurements of position sense ranged from 0.84 to 0.97. CONCLUSIONS: The proposed instruments and method are adequate for measuring lumbosacral repositioning accuracy. Healthy subjects are capable of repositioning their pelvis and back precisely. RELEVANCE: A reliable method assessing the lumbosacral repositioning accuracy can add insight into neuromuscular dysfunction as a cause of mechanical low back pain.

Biomechanical Phenomena↗

PubMed1997

Accuracy of children's pain memories.

Despite its importance in clinical practice, little research has examined memory for pain in children. This prospective study tried to justify the use of children's pain recall in clinical practice. The purpose of this study was to (a) investigate the accuracy of children's recall of their worst and average pain intensity when controlling for the effects of repeated pain measurement and (b) examine the influence of children's anxiety, age, general memory ability and pain coping strategies on this accuracy. The accuracy of children's recalled pain intensities was studied in 55 inpatients aged 5-16 years by comparing the level of recorded pain intensity with the level of recalled pain intensity 1 day and 1 week after recording using Bieri's Faces Pain Scale. The accuracy of children's recalled pain intensities was high and showed little decrement over 1 week. Older children had more accurate recall of their worst pain intensity. Anxiety, general memory ability and pain coping strategies were not related to accuracy of recalled pain intensities.

Adaptation, Psychological↗

PubMedDate not supplied

Reliability, validity, and classification accuracy of the South Oaks Gambling Screen (SOGS).

The South Oaks Gambling Screen (SOGS) was originally developed to screen for pathological gambling in clinical settings; however, its use has expanded to other purposes, settings, and populations, including prevalence studies of pathological gambling in the general population. Questions have been raised about the accuracy of the SOGS with its use in these new settings and populations. The purpose of this study is to examine current estimates of the reliability, validity, and classification accuracy of the SOGS in two different samples: (a) a general population sample (N= 803) and (b) a gambling treatment sample (N = 1,589). DSM-IV diagnostic criteria served as the standard against which to measure the SOGS classification accuracy and both the SOGS and DSM-IV diagnostic criteria were administered to participants. The SOGS was found to have satisfactory reliability with coefficient alphas of .69 and .86 in the general population and gambling treatment samples, respectively. The SOGS demonstrated satisfactory validity by differentiating between the general population and the gambling treatment sample and by exhibiting high correlations with DSM-IV diagnostic criteria and moderate correlations with other measures of gambling problem severity. The SOGS demonstrated good to excellent classification accuracy in the gambling treatment sample, but had poorer accuracy in the general population sample with a 50% false positive rate. The SOGS overestimated the number of pathological gamblers in the general population, as compared to DSM-IV diagnostic criteria.

Adult↗

PubMed2002

Investigations of a minimally invasive method for treatment of spinal malignancies with LINAC stereotactic radiation therapy: accuracy and animal studies.

PURPOSE: A new method for stereotactic irradiation of spinal malignancies is presented, with evaluations of the theoretic and practical limitations of localization accuracy and the implementation of the method in swine. MATERIALS AND METHODS: In a percutaneous procedure, a minimum of three small (1.7-mm-diameter) titanium markers are permanently affixed to a vertebra. Markers are localized on biplanar radiographs while isocenter positions are determined on CT. An external fiducial frame defines a three-dimensional coordinate system through the patient. Radiographs coupled with a rigid body rotation algorithm account for daily differences in patient position. Phantom studies were used to verify theoretic uncertainty calculations from a simulation program. A swine model was used to evaluate the difficulty and duration of the implant technique, the suitability of the vertebral process as an implant site, vertebral motion due to normal respiration, and the ability to target one vertebra with markers in an adjacent vertebra. RESULTS: Theoretic accuracy studies confirmed that localization accuracy is a function of marker separation. Phantom studies involving 296 measurements showed that individual implants could be localized within +/-0.25 mm. The largest targeting error observed in 3,600 measurements of 100 implant configurations was 1.17 mm. The implant procedure took 5-10 minutes per site. No significant migration of implants was observed up to 35 days postimplantation, and respiratory motion had no detectable influence on vertebral position. Adjacent vertebrae may be useful for targeting one another with a small sacrifice in localization accuracy. CONCLUSIONS: The use of implanted markers for localization of spinal malignancies has potential for applications in stereotactic radiotherapy. Phantom measurements suggest that localization accuracy similar to intracranial stereotactic radiotherapy techniques is achievable. Swine studies suggest that the implant technique is expedient and feasible for tumor targeting purposes.

Animals↗

PubMed2000

Extracranial stereotactic radiation therapy: set-up accuracy of patients treated for liver metastases.

PURPOSE: Patients with liver metastases might benefit from high-dose conformal radiation therapy. A high accuracy of repositioning and a reduction of target movement are necessary for such an approach. The set-up accuracy of patients with liver metastases treated with stereotactic single dose radiation was evaluated. METHODS AND MATERIALS: Twenty-four patients with liver metastases were treated with single dose radiation therapy on 26 occasions using a self-developed stereotactic frame. Liver movement was reduced by abdominal pressure. The effectiveness was evaluated under fluoroscopy. CT scans were performed on the planning day and directly before treatment. Representative reference marks were chosen and the coordinates were calculated. In addition, the target displacement was quantitatively evaluated after treatment. RESULTS: Diaphragmal movement was reduced to median 7 mm (range: 3-13 mm). The final set-up accuracy of the body was limited to all of median 1.8 mm in latero-lateral direction (range: 0.3-5.0 mm) and 2.0 mm in anterior-posterior direction (0.8-3.8 mm). Deviations of the body in cranio-caudal direction were always less than the thickness of one CT slice (<5 mm). However, a repositioning was necessary in 16 occasions. The final target shift was median 1.6 mm (0.2-7.0 mm) in latero-lateral and 2.3 mm in anterior-posterior direction (0.0-6.3 mm). The median shift in cranio-caudal direction was 4.4 mm (0.0-10.0 mm). CONCLUSIONS: In patients with liver metastases, a high set-up accuracy of the body and the target can be achieved. This allows a high-dose focal radiotherapy of these lesions. However, a control CT scan should be performed directly before therapy to confirm set-up accuracy and possibly prompt necessary corrections.

Aged↗

PubMed2002

Influence of wall stress and left ventricular geometry on the accuracy of dobutamine stress echocardiography.

OBJECTIVE: The goal of this study was to determine whether wall stress at rest and during stress could explain the influence of left ventricular (LV) morphology on the accuracy of dobutamine stress echocardiography (DSE). BACKGROUND: The sensitivity of DSE appears to be reduced in patients with concentric remodeling, but the cause of this finding is unclear. METHODS: We studied 161 patients without resting wall motion abnormalities who underwent DSE and coronary angiography. Patients were classified into four groups according to relative wall thickness (normal <0.45) and LV mass (normal </=131 g/m(2) in men and </=100 g/m(2) in women): normal geometry, concentric remodeling, concentric hypertrophy, and eccentric hypertrophy. Significant coronary artery disease was defined as >/=50% stenosis. Circumferential (cESS) and meridional end-systolic wall stress (mESS) were calculated at rest and peak DSE. RESULTS: Both false-negative and false-positive results for DSE were present in 35 patients (22%). The accuracy of DSE in patients with concentric remodeling (61%) was lower than that in patients with normal geometry (85%, p < 0.05) or concentric hypertrophy (86%, p < 0.05), but the accuracy with eccentric hypertrophy (64%, p < 0.05) was lower than with concentric hypertrophy. Patients in lowest quartile of cESS and mESS at peak had significantly lower sensitivity and accuracy than those in the highest quartile. A reduced cESS at peak (p = 0.012), presence of concentric remodeling (p = 0.044), and eccentric hypertrophy (p = 0.012) were significant predictors of both false-negative and false-positive results for DSE. CONCLUSIONS: The accuracy of DSE is influenced by the LV geometric pattern and peak wall stress.

Aged↗

PubMed2001

Impact of different definitions on estimates of accuracy of the diagnosis data in a clinical database.

Computerized medical databases are increasingly used for research. The influence of different definitions of the accuracy of matching on the estimated accuracy of diagnosis data was assessed in a database of visits to a public pediatric clinic. Differences between definitions involved 1) unit of analysis, 2) number of diagnoses required to match per visit, and/or 3) whether database contents are required to match the medical record or medical record contents are required to be matched in the database. Overall, 90% of diagnoses in the database (391/435) were accurately coded relative to the medical record. Alternatively, 77% of diagnoses listed in the medical record (391/506) were accurately coded in the database. When individual visits were used as the unit of analysis, estimates of accuracy using six definitions ranged from 65% to 92%. The most appropriate definition to use for estimating accuracy of diagnosis data likely depends on the purpose of the study. Use of two or more such definitions may enhance portrayal of the accuracy of diagnosis data.

Algorithms↗

PubMed2001

Evaluation of the accuracy of seizure descriptions by the relatives of patients with epilepsy.

The descriptions of seizures by witnesses are important in the diagnosis and classification of epileptic seizures. The aim of the study was to evaluate the accuracy of this information obtained from relatives of patients with epileptic and non-epileptic attacks. Thirty patients with epileptic or non-epileptic attacks had seizures videorecorded whilst inpatients at the Assessment and Treatment Centre of the National Society for Epilepsy and the National Hospital for Neurology and Neurosurgery, Chalfont, Buckinghamshire, UK. A relative or close friend of each patient viewed the recording and subsequently completed a structured questionnaire, testing recall of 15 separate elements of the episode. This account was compared to a definitive evaluation completed by medical staff. An accuracy of describing seizures was therefore obtained. Our results showed that there was a wide variation in the accuracy of recall with convulsive episodes described less well than non-convulsive (median accuracies 44.5 and 70%, respectively, P<0.05). Attacks in which the diagnosis had been changed, following admission, from the one obtained on history alone were particularly inaccurately described (median accuracy 26%). Elements of the questionnaire that were most inaccurately recalled were description of limb movement and post-ictal behaviour. Those most accurately described were facial appearance and vocalization. Features only present in non-epileptic attacks included reactivity to eyelash stimulation, opisthotonic posturing, flailing or protective limb movements. In conclusion, our results confirm that inaccuracy exists when witnesses describe attacks and that this may lead to errors in diagnosis and subsequent treatment.

Adolescent↗

PubMed1997

Accuracy in target localization in stereotactic radiosurgery.

The accuracy in target localization of CT, MRI, and digital angiography and the isocentric deviation of linear accelerator were investigated for stereotactic radiosurgery. Twenty-five slice images using CT and MRI were obtained out of geometrical phantom which was designed to produce exact 3-dimensional coordinates of several points within a 0.1 mm error range. These diagnostic images were transferred to a 3-D treatment planning system through ethernet. Measured 3-D coordinates of these images from the planning system were compared to known values by geometrical phantom. Anterior-posterior and lateral films were taken by digital angiography for measurement of spatial accuracy. The accuracy of gantry isocenter aligned by laser localizer was also measured. Lead ball was located at the isocenter of linear accelerator and x-ray films were taken by 4-MV photon beam with gantry angles of 0, 90, 180 and 270 degrees, Overall procedure from CT scanning to treatment was carried out using the geometrical phantom. The target accuracy was verified by high energy x-ray portal film. The accuracy of diagnostic machines were within 2.1 mm except MR-axial images. In case of linear accelerator, the deviation of isocenter was within 0.7 mm. Finally, the total isocentric deviation of overall procedure was 1.3 +/- 0.5 mm (using CT localization).

Angiography, Digital Subtraction↗

PubMed2000

Validity and coverage of estimates of relative accuracy.

PURPOSE: Studies comparing test accuracy often restrict the confirmation procedure to subjects classified as positive by either test. Relative sensitivity (RSN) and relative false-positive rate (RFP) are two estimable comparative measures of accuracy. This article evaluates the influence of sample size, disease prevalence, and test accuracy on the validity of point estimates of RSN and RFP, and on the coverage of their confidence intervals (CI). METHODS: For each combination of sample size, disease prevalence, test accuracy, and interdependence between tests 1,000 samples were generated using computer simulations. The percent bias in the RSN and RFP estimates was measured by comparing the means of the 1,000 values computed in each simulation (log-transformed) with their theoretical values. Coverage of the estimated CI was measured by computing the proportion that actually included the theoretical values. Application of these methods was illustrated with data from a study comparing mammography and physical examination in screening for breast cancer. RESULTS: RSN estimates were valid if the true number of diseased cases exceeded 30, and RFP estimates were valid if the number of nondiseased subjects exceeded 200. When the numbers of diseased and nondiseased subjects exceeded 150 each, the 95% CI of RSN and RFP provided adequate coverage of the parameters (95 +/- 2%). CONCLUSION: Sample size is the most important variable for the validity and coverage of RSN and RFP estimates. For small samples, validity and coverage of RSN and RFP also depend on the accuracy of each test and on the degree of interdependence between the tests.

Adult↗

PubMedDate not supplied

The histologic estimation of coronary artery stenoses: accuracy and the effect of lumen shape.

The authors have recently investigated the histologic estimation of coronary artery stenoses (CAS) to determine its reproducibility and the effect of training on reproducibility. The present study extends this work, examining the accuracy, the sensitivity, and the specificity of the estimation of CAS. Further, the effect of one histologic variable (i.e., arterial lumen shape) on the evaluation of CAS is examined. As described previously, 20 randomly selected Movat-stained coronary artery cross-sections were reviewed three times, at 3-month intervals, by six clinical pathologists (CPs), six pathology residents (Res), seven anatomic pathologists (APs), and two cardiovascular pathologists (CVPs). Before the third iteration, training in CAS assessment was provided. In the present study, for comparison with observer estimates, image analysis was used to establish the actual percent CAS and determine observer accuracy. The results of this study showed, paradoxically, that greater experience did not correlate with greater accuracy: The CPs consistently had the highest accuracy scores and the CVPs consistently had the lowest. Training, however, improved the accuracy scores of all groups. Stenotic arterial cross-sections with residual lumens showing concentric or eccentric polymorphous shapes were consistently underestimated compared to image analysis, while lumens with a eccentric slitlike shape were consistently overestimated.

Arteries↗

PubMed2001

Experimental tests of EEG source localization accuracy in realistically shaped head models.

OBJECTIVES: To determine the accuracy with which electrical sources in the human brain can be located using realistically shaped boundary element models of the head and to compare this accuracy with that using spherical head models. METHODS: In a previous study, electroencephalographs (EEGs) produced by sources at known locations in the brains of human subjects were recorded. The sources were created by injecting current into implanted depth electrodes. The locations of the implanted depth and scalp EEG electrodes and head shape were determined from computerized tomography images. The EEGs were used to calculate source locations in spherical head models and localization accuracy was determined by comparing the calculated and actual locations. In this study, these same EEGs are used to determine localization accuracy in realistically shaped head models. RESULTS: An average localization error of 10.5 (SD=5.4) mm was obtained in the realistically shaped models for all 176 sources in 13 subjects. This compares with 10.6 (5.5) mm in the spherical models. The average localization error for 105 sources at superior locations in the brain is 9.1 (4.2) mm. The average error for 71 inferior location sources is 12.4 (6.4) mm. The corresponding values for the spherical models are 9.2 (4.4) and 12.8 (6.2) mm. CONCLUSIONS: The realistically shaped head boundary element models used in this study produced very nearly the same localization accuracy as spherical models.

Brain↗

PubMed2004

Assessing the accuracy of forecasting: applying standard diagnostic assessment tools to a health technology early warning system.

OBJECTIVES: Early warning systems are an integral part of many health technology assessment programs. Despite this finding, to date, there have been no quantitative evaluations of the accuracy of predictions made by these systems. We report a study evaluating the accuracy of predictions made by the main United Kingdom early warning system. METHODS: As prediction of impact is analogous to diagnosis, a method normally applied to determine the accuracy of diagnostic tests was used. The sensitivity, specificity, and predictive values of the National Horizon Scanning Centre's prediction methods were estimated with reference to an (imperfect) gold standard, that is, expert opinion of impact 3 to 5 years after prediction. RESULTS: The sensitivity of predictions was 71 percent (95 percent confidence interval [CI], 0.36-0.92), and the specificity was 73 percent (95 percent CI, 0.64-0.8). The negative predictive value was 98 percent (95 percent CI, 0.92-0.99), and the positive predictive value was 14 percent (95 percent CI, 0.06-0.3). CONCLUSIONS: Forecasting is difficult, but the results suggest that this early warning system's predictions have an acceptable level of accuracy. However, there are caveats. The first is that early warning systems may themselves reduce the impact of a technology, as helping to control adoption and diffusion is their main purpose. The second is that the use of an imperfect gold standard may bias the results. As early warning systems are viewed as an increasingly important component of health technology assessment and decision making, their outcomes must be evaluated. The method used here should be investigated further and the accuracy of other early warning systems explored.

Diagnostic Techniques and Procedures↗

PubMed2004

The influence of clinical information on the accuracy of diagnostic mammography.

OBJECTIVE: This study examined the influence of knowledge of clinical information on the accuracy of mammography in women referred for investigation of breast symptoms. METHODS: Subjects were sampled from all women consecutively attending a symptomatic breast clinic and aged 25-55 years. This included all 240 women shown to have breast cancer and 240 age-matched women shown not to have cancer. Mammography films were prospectively reported by two radiologists independently of each other in a blinded manner and without knowledge of any clinical information. The films were then re-read with information about the type and site of symptoms (and without knowledge of the level of suspicion of cancer on clinical examination). The accuracy of reading with and without information on symptoms was compared using sensitivity and specificity and receiver operating characteristic (ROC) curves. The effect of age on changes in test accuracy was examined. RESULTS: Reporting the mammogram with knowledge of clinical information (compared to without any information) significantly improved sensitivity (75.8 vs. 71.3%, P = 0.003) for one radiologist, with a non-significant reduction in specificity (85.4 vs. 87.1%, P = 0.22). For the other radiologist, it resulted in non-significant improvement in both sensitivity (75.4 vs. 73.8%, P = 0.13) and specificity (89.2 vs. 87.9%, P = 0.25). Age did not have a statistically significant effect on changes in test accuracy in our data. ROC curves for both radiologists showed that reporting mammography with knowledge of clinical information resulted in small (about 2%) but significant improvement in overall test accuracy. CONCLUSION: Our findings support the provision of clinical information relating to patients' presentation to radiologists reporting diagnostic mammography.

Adult↗