Artificial intelligence as supporting reader in breast screening: a novel workflow to preserve quality and reduce workload

Objective To evaluate the effectiveness of a new strategy for using artificial intelligence (AI) as supporting reader for the detection of breast cancer in mammography-based double reading screening practice. Methods Large-scale multi-site, multi-vendor data were used to retrospectively evaluate a new paradigm of AI-supported reading. Here, the AI served as the second reader only if it agrees with the recall/no-recall decision of the first human reader. Otherwise, a second human reader made an assessment followed by the standard clinical workflow. The data included 280 594 cases from 180 542 female participants screened for breast cancer at seven screening sites in two countries and using equipment from four hardware vendors. The statistical analysis included non-inferiority and superiority testing of cancer screening performance and evaluation of the reduction in workload, measured as arbitration rate and number of cases requiring second human reading. Results Artificial intelligence as a supporting reader was found to be superior or noninferior on all screening metrics compared with human double reading while reducing the number of cases requiring second human reading by up to 87% (245 395/280 594). Compared with AI as an independent reader, the number of cases referred to arbitration was reduced from 13% (35 199/280 594) to 2% (5056/280 594). Conclusion The simulation indicates that the proposed workflow retains screening performance of human double reading while substantially reducing the workload. Further research should study the impact on the second human reader because they would only assess cases in which the AI prediction and first human reader disagree

Subversive Property: Reshaping Malleable Spaces of Belonging

Despite a wide field of scholarship critiquing the idea and workings of property, most understandings still centre around the propertied subject. This paper spatializes property in order to shift the focus away from the propertied subject and onto the broader networks of relations that interact to form property. It draws on critical geography, phenomenology and empirical socio-legal work to argue that property can be understood as a relationship of belonging that is held up by the surrounding space – a relationship that is not fixed or essential but temporally and spatially contingent. Building on Davina Cooper’s analysis of ‘property practices’, I argue that when analysed spatially, the two types of belonging she discusses – belonging between a subject and an object and between a part and a whole – become indistinguishable. As such, characteristics generally associated with identity politics can be understood as property in the same way that owning a house can - in terms of belonging in space. This spatialized understanding shows the breadth of property’s political potential. Although property tends to be (re)productive of the status quo, it can also be subversive. Property can unsettle spaces too

Psychosocial Impact on Mothers Receiving Expanded Newborn Screening Results

Expanded newborn screening (NBS) for genetic disorders has improved diagnosis of numerous treatable diseases, positively impacting children\u27s health outcomes. However, research about the psychological impact of expanded NBS on families, especially mothers, has been mixed. Our study examined associations between maternal experiences of expanded NBS and subsequent psychosocial functioning and parenting stress in mothers whose infants received either true negative (TN), true positive (TP) or false positive (FP) results after a 4- to 6-month period. The Parenting Stress Index and the Depression, Anxiety and Stress Scale were used to assess symptoms of anxiety, stress and depression in 3 sets of mothers, whose infants received TN (n = 31), TP (n = 8) or FP (n = 18) results. Multivariate analyses of variance (MANOVA) results revealed no significant differences among these three groups of mothers regarding overall anxiety, stress and depression. However, FP mothers experienced lower levels of stress related to their own health compared to TN group. Two potential trends were also identified; results suggested TN mothers might experience higher levels of isolation than mothers in the TP group and that FP mothers might report higher stress levels in relation to spousal relationships compared to the TN group. FP mothers seemed to report similar or better levels of psychosocial functioning than TN mothers. Our findings are encouraging with respect to impacts of NBS on maternal well-being. We also identify key areas for improvement (parental education) and research (isolation and spousal relationships)