6 research outputs found
Radiographers supporting radiologists in the interpretation of screening mammography: a viable strategy to meet the shortage in the number of radiologists.
BackgroundAn alternative approach to the traditional model of radiologists interpreting screening mammography is necessary due to the shortage of radiologists to interpret screening mammograms in many countries.MethodsWe evaluated the performance of 15 Mexican radiographers, also known as radiologic technologists, in the interpretation of screening mammography after a 6 months training period in a screening setting. Fifteen radiographers received 6 months standardized training with radiologists in the interpretation of screening mammography using the Breast Imaging Reporting and Data System (BI-RADS) system. A challenging test set of 110 cases developed by the Breast Cancer Surveillance Consortium was used to evaluate their performance. We estimated sensitivity, specificity, false positive rates, likelihood ratio of a positive test (LR+) and the area under the subject-specific Receiver Operating Characteristic (ROC) curve (AUC) for diagnostic accuracy. A mathematical model simulating the consequences in costs and performance of two hypothetical scenarios compared to the status quo in which a radiologist reads all screening mammograms was also performed.ResultsRadiographer's sensitivity was comparable to the sensitivity scores achieved by U.S. radiologists who took the test but their false-positive rate was higher. Median sensitivity was 73.3 % (Interquartile range, IQR: 46.7-86.7 %) and the median false positive rate was 49.5 % (IQR: 34.7-57.9 %). The median LR+ was 1.4 (IQR: 1.3-1.7 %) and the median AUC was 0.6 (IQR: 0.6-0.7). A scenario in which a radiographer reads all mammograms first, and a radiologist reads only those that were difficult for the radiographer, was more cost-effective than a scenario in which either the radiographer or radiologist reads all mammograms.ConclusionsGiven the comparable sensitivity achieved by Mexican radiographers and U.S. radiologists on a test set, screening mammography interpretation by radiographers appears to be a possible adjunct to radiologists in countries with shortages of radiologists. Further studies are required to assess the effectiveness of different training programs in order to obtain acceptable screening accuracy, as well as the best approaches for the use of non-physician readers to interpret screening mammography
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Medical Cost to Treat Cervical Cancer Patients at a Social Security Third Level Oncology Hospital in Mexico City
Background: Cervical Cancer (CC) is an important public health problem worldwide. In 2015, CC was the sixth
leading cause of death for women aged 30-59 years in Mexico. Despite the importance of having high-quality and
accurate estimates of CC treatment costs that can be used to effectively evaluate the impact of preventive programs, there
is scarce information on this topic in Mexico. Objective: To estimate the treatment costs by stage diagnosis in patients
with CC at a Mexican Social Security Institute (IMSS) oncology hospital in Mexico City. Methods: An observational
retrospective study of the resources used to treat 346 women with CC was conducted. Medical charts were reviewed and
relevant resource use information was extracted using a data collection instrument that was created based on treatment
guidelines. Data were classified into nine cost categories to estimate the total cost per patient. Results: The mean age
of patients in the study sample was 54.3 years (range: 41-67), and the average body mass index (BMI) was >26 kg/m2.
Among the participants, 37% were smokers, 39% had diabetes, and 56% had hypertension. The medical cost for stages
I-IV ranged from 6,058 USD, with an estimated average cost of $5,114 USD. Conclusion: Total treatment
costs per patient are high, especially since they were estimated considering only 7.5 months of treatment. This is the
first study to estimate the annual cost to treat CC in Mexico and to additionally document the resource pattern use, cost
by stage of cancer, and the distribution by cost categories