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

3D virtual learning environments in education: a meta-review

Karakus Yilmaz, Turkan/0000-0002-5809-3962; Yilmaz, Rabia/0000-0002-0453-1357WOS: 000396188300007The aim of this study is to investigate recent empirical research studies about 3D virtual learning environments. A total of 167 empirical studies that involve the use of 3D virtual worlds in education were examined by meta-review. Our findings show that the "Second Life" platform has been frequently used in studies. Among the reviewed papers, case study designs and quasi-experimental studies were more common. Sample sizes were below 100 for most studies. 3D virtual learning environments are mainly designed for learning support, simulation, and game. Language learning and science have been the most extensively studied topics. Collaborative and exploration-based learning strategies have been used most frequently in 3D virtual learning environments. Presence, satisfaction, communication skills, and engagement were examined as emotional and cognitive achievements.Turkish Science and Technology Institution [111K516]This study was conducted as part of the "Effects of Virtual and Multimedia Environments on Interest and Awareness Toward Winter Sports" project, supported by the Turkish Science and Technology Institution Project, number "111K516"