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Changing case order to optimise patterns of performance in mammography screening (CO-OPS) : study protocol for a randomized controlled trial
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Taylor-Phillips, Sian, Wallis, Matthew G., Parsons, Helen, Dunn, Janet A., Stallard, Nigel, Campbell, Helen, Sellars, Sarah, Szczepura, Ala, Gates, Simon and Clarke, Aileen (2014) Changing case order to optimise patterns of performance in mammography screening (CO-OPS) : study protocol for a randomized controlled trial. Trials, Volume 15 . Article number 17. doi:10.1186/1745-6215-15-17
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Official URL: http://dx.doi.org/10.1186/1745-6215-15-17
Abstract
Background: X-ray mammography remains the predominant test for screening for breast cancer, with the aim of reducing breast cancer mortality. In the English NHS Breast Screening Programme each woman’s mammograms are examined separately by two expert readers. The two readers read each batch in the same order and each indicates if there should be recall for further tests. This is a highly skilled, pressurised, repetitive and frequently intellectually unchallenging activity where readers examine one or more batches of 30–50 women’s mammograms in each session. A vigilance decrement or performance decrease over time has been observed in similar repetitive visual tasks such as radar operation.
Methods/Design: The CO-OPS study is a pragmatic, multi-centre, two-arm, double blind cluster randomised controlled trial of a computer software intervention designed to reduce the effects of a vigilance decrement in breast cancer screening. The unit of randomisation is the batch. Intervention batches will be examined in the opposite order by the two readers (one forwards, one backwards). Control batches will be read in the same order as one another, as is current standard practice. The hypothesis is that cancer detection rates will be higher in the intervention group because each readers’ peak performance will occur when examining different women’s mammograms. The trial will take place in 44 English breast screening centres for 1 year and 4 months. The primary outcome is cancer detection rate, which will be extracted from computer records after 1 year of the trial. The secondary outcomes include rate of disagreement between readers (a more statistically powerful surrogate for cancer detection rate), recall rate, positive predictive value, and interval cancer rate (cancers found between screening rounds which will be measured three years after the end of the trial).
Discussion: This is the first trial of an intervention to ameliorate a vigilance decrement in breast cancer screening.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Breast -- Cancer, Breast -- Cancer -- Research , Breast -- Radiography | ||||
| Journal or Publication Title: | Trials | ||||
| Publisher: | Biomed Central | ||||
| ISSN: | 1745-6215 | ||||
| Official Date: | 10 January 2014 | ||||
| Dates: |
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| Volume: | Volume 15 | ||||
| Page Range: | Article number 17 | ||||
| DOI: | 10.1186/1745-6215-15-17 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR), University of Warwick |
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