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Measuring performance in clinical breast examination
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Wishart, G. C., Warwick, Jane, Pitsinis, V., Duffy, Stephen W. and Britton, P. D. (2010) Measuring performance in clinical breast examination. British Journal of Surgery, Volume 97 (Number 8). pp. 1246-1252. doi:10.1002/bjs.7108 ISSN 0007-1323.
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Official URL: http://dx.doi.org/10.1002/bjs.7108
Abstract
Background:
Clinical breast examination (CBE) remains an essential part of triple assessment of breast lumps, but to date there are no performance measures for clinicians using this technique. The aim of this retrospective audit was to compare the performance and accuracy of CBE to identify key indicators that could be used to monitor performance prospectively.
Methods:
Clinical examination findings (E1, normal, to E5, malignant) for 16,585 patients who had CBE as part of triple assessment were obtained from electronic medical records. The performance of CBE, by age group, mammographic density and clinician, was assessed by calculating the sensitivity, specificity and area under the receiver operating characteristic (ROC) curve.
Results:
There was marked variation in sensitivity between clinicians (range 44.6-65.9 per cent). There was a strong downward trend in the percentage classified as E5 as sensitivity for breast cancer detection decreased, and a corresponding strong downward trend in the proportion of E4 and E5 cancers classified as E5. Both of these measures could be used as indicators to monitor CBE performance.
Conclusion:
The performance measures outlined here could help to identify clinicians who have a lower sensitivity for CBE and who may therefore require feedback and further training.
| Item Type: | Journal Article | ||||||
|---|---|---|---|---|---|---|---|
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | British Journal of Surgery | ||||||
| Publisher: | John Wiley & Sons Ltd. | ||||||
| ISSN: | 0007-1323 | ||||||
| Official Date: | August 2010 | ||||||
| Dates: |
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| Volume: | Volume 97 | ||||||
| Number: | Number 8 | ||||||
| Page Range: | pp. 1246-1252 | ||||||
| DOI: | 10.1002/bjs.7108 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Restricted or Subscription Access |
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