Eugenio Alberdi, PhD, Andrey A. Povyakalo, PhD, Lorenzo Strigini, M.Eng, Peter Ayton, PhD, Mark Hartswood, PhD,
Rob Procter, PhD, Roger Slack, PhD

ABSTRACT:

We summarise a set of analyses and studies we have conducted to assess the effects of the use of a Computer Aided Detection (CAD) tool in breast screening. We have used an interdisciplinary approach which combines: a) statistical analyses inspired by reliability modelling in engineering, b) experimental studies of mammography experts’ decisions using the tool, interpreted in the light of human factors psychology; and c) ethnographic observations of the use of the tool both in trial conditions and in everyday screening practice. Our investigations have shown patterns of human behaviour and effects of computer-based advice that would not have been revealed by a standard clinical trial approach. For example, we found that the negligible measured effect of CAD could be explained by a range of effects on experts’ decisions, beneficial in some cases and detrimental in others. There is some evidence of the latter effects being due to the experts using the computer tool differently from the developers’ intentions. We integrate insights from the different pieces of evidence and highlight their implications for the design, evaluation and deployment of this sort of computer tool.

KEYWORDS:
Breast cancer screening, digital imaging, mammography

Brit J  Radiol. 2005; 78: 31-40.