Mammo call back rates higher in hospitals than community radiology practices

Mammography call back rates could be higher in hospitals than at community medical offices, according to a new study published online in Radiology.

According to the study's authors, the variations in call back rates can be attributed to differences among patients. They also suggest that there may be a limit to the use of call back rates as a quality measure when assessing mammography.

"Recall rate by itself is used as a quality indicator by the federal government," co-author Ana Lourenco, M.D., a radiologist at the Rhode Island Hospital and the Alpert School of Medicine at Brown University in Providence, said in an announcement. "Therefore, it remains important to understand the factors that influence recall rate for individuals and practices."

Consequently, in their study, Lourenco and her colleagues interpreted nearly 75,000 screening mammograms from both a community office practice and an academic referral hospital. About 5,800 patients were recalled for an overall recall rate of 7.8 percent. The recall rate at the community site was 6.9 percent--lower than the hospital rate of 8.6 percent.

However, there were differences in the patients in the hospital and community office practice groups that could have affected the recall rates, the researchers discovered. For example, the hospital patients had previously undergone more surgeries (13 percent compared to 5.6 percent) and biopsies (7 percent compared to 1.4 percent) than their office practice counterparts.

"These patients may have more complicated mammograms to interpret or may be at higher risk for cancer than patients at the community site," Lorenco said. "Higher risk patients would be expected to increase the recall rate of the population."

In addition, the average age of the office patient group was 63, seven years older than the hospital group, and Lourenco pointed out that recall rates are associated with younger ages rather than older ages.

The conclusion, said Lourenco, is that observers should be careful about the utility of using recall rates as a quality measure for breast cancer screening since those rates could be related to factors that are out of a radiologist's control.

To learn more:
- read the study in Radiology
look at the announcement

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