Computer-aided detection mammography for XXXX screening: systematic review and meta-analysis.

@entity5 @entity1 @entity0
CONTEXT: Mammography is generally accepted as the best available @entity0 screening method; however, some @entity5 detectable on mammography images are missed. Computer-aided detection (CAD) systems for mammography are intended to reduce false negatives by marking suspicious areas of the mammograms for reviewers to consider. Although the prospect of improving the sensitivity of screening mammograms has led to the diffusion of CAD for mammography, little is known about its diagnostic accuracy. OBJECTIVE: To assess the diagnostic performance of CAD for screening mammography in terms of sensitivity and specificity and incremental recall, biopsy, and @entity5 diagnosis rates. DATA SOURCES: Published literature identified by systematic literature searches of 17 databases, including MEDLINE, EMBASE, and the Cochrane Library, searched through 25 September 2008. STUDY SELECTION: A reviewer and an information specialist selected full-length English-language articles that enrolled asymptomatic @entity1 for routine @entity0 screening and provided data needed for our analyses using criteria established a priori. We identified 75 potentially relevant publications, of which 7 (9%) were included. DATA EXTRACTION: Data were extracted and internal validity was assessed by a single review author, and forms were approved by the co-authors. RESULTS: Three studies (n = 347,324) reported sensitivity and specificity, or data to calculate them, and five studies (n = 51,162) reported data to calculate incremental rates of @entity5 diagnoses and recall and biopsy of @entity1 who did not have @entity0 . The pooled sensitivity was 86.0% (95% CI 84.2-87.6%) and specificity was 88.2% (95% CI 88.1-88.3%). Of the 100,000 @entity1 screened, CAD yielded an additional 50 (95% CI 30-80) correct @entity0 diagnoses, 1,190 (95% CI 1,090-1,290) recalls of healthy @entity1 , and 80 (95% CI 60-100) biopsies of healthy @entity1 . A total of 96% (95% CI 93.9-97.3%) of @entity1 recalled based upon CAD and 65.1% (95% CI 52.3-76.0%) of @entity1 biopsied based upon CAD were healthy. No studies reported @entity1 -oriented clinical outcomes.
