Should an optimal number of readings vs. no specific number be used for allowing mammography readers to work in mammography screening programmes?

The right balance between sensitivity (true positives) and specificity (false positives) was found within the selected range of readings per reader.

• This optimal range should be implemented as part of screening programmes that use double reading (which is a conditional recommendation previously issued), as double reading of mammograms will improve the overall quality of the reading.
• Efforts to provide support with centralised reading may help implementing this recommendation.
• The number of readings should be averages over longer periods and use appropriate sampling for this measurement.
• The GDG recognised that local circumstances of the individual's performance will affect the quality of readings as much as the number of readings.
• The suggested range applies to mammography screening, not tomosynthesis.

Programmes should continue to monitor the number of readings by readers and the quality indicators of the reading process.

The GDG suggested the following research priorities:

• More published evidence is required which could also come from good monitoring data.
• Further research on elements that may influence results such as: when to read during the day, how many mammograms to read per day, time needed and variation of time for readings between readers, relationship between breast cancer detection and false positives, comparison between those reading only screening mammograms and those doing screening and clinical/diagnostic mammography.
• More research on types of training for mammography readers.
• Research into the role of artificial intelligence in double reading.