Table 2.
Characteristics of test set cases by whether a participant pathologist would request a second opinion (N = 115 participants, 6900 independent assessments)
| Would you ask for a second pathologist’s opinion of this case before finalising the report? (Assume a pathologist is available.) | ||||||||
|---|---|---|---|---|---|---|---|---|
|
| ||||||||
| Combined yes response rate (95% CI) |
Response options N (%) |
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|
|
|
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| Case characteristics* |
Number of cases |
Number of assessments |
Rate of second opinion for combined responses† |
p Value‡ | Yes, because I would want a second pathologist’s opinion for diagnostic reasons |
Yes, because it is our policy to get a second opinion in cases with this diagnosis |
Yes to both, because I would want it and because it is our policy |
No, I do not want a second opinion |
| Total | 240 | 6900 | 70 (65 to 75) | − | 1731 (25) | 2376 (34) | 720 (10) | 2073 (30) |
| Patient characteristics for breast biopsy cases | ||||||||
| Patient age (years)§ | ||||||||
| 40–49 | 118 | 3391 | 71 (66 to 76) | 0.038 | 856 (25) | 1188 (35) | 356 (10) | 991 (29) |
| 50–59 | 67 | 1924 | 70 (65 to 75) | 495 (26) | 663 (34) | 195 (10) | 571 (30) | |
| 60–69 | 29 | 833 | 67 (60 to 73) | 171 (21) | 295 (35) | 88 (11) | 279 (33) | |
| 70+ | 26 | 752 | 69 (63 to 75) | 209 (28) | 230 (31) | 81 (11) | 232 (31) | |
| Breast density§ | ||||||||
| Low density | 118 | 3391 | 68 (63 to 73) | <0.001 | 786 (23) | 1184 (35) | 340 (10) | 1081 (32) |
| High density | 122 | 3509 | 72 (67 to 77) | 945 (27) | 1192 (34) | 380 (11) | 992 (28) | |
| Biopsy type§,¶ | ||||||||
| Core needle biopsy | 138 | 3953 | 72 (67 to 77) | 0.006 | 969 (25) | 1415 (36) | 459 (12) | 1110 (28) |
| Excisional biopsy | 102 | 2947 | 67 (62 to 73) | 762 (26) | 961 (33) | 261 (9) | 963 (33) | |
| Case characteristics assessed by participant pathologists | ||||||||
| Cumulative number of unique sub-diagnoses given to a case** | ||||||||
| <4 | 50 | 1436 | 64 (58 to 71) | <0.001 | 141 (10) | 702 (49) | 80 (6) | 513 (36) |
| 4–7 | 137 | 3938 | 70 (66 to 75) | 1090 (28) | 1240 (31) | 445 (11) | 1163 (30) | |
| ≥8 | 53 | 1526 | 74 (69 to 79) | 500 (33) | 434 (28) | 195 (13) | 397 (26) | |
| Degree of challenge | ||||||||
| Low | − | 4829 | 59 (53 to 66) | <0.001 | 701 (15) | 1879 (39) | 292 (6) | 1957 (41) |
| High | − | 2071 | 94 (92 to 97) | 1030 (50) | 497 (24) | 428 (21) | 116 (6) | |
| Confidence in assessment | ||||||||
| High Confidence | − | 5640 | 65 (59 to 70) | <0.001 | 1107 (20) | 2071 (37) | 464 (8) | 1998 (35) |
| Low confidence | − | 1260 | 94 (91 to 97) | 624 (50) | 305 (24) | 256 (20) | 75 (6) | |
| Case considered borderline | ||||||||
| Yes | − | 1803 | 95 (93 to 97) | <0.001 | 954 (53) | 366 (20) | 398 (22) | 85 (5) |
| No | − | 5097 | 61 (55 to 67) | 777 (15) | 2010 (39) | 322 (6) | 1988 (39) | |
| Participant diagnosis | ||||||||
| Benign w/o atypia | − | 2658 | 55 (49 to 61) | <0.001 | 579 (22) | 708 (27) | 167 (6) | 1204 (45) |
| Atypia | − | 1336 | 88 (83 to 93) | 647 (48) | 292 (22) | 236 (18) | 161 (12) | |
| DCIS | − | 2186 | 77 (71 to 83) | 413 (19) | 998 (46) | 269 (12) | 506 (23) | |
| Invasive | − | 720 | 72 (65 to 79) | 92 (13) | 378 (53) | 48 (7) | 202 (28) | |
By self-report on baseline survey.
Row percentages might not add up to 100 due to rounding.
Binary variable created from all three affirmative responses where 1=yes, 0=no. LS means and CIs estimated on logit scale and back transformed on the scale of the mean using the inverse link function.
Probability > χ2, Wald statistics for type 3 GEE analysis.
Women’s age and biopsy type were provided to participants during specimen assessment; breast density was not provided.
Low density (≤50 fibroglandular; BIRADS category 1 and 2) and high density (≤51% fibroglandular; BIRADS category 3 and 4; breast density was not provided to participants during specimen assessment).
Number of unique diagnostic subtypes at the level of each case as determined by participants.
DCIS, ductal carcinoma in situ; GEE, generalised estimating equation; LS, least square.