Table 2.

Diagnostic performance of the readers in two reading modes with a Breast Imaging Reporting and Data System Category 4A threshold.

Lesions			Novice Reader												Expert Reader
			Without CADa					Combined with CAD					P value		Without CAD						Combined with CAD						P value
			+		–			+	–						+		–				+		–
Lesions≤2 cm
	Pathology
		+	44		22			64		23					52		9				69		33
		–	27		157			7		156					19		170				2		146
	Sensitivityb		61.97					90.14					<.001		73.24						97.18						<.001
	Specificityb		87.71					87.15					.83		94.97						81.56						.004
	PPVc		66.66					73.56					.22		85.25						67.65						.005
	NPVd		85.33					95.71					.008		89.95						98.65						.005
	Accuracy		80.40					88.00					.12		88.8						86						.52
	AUCe (95% CI)		0.74 (0.67-0.82)					0.88 (0.83-0.93)					<.001		0.84 (0.77-0.90)						0.90 (0.86-0.94)						.002
Lesions>2 cm
	Pathology
		+	61			11		79			28				67			4		79				23
		–	18			58		0			41				12			65		0				46
	Sensitivity		77.22					100					<.001		86.67						100						<.001
	Specificity		84.06					59.42					<.001		96.72						66.66						<.001
	PPV		84.72					73.83					.05		96.30						77.45						<.001
	NPV		76.32					100					<.001		88.06						100						<.001
	Accuracy		80.41					81.08					.86		91.74						84.46						.13
	AUC (95% CI)		0.81 (0.73-0.88)					0.80 (0.72-0.87)					.81		0.90 (0.84-0.95)						0.83 (0.76-0.91)						.03
All lesions
	Pathology
		+	105			33		143			51				119			13		148				52
		–	45			215		7			197				31			235		2				96
	Sensitivity		70					95.33					<.001		79.33						98.66						<.001
	Specificity		86.69					79.43					.13		94.75						79.03						.001
	PPV		76.08					73.71					.74		90.15						74.00						.003
	NPV		82.69					96.57					.001		88.34						98.98						.002
	Accuracy		80.40					85.43					.35		88.94						86.43						.52
	AUC (95% CI)		0.78 (0.73-0.83)					0.87 (0.84-0.91)					<.001		0.87 (0.83-0.91)						0.89 (0.85-0.92)						.29

^aCAD: computer-aided diagnosis.

^bBreast Imaging Reporting and Data System assessment categories 4B, 4C, and 5 were considered positive for cancer for the calculation of sensitivity and specificity.

^cPPV: positive predictive value.

^dNPV: negative predictive value.

^eAUC: area under the receiver operating characteristic curve.