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Development and content validity evaluation of a candidate instrument to assess image quality in digital mammography : A mixed-method study

Boita, Joana ; Bolejko, Anetta LU ; Zackrisson, Sophia LU ; Wallis, Matthew G. ; Ikeda, Debra M. ; Van Ongeval, Chantal ; van Engen, Ruben E. ; Mackenzie, Alistair ; Tingberg, Anders LU and Bosmans, Hilde , et al. (2021) In European Journal of Radiology 134.
Abstract

Purpose: To develop a candidate instrument to assess image quality in digital mammography, by identifying clinically relevant features in images that are affected by lower image quality. Methods: Interviews with fifteen expert breast radiologists from five countries were conducted and analysed by using adapted directed content analysis. During these interviews, 45 mammographic cases, containing 44 lesions (30 cancers, 14 benign findings), and 5 normal cases, were shown with varying image quality. The interviews were performed to identify the structures from breast tissue and lesions relevant for image interpretation, and to investigate how image quality affected the visibility of those structures. The interview findings were used to... (More)

Purpose: To develop a candidate instrument to assess image quality in digital mammography, by identifying clinically relevant features in images that are affected by lower image quality. Methods: Interviews with fifteen expert breast radiologists from five countries were conducted and analysed by using adapted directed content analysis. During these interviews, 45 mammographic cases, containing 44 lesions (30 cancers, 14 benign findings), and 5 normal cases, were shown with varying image quality. The interviews were performed to identify the structures from breast tissue and lesions relevant for image interpretation, and to investigate how image quality affected the visibility of those structures. The interview findings were used to develop tentative items, which were evaluated in terms of wording, understandability, and ambiguity with expert breast radiologists. The relevance of the tentative items was evaluated using the content validity index (CVI) and modified kappa index (k*). Results: Twelve content areas, representing the content of image quality in digital mammography, emerged from the interviews and were converted into 29 tentative items. Fourteen of these items demonstrated excellent CVI ≥ 0.78 (k* > 0.74), one showed good CVI < 0.78 (0.60 ≤ k* ≤ 0.74), while fourteen were of fair or poor CVI < 0.78 (k* ≤ 0.59). In total, nine items were deleted and five were revised or combined resulting in 18 items. Conclusions: By following a mixed-method methodology, a candidate instrument was developed that may be used to characterise the clinically-relevant impact that image quality variations can have on digital mammography.

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Contribution to journal
publication status
published
subject
keywords
Content validity evaluation, Content validity index, Digital mammography, Directed content analysis, Image quality evaluation, Visual grading analysis
in
European Journal of Radiology
volume
134
article number
109464
publisher
Elsevier
external identifiers
  • pmid:33307458
  • scopus:85097710285
ISSN
0720-048X
DOI
10.1016/j.ejrad.2020.109464
language
English
LU publication?
yes
id
2a6778ef-91df-4a2c-8560-c24c0e9dac46
date added to LUP
2021-01-04 14:46:26
date last changed
2021-02-23 03:43:58
@article{2a6778ef-91df-4a2c-8560-c24c0e9dac46,
  abstract     = {<p>Purpose: To develop a candidate instrument to assess image quality in digital mammography, by identifying clinically relevant features in images that are affected by lower image quality. Methods: Interviews with fifteen expert breast radiologists from five countries were conducted and analysed by using adapted directed content analysis. During these interviews, 45 mammographic cases, containing 44 lesions (30 cancers, 14 benign findings), and 5 normal cases, were shown with varying image quality. The interviews were performed to identify the structures from breast tissue and lesions relevant for image interpretation, and to investigate how image quality affected the visibility of those structures. The interview findings were used to develop tentative items, which were evaluated in terms of wording, understandability, and ambiguity with expert breast radiologists. The relevance of the tentative items was evaluated using the content validity index (CVI) and modified kappa index (k*). Results: Twelve content areas, representing the content of image quality in digital mammography, emerged from the interviews and were converted into 29 tentative items. Fourteen of these items demonstrated excellent CVI ≥ 0.78 (k* &gt; 0.74), one showed good CVI &lt; 0.78 (0.60 ≤ k* ≤ 0.74), while fourteen were of fair or poor CVI &lt; 0.78 (k* ≤ 0.59). In total, nine items were deleted and five were revised or combined resulting in 18 items. Conclusions: By following a mixed-method methodology, a candidate instrument was developed that may be used to characterise the clinically-relevant impact that image quality variations can have on digital mammography.</p>},
  author       = {Boita, Joana and Bolejko, Anetta and Zackrisson, Sophia and Wallis, Matthew G. and Ikeda, Debra M. and Van Ongeval, Chantal and van Engen, Ruben E. and Mackenzie, Alistair and Tingberg, Anders and Bosmans, Hilde and Pijnappel, Ruud and Sechopoulos, Ioannis and Broeders, Mireille},
  issn         = {0720-048X},
  language     = {eng},
  publisher    = {Elsevier},
  series       = {European Journal of Radiology},
  title        = {Development and content validity evaluation of a candidate instrument to assess image quality in digital mammography : A mixed-method study},
  url          = {http://dx.doi.org/10.1016/j.ejrad.2020.109464},
  doi          = {10.1016/j.ejrad.2020.109464},
  volume       = {134},
  year         = {2021},
}