Much Ado About Mammography Variability

Variability in quality of medical care is its Achilles ’ heel, and one in great need of repair. But, how do we improve the quality of a procedure such as mammography and ensure that variability is minimized? This fundamental issue underlies the article by Elmore et al. in this issue of the Journal (1). For almost 10 years, Elmore and colleagues have examined the issue of variability of radiologists ’ readings of mammograms (2–4). After reestablishing the well-known phenomenon of vari-ability in radiologic reading in general (5,6), these authors have explored the factors that influence this variability, hoping they can find ways to reduce it (1). In their community-based study, they have found that false-positive rates ranged from 2.6 % to 15.9%. They can account for half this range by controlling for patient, radiologist, and testing characteristics (e.g., year of mammographic examination or availability of previous mam