Consensus double reading of mammograms was more effective and less costly than single reading

In the analysis by Brown and colleagues that compared the current rnammography reading policy at St. Margaret's Hospital (double reading with consensus required for recall) with 2 alternative hypothetical strategies, the authors showed that the current strategy used is the most cost-effective. 2 elements of this study must he considered when attempting to generalise the conclusions to other settings. First, the costs assigned in this meta-arialysis are likely to vary among institutions and countries. Therefore, it is necessary to apply local charges to see whether the results of this study can be applied locally. The time and costs assigned for a second reading might exceed the threshold values determined by the sensitivity analysis in other settings (1). Similarly, the costs for assessing abnormal results are mammograms by 1 radiologist; 2) nonconsensus double reading of mammograms by 2 radiologists with recall if recommended by either radiologist; and 3) consensus double reading of mammograms with recall if the radiologists agreed; if they disagreed, a decision was made by the senior consultant radiologist or by discussion between the 2 readers (the strategy in place at St. Margaret's Hospital).