Impact of CAD with full field digital mammography on workflow and cost

The cost-effectiveness of single reading with CAD as an alternative to double reading was assessed in a national screening programme using CAD with full field digital mammography The impact of CAD on the time taken to read screening films (n=5710) and on the proportion of films referred for arbitration and for assessment was measured (n=3064) No evidence was found of a change in the time taken to read films and no evidence of a change in rates of referral or recall Estimates of the cost implications were made under three different scenarios for screening units We conclude that single reading with CAD is likely to be a cost-effective alternative to double reading in terms of radiologist time Published data however shows increased recall rates using CAD and no significant increase in sensitivity for CAD use over single reading Any decision to introduce CAD instead of double reading should take into account the impact of sensitivity and specificity on women attending for screening.