Title: Impact of Same Day Screening Mammogram Results on Women’s Satisfaction and
Overall Breast Cancer Screening Experience - A Quality Improvement Survey Analysis
Version: 0 Date: 24 Feb 2022
Reviewer's report:
The primary objective of this work was to evaluate the impact on women's satisfaction of a
change in the mammography screening pathway. The change experienced was providing women
with the result of their screening mammogram on the same day they performed it (83.2% of
women received the outcome within 30 minutes).
Although the topic is interesting in itself, some considerations make the work not very innovative
and in need of substantial revision.
Title.
The term patients should be replaced with that of women.
Introduction.
The bibliography is completely out of place. Need to correct this error throughout the article.
this makes reading (and reviewing) not easy.
Materials and Methods.
The authors mention 'our institution' but do not clarify what kind of institution it is...is the
screening offered spontaneously? Is the testing free? Is the return to subsequent rounds also
spontaneous, i.e., in subsequent screening rounds, does the woman herself have to make the
appointment for the mammography or is she contacted in some way? Having more background
information would also be helpful to better frame the context of the study.
The mammogram is only read by one radiologist anyway, is there no double reading? (If there
is no dual reading, this should also be commented on in the discussion of results)
The authors state that 200 women 'opted' for same day screening mammogram results; which
was the denominator? how many women were contacted, that is, how many were offered this
procedure? Are the reasons for refusal known?
What was the age range of the respondent women? Are they working women? Is there any
sociodemographic information about them the authors could use to enrich the comments?
For the 155 patients who had been tested before, did they all have a 1-year interval?
Of the approximately 150 women, about 8-10 women have been (probably) recalled for further
diagnostic testing: how did these women respond? Did they perform the in-depth diagnostics on
the same day as the mammogram? Or did they return at a later time?
Discussion:
In this part, the authors correctly point out what represents the study's greatest weakness: not
having a randomized comparison group.
This makes the data unrobust and rather weak.
The results go in the direction of greater satisfaction for women who have their results on the
same day of mammography (although not significant) but the generalizability of the results is
really poor (given the small size of the population involved and the methodology of enrolment).
Authors should comment on the economic impact of this method ( linked to the increase of
radiologist time for the delivery of results). This comments are due since half of the women did
not express a substantial change in satisfaction in comparison to the previous experience.
To consider a reduction in anxiety as a direct consequence of a (non-significant) increase in
satisfaction seems risky. The questionnaire used by the authors does not allow any possible
hypothesis in this direction.