Breast ultrasound in Chinese hospitals: A cross-sectional study of the current status and influencing factors of BI-RADS utilization and diagnostic accuracy

Luying Gao; Jianchu Li; Yang Gu; Li Ma; Wen Xu; Xixi Tao; Ruojiao Wang; Rui Zhang; Yixuan Zhang; Hongyan Wang; Yuxin Jiang

The Lancet Regional Health. Western Pacific (Dec 2022)

Breast ultrasound in Chinese hospitals: A cross-sectional study of the current status and influencing factors of BI-RADS utilization and diagnostic accuracy

Luying Gao,
Jianchu Li,
Yang Gu,
Li Ma,
Wen Xu,
Xixi Tao,
Ruojiao Wang,
Rui Zhang,
Yixuan Zhang,
Hongyan Wang,
Yuxin Jiang

Affiliations

Luying Gao: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Jianchu Li: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Yang Gu: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Li Ma: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Wen Xu: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Xixi Tao: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Ruojiao Wang: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Rui Zhang: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Yixuan Zhang: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China
Hongyan Wang: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China; Corresponding authors at: Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China.
Yuxin Jiang: Department of Ultrasound, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Ultrasound Medical Quality Control Center, Beijing, China; Corresponding authors at: Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1 Shuai Fu Yuan, Dong Cheng District, Beijing 100730, China.

Journal volume & issue: Vol. 29
p. 100576

Abstract

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Summary: Background: With the growing demand for breast screening in public health services and clinical care, ultrasound departments in China are facing tremendous challenges. Methods: A cross-sectional nationwide survey was conducted in 5,460 departments providing ultrasound diagnoses in mainland China from 2020 to 2021. The survey included general information about the ultrasound department, the characteristics of sonologists, the use of Breast Imaging Reporting and Data System (BI-RADS) templates, and the diagnostic accuracy rate of breast cancer ultrasound. Findings: There were on average 2.25 sonologists per 10,000 patients in mainland China per year. The average utilization rate of BI-RADS in Chinese hospitals was 87.02%. The GDP per capita of the province (P = 0.008), whether the hospital was specialized (P = 0.002) or a Tier 3 facility (P < 0.001), the percentage of doctors with master's and doctoral degrees (P < 0.001) and doctors ≤35 years (P = 0.005) were significantly and independently associated with the utilization rate of BI-RADS. The average diagnostic accuracy rate of breast cancer ultrasound in Chinese hospitals was 73.64%, and we observed significant positive associations between GDP per capita (P = 0.02), BI-RADS utilization rate (P = 0.019), and breast cancer ultrasound diagnostic accuracy. Interpretation: The utilization of BI-RADS templates effectively improved the diagnostic accuracy of ultrasound. Moreover, the survey summarized the current situation of departments and sonologists providing breast ultrasound diagnosis in mainland China, which helped monitor the development of the discipline and provide information for administrators to meet the growing demand. Funding: This work was supported by Natural Science Foundation of Beijing (7202156) and Foundation of ihecc (2019-C-0646-2).

Published in The Lancet Regional Health. Western Pacific

ISSN: 2666-6065 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanwpc/home

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