Discovering interobserver variability in the cytodiagnosis of breast cancer using decision trees and Bayesian networks

We evaluate the performance of two decision tree procedures and four Bayesian network classifiers as potential decision support systems in the cytodiagnosis of breast cancer. In order to test their performance thoroughly, we use two real-world databases containing 692 cases and 322 cases collected by a single observer and 19 observers, respectively. The results show that, in general, there are considerable differences in all tests (accuracy, sensitivity, specificity, PV+, PV− and ROC) when a specific classifier uses the single-observer dataset compared to those when this same classifier uses the multiple-observer dataset. These results suggest that different observers see different things: a problem known as interobserver variability. We graphically unveil such a problem by presenting the structures of the decision trees and Bayesian networks resultant from running both databases.