Mammography image assessment; validity and reliability of current scheme

•Currently no robust evidence based marking tools in use for the assessment of images in mammography.•Is current system valid, reliable and robust?•How can the current image assessment tool be improved?•Should students and qualified mammographers use the same tool?•What marking criteria are available for image assessment?

Mammographers currently score their own images according to criteria set out by Regional Quality Assurance. The criteria used are based on the ‘Perfect, Good, Moderate, Inadequate’ (PGMI) marking criteria established by the National Health Service Breast Screening Programme (NHSBSP) in their Quality Assurance Guidelines of 20061.This document discusses the validity and reliability of the current mammography image assessment scheme. Commencing with a critical review of the literature this document sets out to highlight problems with the national approach to the use of marking schemes.The findings suggest that ‘PGMI’ scheme is flawed in terms of reliability and validity and is not universally applied across the UK. There also appear to be differences in schemes used by trainees and qualified mammographers. Initial recommendations are to be made in collaboration with colleagues within the National Health Service Breast Screening Programme (NHSBSP), Higher Education Centres, College of Radiographers and the Royal College of Radiologists in order to identify a mammography image appraisal scheme that is fit for purpose.