Patient satisfaction with screening mammography: online vs off-line interpretation.

RATIONALE AND OBJECTIVES: The purpose of this study was to determine patient satisfaction with online and off-line methods of interpreting screening mammograms and to determine those characteristics that most influence patient preferences. MATERIALS AND METHODS: A survey consisting of 17 questions assessing satisfaction and demographics was distributed to women whose screening mammograms were read in one of two ways at the same facility: (a) the "online" method, in which all additional requested studies are completed and results are immediately communicated, and (b) the "off-line" method, in which mammograms are read in batches the next day, results are communicated at a later time, and patients return for diagnostic studies. To ensure statistical power, at least 174 surveys were collected from each group. RESULTS: Of 192 women whose mammograms were interpreted online, 188 (97%) responded, and of 247 women whose mammograms were interpreted off-line, 181 (73%) responded. Overall mean satisfaction with the mammographic experience and with the time it took to receive results differed significantly between the two groups (P < .002). Analysis of the subgroup of very satisfied respondents disclosed that 92% of patients in the online group and 59% of patients in the off-line group were very satisfied with their mammography experience. If allowed to choose the method of interpretation, 97% of patients in the online group and 91% of patients in the off-line group would choose online interpretation. CONCLUSION: Patients preferred online mammographic interpretation of screening studies.

Breast infection. Mammographic and sonographic findings with clinical correlation.

RATIONALE AND OBJECTIVES: To characterize the mammographic, sonographic, and clinical findings of breast infection and to determine characteristics that could help differentiate it from inflammatory breast carcinoma. METHODS: The mammograms, sonograms, and clinical records of 21 consecutive patients who had mammography or sonography within 48 hours of presenting with breast infection were retrospectively reviewed. To exclude other causes of breast inflammation, patients were required to have histologic or aspiration results specific for infection. RESULTS: Twelve of 19 (63%) mammograms were abnormal. Mammographic abnormalities included an irregular mass (6; 32%), focal asymmetric density (2; 11%), diffuse asymmetric density (2; 11%), circumscribed mass (1; 5%), and architectural distortion (1; 5%). Mammographic skin thickening, present in four (21%) patients, was focal in three and diffuse in one patient with primary breast Mycobacterium tuberculosis infection. No abnormally dense lymph nodes were demonstrated. There was no abnormal soft tissue gas. All 11 (100%) sonograms showed heterogeneous masses that contained internal echoes, 5 of these in patients who had normal mammograms. All 21 patients presented with clinical abnormalities, including palpable mass (20; 95%), pain (11; 52%), erythema (11; 52%), warmth (7; 33%), skin thickening or fixation (4; 19%), and breast swelling (3; 14%). One patient was lactating. CONCLUSIONS: Mammographic, sonographic, and clinical abnormalities were usually present with breast infection that could mimic inflammatory carcinoma. However, diffuse mammographic skin thickening, edema, and dense lymph nodes were rare, and when present may prospectively suggest carcinoma or an unusual infection. Early surgical consultation is advised.

Prior occupational experience and choice of alcoholism rehabilitation counselors.

Although the use of recovering alcoholics as counselors in professional settings is increasing, there is little information on the factors important in selecting counselors. This study looks at previous occupational socialization as one such factor. On the basis of a study of alcoholism rehabilitation counselors and their supervisors in Indiana it has been concluded that such socialization is an important factor. It is recommended that prospective employers be wary of applicants without some experience in "bureaucratic" types of work experience, that is, who have not had experience in work settings or with work requirements somewhat analogous to those in the professional setting.