Applying the “positive predictive value–recall diagram” to monitor performance and provide recommendations for screening radiologists

Question Can positive predictive value (PPV)-recall diagrams help audit teams provide recommendations to radiologists to enhance their reading performance in a breast cancer screening programme? Findings PPV-recall diagrams help audit teams identify screening outcome variation. Recall rates often changed in the desired direction after recommendations, but did not always meet targets. Clinical relevance Incorporating PPV-recall diagrams into quality assurance audits in breast cancer screening can support audit teams to provide recommendations to radiologists to maximise cancer detection and minimise false positives. Radiologists may need additional individual feedback to optimally achieve these improvements.