Breast Cancer Clinical Trial
Official title:
Women's Experiences of Mammography: Quantitative Evaluation
Study will develop, validate and pilot measures to assess quality of experiences of mammography. Pilot data collection and analysis will investigate modifiable factors most important in determining quality of patient experiences of mammography.
While instruments to measure experiences of breast screening and mammography have been
developed in the past, there is none which (a) concentrates in depth on the experience of the
examination itself, (b) includes detailed breast positioning variables, (c) has been designed
based on robust and transparent qualitative evidence, and (d) has been validated in a UK
breast setting. Such a tool is needed to inform the design, development and testing of
interventions to improve experiences of mammography. This is an important goal because many
women are deterred from future breast screening by poor mammography experiences. Furthermore,
regular client satisfaction surveys are required by the UK national breast screening
programmes but there is no standard, validated measure in place.
The aim of this project is to develop, and obtain evidence for the validity of, a
comprehensive toolkit of measures to evaluate experiences of mammography. The measures will
be capable of assessing the quality of experiences of mammography and identifying modifiable
predictors thereof. The investigators will pilot the measures in a sample of women attending
for NHS breast screening. The resulting data will be used as the basis for building a
statistical analysis model, for further validation of the measures, and for producing
preliminary findings on what they are intended to measure.
Items generated from the investigators recent qualitative study will be combined with items
from existing literature and with novel image-based metrics to draft comprehensive measures
of women's mammography experiences. Questionnaires will capture 1. relevant modifiable
potential determinants of overall quality of experience, such as the mammographer's ability
to put the client at ease, 2. key potential confounding variables (e.g. client physical
characteristics such as mobility problems or breast tenderness), and 3. outcome variables
representing or postulated to contribute to overall quality of experience, including pain
from the mammogram. Questionnaire development will follow established methods, including
testing for face and content validity with a sample of field experts and of the target
population, and checking for question design errors - such as leading questions - by a member
of the team experienced in questionnaire construction. The draft questionnaires will be
cognitively tested for understandability and acceptability with a small sample of women
eligible for breast screening, and refined before administration to a larger sample of women
attending for screening mammography. The questionnaire data will be incorporated into a
statistical analysis model along with additional data which the investigators will extract
from participants' mammographic images as follows.
The mammographic images will be examined for variables which may affect the client
experience. These will include e.g. the compression force applied to the breast tissue during
mammography, and features of the breast positioning technique. Thus, the measurement toolkit
will have multiple parts. The investigators expect it to be capable of rigorous routine
service and performance evaluation in mammography, of identifying what nature of
interventions are needed to improve mammography experiences, and of evaluating the
effectiveness of such interventions in the future.
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