User preferences for design scenarios of a new imaging technique to detect breast cancer

Currently, new techniques for the detection of breast cancer are being developed that cause less patient discomfort than X-ray mammography. One of these techniques is photo-acoustic mammography. However, it is still unknown how important performance requirements related to diagnostic performance, discomfort, risks, and efficiency are to the adoption of new imaging technology in breast cancer screening. The Analytic Hierarchy Process (AHP), a technique for multi-criteria analysis, was used to estimate health care professionals’ preferences for three scenarios of the new imaging technology. These scenarios differed in the diagnostic performance that could be achieved. Preferences for the scenarios of photo-acoustic mammography were compared with the preferences for X-ray mammography. Criteria related to the diagnostic performance, efficiency, patient comfort and risks. We elicited preferences of 20 health care professionals involved in a breast cancer screening program. Health care professionals considered the sensitivity of the imaging technique to be the criterion of utmost importance in the selection of a new imaging technique to detect breast cancer. Advantages of less discomfort have relatively less meaning according to the radiology assistants and radiologists involved. Our scenario analysis indicated the minimal performance requirements for the diagnostic performance of the new imaging technique. This study supported the design and market decisions of the developers of the new imaging technique. It showed that the new technique should exceed the diagnostic performance of Xray mammography. Reduction of the scan time appeared to be important to increase the efficiency of the breast cancer screening program.