{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:05:17Z","timestamp":1792098317755,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,7,31]],"date-time":"2015-07-31T00:00:00Z","timestamp":1438300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":32,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA165229"],"award-info":[{"award-number":["R01CA165229"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01LM011028"],"award-info":[{"award-number":["R01LM011028"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["BE5474\/1\u20101"],"award-info":[{"award-number":["BE5474\/1\u20101"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health (NIH)","doi-asserted-by":"publisher","award":["R01CA165229"],"award-info":[{"award-number":["R01CA165229"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health (NIH)","doi-asserted-by":"publisher","award":["R01LM011028"],"award-info":[{"award-number":["R01LM011028"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft (DFG)","doi-asserted-by":"publisher","award":["BE5474\/1-1"],"award-info":[{"award-number":["BE5474\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA165229"],"award-info":[{"award-number":["R01CA165229"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01LM011028"],"award-info":[{"award-number":["R01LM011028"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["BE5474\/1-1"],"award-info":[{"award-number":["BE5474\/1-1"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aip.org"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2015,8]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p>Lesions detected at mammography are described with a highly standardized terminology: the breast imaging\u2010reporting and data system (BI\u2010RADS) lexicon. Up to now, no validated semantic computer assisted classification algorithm exists to interactively link combinations of morphological descriptors from the lexicon to a probabilistic risk estimate of malignancy. The authors therefore aim at the external validation of the mammographic mass diagnosis (MMassDx) algorithm. A classification algorithm like MMassDx must perform well in a variety of clinical circumstances and in datasets that were not used to generate the algorithm in order to ultimately become accepted in clinical routine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>The MMassDx algorithm uses a na\u00efve Bayes network and calculates post\u2010test probabilities of malignancy based on two distinct sets of variables, (a) BI\u2010RADS descriptors and age (\u201cdescriptor model\u201d) and (b) BI\u2010RADS descriptors, age, and BI\u2010RADS assessment categories (\u201cinclusive model\u201d). The authors evaluate both the MMassDx (descriptor) and MMassDx (inclusive) models using two large publicly available datasets of mammographic mass lesions: the digital database for screening mammography (DDSM) dataset, which contains two subsets from the same examinations\u2014a medio\u2013lateral oblique (MLO) view and cranio\u2013caudal (CC) view dataset\u2014and the mammographic mass (MM) dataset. The DDSM contains 1220 mass lesions and the MM dataset contains 961 mass lesions. The authors evaluate discriminative performance using area under the receiver\u2010operating\u2010characteristic curve (AUC) and compare this to the BI\u2010RADS assessment categories alone (i.e., the clinical performance) using the DeLong method. The authors also evaluate whether assigned probabilistic risk estimates reflect the lesions\u2019 true risk of malignancy using calibration curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The authors demonstrate that the MMassDx algorithms show good discriminatory performance. AUC for the MMassDx (descriptor) model in the DDSM data is 0.876\/0.895 (MLO\/CC view) and AUC for the MMassDx (inclusive) model in the DDSM data is 0.891\/0.900 (MLO\/CC view). AUC for the MMassDx (descriptor) model in the MM data is 0.862 and AUC for the MMassDx (inclusive) model in the MM data is 0.900. In all scenarios, MMassDx performs significantly better than clinical performance, <jats:italic>P<\/jats:italic> &lt; 0.05 each. The authors furthermore demonstrate that the MMassDx algorithm systematically underestimates the risk of malignancy in the DDSM and MM datasets, especially when low probabilities of malignancy are assigned.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The authors\u2019 results reveal that the MMassDx algorithms have good discriminatory performance but less accurate calibration when tested on two independent validation datasets. Improvement in calibration and testing in a prospective clinical population will be important steps in the pursuit of translation of these algorithms to the clinic.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4927260","type":"journal-article","created":{"date-parts":[[2015,7,31]],"date-time":"2015-07-31T17:01:50Z","timestamp":1438362110000},"page":"4987-4996","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":7,"title":["External validation of a publicly available computer assisted diagnostic tool for mammographic mass lesions with two high prevalence research datasets"],"prefix":"10.1002","volume":"42","author":[{"given":"Matthias","family":"Benndorf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth S.","family":"Burnside","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Herda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar","family":"Kotter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3121511"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.187.1.8451441"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.196.3.7644649"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2513081346"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1109\/IEMBS.2004.1403858"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0010\u20104825(96)00039\u2010X"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.2786864"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010013\u20102836\u20108"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.3345"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b605"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u201040"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010014\u20103570\u20106"},{"key":"e_1_2_6_14_1","volume-title":"UCI Machine Learning Repository","author":"Bache K.","year":"2013"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4870379"},{"key":"e_1_2_6_16_1","first-page":"212","volume-title":"Proceedings of the 5th International Workshop on Digital Mammography,","author":"Heath M.","year":"2001"},{"key":"e_1_2_6_17_1","unstructured":"E. A. Sickles"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2009.07.023"},{"key":"e_1_2_6_19_1","first-page":"5446","article-title":"State certification of mammography facilities","volume":"67","journal-title":"Fed. Regist."},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2006.08.034"},{"key":"e_1_2_6_21_1","first-page":"609","volume-title":"International Conference on Machine Learning","author":"Zadrozny B.","year":"2001"},{"key":"e_1_2_6_22_1","unstructured":"P.DomingosandM.Pazzani \u201cBeyond independence: Conditions for the optimality of the simple Bayesian classifier \u201d inProceedings of the 13th International Conference on Machine Learning(Morgan Kaufmann Burlington MA 1996) pp.105\u2013112."},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751\u20105823.2001.tb00465.x"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2004.11.030"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/39.4.561"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181c30fb2"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010130\u20106\u2010199903160\u201000016"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197810262991705"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa066099"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0803545"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2411051504"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.171.1.9648759"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.211.3.r99jn31845"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010004\u20102373\u20106"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201006\u20100034"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1086\/375033"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0048820"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2392042127"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.166.4.8610547"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.174.6.1741769"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2243011626"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0001\u20102998(78)80014\u20102"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acra.2008.04.022"}],"container-title":["Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1118%2F1.4927260","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1118%2F1.4927260","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1118\/1.4927260","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,18]],"date-time":"2023-09-18T08:17:26Z","timestamp":1695025046000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1118\/1.4927260"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,31]]},"references-count":43,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2015,8]]}},"alternative-id":["10.1118\/1.4927260"],"URL":"https:\/\/doi.org\/10.1118\/1.4927260","archive":["Portico"],"relation":{},"ISSN":["0094-2405","2473-4209"],"issn-type":[{"value":"0094-2405","type":"print"},{"value":"2473-4209","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,31]]},"assertion":[{"value":"2015-02-10","order":0,"name":"received","label":"received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-05-12","order":1,"name":"revised","label":"revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-12","order":2,"name":"accepted","label":"accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-07-31","order":6,"name":"published","label":"published","group":{"name":"publication_history","label":"Publication History"}}]}}