PERFORMS – improving the diagnosis of breast cancer

Online self-assessment and training resource for breast screening radiologists.

Developed by Loughborough’s Applied Vision Research Centre (AVRC) in collaboration with the NHS Breast Screening Programme, now part of Public Health England, PERFORMS is an online self-assessment and training resource for breast screening radiologists.

Professor Alastair Gale started work on PERFORMS in the mid-1980s, and it has been used by the NHS for the past 26 years to help maintain and improve radiological diagnostic performance.

Indeed, the Royal College of Radiologistsrequires all screeners to undergo annual PERFORMS assessment to ensure that the accuracy of mammogram interpretation and early detection of breast cancer in the UK remains world-leading.

The programme allows screeners to study many more abnormal and malignant variations than they would normally encounter, and provides immediate feedback – identifying training needs so that screeners can improve their knowledge and skills.

Interest in PERFORMS is global. Dr Chen – PERFORMS Research Manager – has delivered more than 20 presentations at international scientific conferences, including the RSNA 2010 international conference in Chicago to 5,000 radiologists.

PERFORMS will be globally available under licence from the University in early 2015.

Meanwhile, they are developing a new iteration of PERFORMS which will assess practitioners’ interpretation of the digital 3D mammograms generated by new technology, tomosynthesis, which provides a higher diagnostic accuracy than conventional mammography.

Impact and milestones

  • Unique 

    PERFORMS is the first assessment and training programme of its kind.

  • Award-winning 

    The PERFORMS team has won various awards and accolades including the University’s Enterprise Award for Consultancy (2009), The Institute of Ergonomics and Human Factors’ President’s Medal (2010), a place among the Lord Stafford Award finalists (2010), and the Cum Laude Prize for best research (SPIE Medical Imaging International Conference 2004, 2005, 2007 and 2012). Members of the team also hold Honorary Membership (Dr Chen, 2014) and Fellowship (Professor Gale, 2006) of the Royal College of Radiologists.

  • Success rate 

    A comprehensive breast cancer screening programme was introduced to the UK in 1988. Today, there are 700 breast screening clinicians – radiologists and advanced practitioner radiographers – in the UK. Between them, they examine over 2.1 million images of women aged 45-74 – resulting in more than eight out of 10 women in England diagnosed with breast cancer surviving for at least five years.