Implementation of evidence-based guidelines for appropriate use of ultrasonography in diagnostic breast imaging: the MAMMOED-2 study.

The routine diagnostic work up in patients suspected with breast disease consists of clinical examination, mammography and ultrasonography when indicated.

A large prospective study at Maastricht University Hospital defined the diagnostic value of additional ultrasonography and identified subgroups of patients in whom this test yields most additional diagnostic information (Arch Int Med 2003; 163:1194-1199).

The current trial concerns the further development of evidence-based guidelines for appropriate use of breast ultrasonography based on these results, as well as the development of cost-effective implementation strategies, by means of an implementation study in a multicentre radiological setting.

Four centres participate in this study:

1. Maastricht University Hospital;

2. Leiden University Medical Centre;

3. Atrium Medical Centre Heerlen;

4. VieCuri Medical Centre Venlo.

1. To develop (cost-) effective implementation strategies which are feasible in daily practice;

2. To test the guidelines in a multicentre effectiveness trial;

3. To develop general quality indicators with appropriate measuring tools for diagnostic breast imaging.

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Implementation of evidence-based guidelines for appropriate use of breast ultrasonography in daily practice.