D1. Breast cancer research funders, such as the National Institutes of Health, Department of Defense, and private foundations, should support research on screening and detection technologies that encompasses each aspect of technology adoption from deployment to application, and should include monitoring of use in practice.

• This will involve identification of optimal combinations and sequencing of breast cancer detection technologies.

• Research funders and private foundations should model and assess changes in practice and organization change that would optimize the benefit of new technology (including risk assessment).

D2. The National Institutes of Health, the Agency for Healthcare Research and Quality, and other public and private research sponsors should collaborate with health systems, providers, and payers to support research that would monitor clinical use of technologies to identify potential failures, as well as opportunities for improvement, with particular attention to:

• How appropriately the technologies are being utilized,

• Their impact on clinical decision making, and

• Their impact on health outcomes.

1. Casey B. 2003, March 11. Breast Center Enlists Radiographers for First Look at Mammograms. Accessed February 19, 2004. Web Page. Available at: http://www.auntminnie.com/default.asp?Sec=sup&Sub=wom&Pag=dis&ItemId=57614&stm=radiographers.

2. Ransohoff DF. 2002. Challenges and opportunities in evaluating diagnostic tests. J Clin Epidemiol 55(12):1178-1182.