Clinical performance assessment and training across radiology, pathology and surgery.


Performance in the UK breast screening programme has been heavily audited as part of the quality assurance process since the screening programme began in 1988, as we know this drives improvements.  A pivotal part of this process is PERFORMS (Personal Performance in Mammographic Screening) which has been scientifically proven to predict individual readers real-life performance and can be used to determine potential reading problems early allowing corrective measures to be implemented in a timely fashion.  For over 30 years, this test set based assessment scheme has been used by the NHS breast screening programme. PERFORMS sets consist of challenging malignant, benign and normal cases selected by an expert panel of radiologists. PERFORMS is undertaken annually by around 1000 UK readers as well as international colleagues who all receive immediate performance feedback and a more detailed personalised performance assessment via their own confidential web portal.

The move

The last 18 months have been momentous for PERFORMS.  We have successfully completed our relocation to the University of Nottingham within the Division of Cancer and Stem Cells.  We are now part of a wider team of international experts in medical imaging, cognitive and perceptual performance assessment and training, all dedicated to improving the diagnostic skills of health professionals. The move has inevitably lead to a short delay in the next round of the PERFORMS scheme, but we are delighted to announce that the latest test set is ready for release and will be with UK mammography readers very soon.

New Developments

Participants will get to experience the new and improved PERFORMS website. This is also the portal to access our sister training programmes and research collaborations. You will see major changes providing opportunities for increased personalised learning and feedback. Users can access more detailed learning outcomes and examine how you, your anonymised peers, and experts reported each case with pathology outcomes. You can review the current and historical test sets with interactive tables, anonymously discuss cases and receive your expert feedback and access your comprehensive individual performance reports. We are also developing a more user-friendly PERFORMS reporting App with new tools to improve the functionality, with detailed graphs and enhanced feedback which should improve the learning opportunities offered to participants. These updates will be released with the new set. As before, the importance of PERFORMS in revalidation and maintaining professional standards is recognised by the award of 4 CPD credits for each set by the UK Royal College of Radiology.


The PERFORMS research group would like to thank all the UK readers who gave permission for us to access their performance data. Our latest publication suggests that PERFORMS is a true reflection of real-life screening performance and has the ability to predict and identify poor performance outliers.  Our latest paper ‘Relationship Between Mammography Readers Real-life Performance and Performance in a Test-set Based Assessment Scheme in a National Breast Screening Programme’ will shortly be published in the journal Radiology: Imaging Cancer.
Finally, we would like to thank all our participating readers who make PERFORMS the success it is. We wish to acknowledge the continued support of the NHS Breast Screening Programme and Public Health England.  We are indebted to the screening units that provide mammographic cases and to those radiologists who give their time to help compile and curate the sets.