PERFORMS is an educational self-assessment and training scheme for breast screening professionals and has been in use across the UK NHS since 2007.

PERFORMS allows radiologists to improve their skill in detecting the earliest signs of cancer, improving patient outcomes.

The PERFORMS scheme is for breast screening professionals and the IMPROVE scheme is for technologists and advanced practitioner radiographers undergoing training.


The Concept

Each year we amass a number of difficult and challenging screening cases which are sent to us from UK breast screening centres (we are always looking for more cases so please contact us if you think you have interesting cases). These cases are anonymised so that they contain no patient identifiable information. A number of expert screening radiologists review these cases judging their difficulty, suitability for the scheme and giving their opinions about various factors including the mammographic appearances.

From the number of cases submitted we derive a set of cases to use in the scheme that year.

After registering with the scheme, an individual takes part by reading the set of cases and reporting their various decisions about each case. This is most conveniently done online by means of a web browser, but where that is not possible an offline version can be sent out to centres on a laptop. We currently offer the latest PERFORMS scheme in a digital format for viewing on mammographic workstations; film was withdrawn after SA11 as directed by the NHSBSP.

Having read the set of cases the participant receives immediate graphical feedback from the reporting software concerning how their decisions agree with those of an expert panel of radiologists and also on how well they identified early and difficult signs of abnormalities. Once everyone in the UK has taken part then all participants receive detailed and anonymous data.

Technology Uses

The PERFORMS system is currently optimised for mammography, but the technology platform could be applicable to any imaging technique.


Technology Benefits

PERFORMS is probably the first radiological self-assessment scheme in the world and which has been implemented nationally.

When the Royal College of Radiologists reviewed the Standards for Self-Assessment of Performance across the domain of radiology in 2007 then the PERFORMS scheme was the only self-assessment scheme referred to. Their standards document can be found here

The PERFORMS scheme has won various awards:

Lord Stafford award for ‘Innovation Achieved’ finalist (2010)

Awarded the President’s Medal, Institute of Ergonomics & Human Factors (2010).

Awarded Loughborough University’s Enterprise Award for Consultancy Enterprise (2009).


Route to Commercialisation

The majority of breast-screening training and assessment work has been for the NHS in the UK.

However the PERFORMS team at Loughborough has expertise in many aspects of medical image interpretation and is also active within the research community and commercial sectors. We feel that it is important to offer our expertise to all sectors in which it can have positive impact.

To that end we offer both bespoke training and assessment services and also are beginning to offer the PERFORMS training scheme internationally.


Contact the PERFORMS team

Patent Information:
Social Sciences
For Information, Contact:
Paul Burrows
IP Exploitation Manager
Loughborough University
Alastair Gale
Yan Chen
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