Diana L. Miglioretti, PhD
Research interests and experience
- Biostatistics: clustered and longitudinal data analysis; latent variable modeling; assessment of diagnostic and screening tests
- Cancer control: biostatistics; breast cancer screening and surveillance; mammographic breast density; risk prediction; colorectal cancer screening
- Radiology: Imaging trends; radiation exposure from medical imaging; evaluation of imaging tests
Senior Investigator and Biostatistician Diana Miglioretti is committed to helping improve early detection of breast cancer. She pursues a rigorous combination of applied and methodological research, overseeing analyses of the largest and most comprehensive collection of breast cancer screening data in the nation.
Dr. Miglioretti co-leads the Breast Cancer Surveillance Consortium (BCSC)—a network of mammography registries linked to tumor and pathology registries. Established in 1994, the BCSC kicked off a new $20 million Program Project grant from the National Cancer Institute (NCI) in 2011. Dr. Miglioretti serves as the program’s contact principal investigator (PI) and the Director of the Biostatistics and Data Management Core, which houses the Statistical Coordinating Center—the repository and central analysis site for all BCSC data.
The vast BCSC database includes information on more than 9.5 million mammograms, 2.3 million women, and 114,000 breast cancer cases. Dr. Miglioretti leads the SCC in maximizing the value of these data: establishing and evaluating data collection, helping individual sites and outside researchers with analyses, and developing new statistical techniques. Through these efforts, BCSC data play an essential role in formulating national breast cancer screening policy decisions and clinical guidelines. It’s a one-of-a-kind resource that lets researchers worldwide answer timely questions about benefits and risks of breast cancer screening.
For example, Dr. Miglioretti worked with GHRI Senior Investigator Diana Buist, PhD, MPH, and colleagues from the University of Sydney in Australia on the first-ever study to rigorously assess screening mammography outcomes for women who’d had breast cancer before. Examining 12 years of information from more than 110,000 mammograms, they found that yearly screening detected second breast cancers at an early stage—results they published February 23, 2011 in the Journal of the American Medical Association (see news release).Another example comes from Dr. Miglioretti’s collaboration with NCI’s Cancer Intervention and Surveillance Modeling Network (CISNET) and the Oregon Evidence-based Practice Center. Publishing in the May 1, 2012, Annals of Internal Medicine, the team found that women age 40 to 49 with a twofold increase in breast cancer risk who have screening mammograms every two years experience similar benefits and harms as average-risk women who start biennial screening at age 50 (see news release).
BCSC data are also being used to better understand variation in radiologists’ interpretive performance of mammography. In the Assessing and Improving Mammography (AIM) study, Dr. Miglioretti worked with BCSC collaborators to develop mammography test sets to assess individual radiologist's interpretive performance (see news release). She is currently working with international colleagues to expand the test set to compare radiologist performance across many counties as part of the International Cancer Screening Network.
Additionally, Dr. Miglioretti develops statistical methods to more rigorously analyze longitudinal mammography data and is tackling questions related to the rapidly increasing use of diagnostic imaging. As imaging rates trend upward, so does exposure to medical radiation—results she reported June 12, 2012, in the Journal of the American Medical Association with Rebecca Smith-Bindman, MD, of the University of California, San Francisco, and colleagues from the Cancer Research Network (see news release).
These many achievements earned Dr. Miglioretti an appointment as the Dean’s Professor of Biostatistics in the Department of Public Health Sciences, School of Medicine at the University of California, Davis—a position she undertook at the outset of 2013, while still maintaining her leadership role in the BCSC and other key GHRI projects. Dr. Miglioretti enthusiastically shares her expertise as an instructor at the Radiological Society of North America's (RSNA) annual workshop in clinical trials methodology, which aims to prepare radiologists to develop clinical research protocols and apply for funding. Among her many professional memberships are the American Association for Cancer Research, the International Biometrics Society Eastern and Western North America regions (ENAR and WNAR), and the American Statistical Association, for whom she served as a Council of Sections representative in Biometrics.
Miglioretti DL, Zhang Y, Johnson E, Lee C, Morin RL, Vanneman N, Smith-Bindman R. Personalized technologist dose audit feedback for reducing patient radiation exposure from CT. J Am Coll Radiol. 2014;11(3):300-8. doi: 10.1016/j.jacr.2013.10.017. PubMed
Keegan J, Miglioretti DL, Gould R, Donnelly LF, Wilson ND, Smith-Bindman R. Radiation dose metrics in CT: assessing dose using the national quality forum CT patient safety measure. J Am Coll Radiol. 2014;11(3):309-15. doi: 10.1016/j.jacr.2013.10.009. PubMed
Burnside ES, Lin Y, Munoz Del Rio A, Pickhardt PJ, Wu Y, Strigel RM, Elezaby MA, Kerr EA, Miglioretti DL. Addressing the challenge of assessing physician-level screening performance: mammography as an example. PLoS One. 2014 Feb 21;9(2):e89418. doi: 10.1371/journal.pone.0089418. PubMed
Menes TS, Rosenberg R, Balch S, Jaffer S, Kerlikowske K, Miglioretti DL. Upgrade of high-risk breast lesions detected on mammography in the Breast Cancer Surveillance Consortium. Am J Surg. 2014 Jan;207(1):24-31. doi:10.1016/j.amjsurg.2013.05.014. Epub 2013 Oct 7. PubMed
Wernli KJ, O’Meara E, Kerlikowske K, Miglioretti D, Muller CY, Onega T, Sprague B, Henderson L, Buist DS. Investigation of mammographic breast density as a risk factor for ovarian cancer. J Nat Cancer Inst. 2014 Jan 1;106(1):djt341. doi: 10.1093/jnci/djt341. Epub 2013 Dec 5. PubMed
O'Meara ES, Zhu W, Hubbard RA, Braithwaite D, Kerlikowske K, Dittus KL, Geller B, Wernli KJ, Miglioretti DL. Mammographic screening interval in relation to tumor characteristics and false-positive risk by race/ethnicity and age. Cancer. 2013 Nov 15;119(22):3959–67. [Epub 2013 Aug 26]. PubMed
Dittus K, Geller B, Weaver DL, Kerlikowske K, Zhu W, Hubbard R, Braithwaite D, O'Meara ES, Miglioretti DL. Impact of mammography screening interval on breast cancer diagnosis by menopausal status and BMI. J Gen Intern Med. 2013 Nov;28(11):1454-62. doi:10.1007/s11606-013-2507-0. Epub 2013 Jun 13. PubMed
Carney PA, Geller BM, Bogart A, Sickles EA, Smith RA, Buist DS, Kerlikowske K, Onega TL, Miglioretti DL, Rosenberg R, Yankaskas BC. Feasibility and acceptability of conducting a randomized clinical trial designed to improve interpretation of screening mammography. Acad Radiol. 2013 Nov;20(11):1389-98. doi: 10.1016/j.acra.2013.08.017. PubMed
Schairer C, Li Y, Frawley P, Graubard BI, Wellman RD, Buist DS, Kerlikowske K, Onega TL, Anderson WF, Miglioretti DL. Risk factors for inflammatory breast cancer and other invasive breast cancers. J Natl Cancer Inst. 2013 Sep 18;105(18):1373-84. PubMed
Roman M, Hubbard RA, Sebuodegard S, Miglioretti DL, Castells X, Hofvind S. The cumulative risk of false-positive results in the Norwegian Breast Cancer Screening Program: updated results. Cancer. 2013 Aug 20. doi: 10.1002/cncr.28320 [Epub ahead of print]. PubMed
Rutter CM, Miglioretti DL, Savarino JE. Bayesian calibration of microsimulation models, Journal of the American Statistical Association, 2009; 104(488):1338–1350.
To view more publications, please see Dr. Miglioretti’s CV.