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Li T, Gandomkar Z, Trieu PDY, Lewis SJ, Brennan PC. Differences in lesion interpretation between radiologists in two countries: Lessons from a digital breast tomosynthesis training test set. Asia Pac J Clin Oncol 2021; 18:441-447. [PMID: 34811880 DOI: 10.1111/ajco.13686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In many western countries, there is good evidence documenting the performance of radiologists reading digital breast tomosynthesis (DBT) images. However, the diagnostic efficiency of Chinese radiologists using DBT, particularly type of errors being made and type of cancers being missed, is understudied. This study aims to investigate the pattern of diagnostic errors across different lesion types produced by Chinese radiologists diagnosing from DBT images. Australian radiologists will be used as a benchmark. METHODS Twelve Chinese radiologists read a DBT test set and located each perceived cancer lesion. True positives, false positives (FP), true negatives and false negatives (FN) were generated. The same test set was also read by 14 Australian radiologists. Z-scores and Pearson correlations were used to compare interpretation of lesions and identification of normal appearances between two groups of radiologists. RESULTS Architectural distortions (p < .001) and stellate masses (p = .02) were more difficult for Chinese radiologists to correctly diagnose compared to their Australian counterparts. Chinese readers categorised more FPs as discrete masses (p < .001) and fewer FPs as architectural distortions (p < .001) comparing with Australian radiologists. The percentages of FN for each cancer case were not correlated (r = 0.37, p = .18) but the percentages of FP for each normal case were moderately correlated (r = 0.52, p = .02) between two groups of readers. CONCLUSIONS Architectural distortions and stellate masses were challenging to Chinese radiologists when reading DBT. Our findings proposed the need of development of training and education programs focussing on imaging cases tailored for specific groups of readers with certain interpretation patterns.
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Walker MJ, Hartman K, Majpruz V, Leung YW, Fienberg S, Rabeneck L, Chiarelli AM. The Impact of Radiologist Screening Mammogram Reading Volume on Performance in the Ontario Breast Screening Program. Can Assoc Radiol J 2021; 73:362-370. [PMID: 34423685 DOI: 10.1177/08465371211031186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Although some studies have shown increasing radiologists' mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets. METHODS This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016. Associations between annual screening volume and meeting performance targets for abnormal call rate, positive predictive value (PPV), invasive cancer detection rate (CDR), sensitivity, and specificity were modeled using mixed-effects multivariate logistic regression. RESULTS Most radiologists read 500-999 (36.7%) or 1,000-1,999 (31.0%) screens annually, and 18.5% read ≥2,000. Radiologists who read ≥2,000 annually were more likely to meet abnormal call rate (OR = 3.85; 95% CI: 1.17-12.61), PPV (OR = 5.36; 95% CI: 2.53-11.34), invasive CDR (OR = 4.14; 95% CI: 1.50-11.46), and specificity (OR = 4.07; 95% CI: 1.89-8.79) targets versus those who read 100-499 screens. Radiologists reading 1,000-1,999 screens annually were more likely to meet PPV (OR = 2.32; 95% CI: 1.22-4.40), invasive CDR (OR = 3.36; 95% CI: 1.49-7.59) and specificity (OR = 2.00; 95% CI: 1.04-3.84) targets versus those who read 100-499 screens. No significant differences were observed for sensitivity. CONCLUSIONS Annual reading volume requirements of 1,000 in Canada are supported as screening volume above 1,000 was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum volume to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality.
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Parikh JR, Bender CE. How Radiology Leaders Can Address Burnout. J Am Coll Radiol 2021; 18:679-684. [PMID: 33958083 DOI: 10.1016/j.jacr.2020.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/08/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
The 2018 Annual Workforce Survey conducted by the ACR Commission on Human Resources demonstrated that, although the majority of radiology practice leaders acknowledge radiologist burnout as a significant problem, only about one in five leaders responded that their practices were either extremely or very effective at addressing physician burnout. Moving forward, leaders will be increasingly held accountable and expected to describe to their teams their reasons for not addressing burnout. In this article, common misperceptions that may contribute to radiology practice leaders not addressing burnout are described, followed by outlining practical skills that leaders should develop to effectively address burnout.
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Cozens NJA. A radiologist's perspective of the value of ultrasound-guided fine needle aspiration cytology in the assessment of head and neck lesions. Cytopathology 2021; 32:394-396. [PMID: 34046968 DOI: 10.1111/cyt.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/10/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022]
Abstract
This viewpoint presents a radiologist's perspective of the value that can be added by close collaboration and teamwork with cytopathologist colleagues to maximise specimen quality, adequacy, and patient outcomes. Various models are discussed and service evolution through teamwork emphasised. The importance of utilising ultrasound guidance for fine needle aspiration in head and neck lesions and critical appraisal of the literature are reviewed.
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Liu YQ, Yuan WF, Liu XY, Zhao XX. Floral-like enhancement might reflect an active liver tuberculous lesion to avoid systemic hematogenous dissemination by surgery: A case report. J Int Med Res 2021; 48:300060520940158. [PMID: 32686532 PMCID: PMC7372627 DOI: 10.1177/0300060520940158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
After primary dissemination of Mycobacterium tuberculosis bacillus
infection that is localized in liver, disease progression and changes to immune function
in the body occur. Various forms of tuberculosis, including granuloma, caseous necrosis,
liquefactive necrosis, fibrosis, and calcification, occur that could be presented at
different stages, and imaging examination shows findings that are consistent with these
stages. Not all liver tuberculosis patients are suitable for liver resection, and
preoperative imaging examination and pathological immunohistochemical results could be
used to determine whether tuberculosis was active, avoid unnecessary liver resection, and
prevent the postoperative spread of tuberculosis. Here, we reported a case of miliary
tuberculosis, pelvic tuberculosis, and tuberculous abscess of the thigh muscle in a
51-year-old man after liver lesion resection. The liver lesion was confirmed to be
tuberculosis by surgical pathology, which is rare and has not been previously reported.
The purpose of this case report is to remind radiologists of the importance of the
floral-like enhancement and to estimate whether liver tuberculosis is active. This will
help to guide clinicians to determine the timing of surgery, avoid unnecessary liver
resection, and avoid hematogenous transmission.
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Ghobadi K, Hager G, Krieger A, Levin S, Unberath M. Responding to a Pandemic: COVID-19 Projects in the Malone Center. Surg Innov 2021; 28:208-213. [PMID: 33980097 PMCID: PMC8685579 DOI: 10.1177/15533506211018446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the scope and scale of the COVID-19 pandemic became clear in early March of 2020, the faculty of the Malone Center engaged in several projects aimed at addressing both immediate and long-term implications of COVID-19. In this article, we briefly outline the processes that we engaged in to identify areas of need, the projects that emerged, and the results of those projects. As we write, some of these projects have reached a natural termination point, whereas others continue. We identify some of the factors that led to projects that moved to implementation, as well as factors that led projects to fail to progress or to be abandoned.
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Mohamed Ali AM, El-Alali E, Weltz AS, Rehrig ST. Thoracic Point-of-Care Ultrasound: A SARS-CoV-2 Data Repository for Future Artificial Intelligence and Machine Learning. Surg Innov 2021; 28:214-219. [PMID: 33960853 DOI: 10.1177/15533506211018671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Current experience suggests that artificial intelligence (AI) and machine learning (ML) may be useful in the management of hospitalized patients, including those with COVID-19. In light of the challenges faced with diagnostic and prognostic indicators in SARS-CoV-2 infection, our center has developed an international clinical protocol to collect standardized thoracic point of care ultrasound data in these patients for later AI/ML modeling. We surmise that in the future AI/ML may assist in the management of SARS-CoV-2 patients potentially leading to improved outcomes, and to that end, a corpus of curated ultrasound images and linked patient clinical metadata is an invaluable research resource.
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Snoeckx A, Franck C, Silva M, Prokop M, Schaefer-Prokop C, Revel MP. The radiologist's role in lung cancer screening. Transl Lung Cancer Res 2021; 10:2356-2367. [PMID: 34164283 PMCID: PMC8182709 DOI: 10.21037/tlcr-20-924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lung cancer is still the deadliest cancer in men and women worldwide. This high mortality is related to diagnosis in advanced stages, when curative treatment is no longer an option. Large randomized controlled trials have shown that lung cancer screening (LCS) with low-dose computed tomography (CT) can detect lung cancers at earlier stages and reduce lung cancer-specific mortality. The recent publication of the significant reduction of cancer-related mortality by 26% in the Dutch-Belgian NELSON LCS trial has increased the likelihood that implementation of LCS in Europe will move forward. Radiologists are important stakeholders in numerous aspects of the LCS pathway. Their role goes beyond nodule detection and nodule management. Being part of a multidisciplinary team, radiologists are key players in numerous aspects of implementation of a high quality LCS program. In this non-systematic review we discuss the multifaceted role of radiologists in LCS.
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Parikh JR, Sun J, Mainiero MB. What Causes the Most Stress in Breast Radiology Practice? A Survey of Members of the Society of Breast Imaging. JOURNAL OF BREAST IMAGING 2021; 3:332-342. [PMID: 34056593 PMCID: PMC8139609 DOI: 10.1093/jbi/wbab012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The objective of this study is to determine the major stressors affecting practicing breast radiologists. METHODS All members of the Society of Breast Imaging within the United States received an email invitation to complete an anonymous survey evaluating stressors that may contribute to physician burnout. Stressors evaluated included pace at work, work-life balance, care of dependents, job security, financial strain, decreasing reimbursement, new regulations, delivering bad news, fear of getting sued, and dealing with difficult patients, radiologists, and administrators. RESULTS The overall response rate was 13.5% (312/2308). For those who opened the email, response rate was 24.6% (312/1269). The most prevalent stressors reported were working too fast (222/312, 71.2%), balancing demands of work with personal life (209/312, 70.0%), fear of getting sued (164/312, 52.6%), and dealing with difficult administrators (156/312, 50%). Prevalence of stress related to new regulation requirements, job security, financial strain, decreased reimbursement, dependent care, call, delivering bad news, and dealing with difficult patients, difficult referrers, and difficult radiologists were present in fewer than 50% of respondents. CONCLUSION The most prevalent sources of stress in breast imaging radiologists relate to working too fast and balancing demands of work with time needed for personal life.
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Li J, Bu Y, Lu S, Pang H, Luo C, Liu Y, Qian L. Development of a Deep Learning-Based Model for Diagnosing Breast Nodules With Ultrasound. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:513-520. [PMID: 32770574 DOI: 10.1002/jum.15427] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Artificial intelligence (AI) has been an important addition to medicine. We aimed to explore the use of deep learning (DL) to distinguish benign from malignant lesions with breast ultrasound (BUS). METHODS The DL model was trained with BUS nodule data using a standard protocol (1271 malignant nodules, 1053 benign nodules, and 2144 images of the contralateral normal breast). The model was tested with 692 images of 256 breast nodules. We used the accuracy, precision, recall, harmonic mean of recall and precision, and mean average precision as the indices to assess the DL model. We used 100 BUS images to evaluate differences in diagnostic accuracy among the AI system, experts (>25 years of experience), and physicians with varying levels of experience. A receiver operating characteristic curve was generated to evaluate the accuracy for distinguishing between benign and malignant breast nodules. RESULTS The DL model showed 73.3% sensitivity and 94.9% specificity for the diagnosis of benign versus malignant breast nodules (area under the curve, 0.943). No significant difference in diagnostic ability was found between the AI system and the expert group (P = .951), although the physicians with lower levels of experience showed significant differences from the AI and expert groups (P = .01 and .03, respectively). CONCLUSIONS Deep learning could distinguish between benign and malignant breast nodules with BUS. On BUS images, DL achieved diagnostic accuracy equivalent to that of expert physicians.
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Abstract
PURPOSE There is worsening of burnout symptoms experienced by radiologists and trainees. We explored potential factors that exacerbate burnout symptoms observed in the Canadian radiological community and currently available protective factors as next steps for establishing viable solutions for burnout. METHODS An 11-question electronic survey was distributed to Canadian radiologists and trainees through the Canadian Association of Radiologists (CAR). Approval from a local ethics board and the CAR were obtained. The survey contained demographics-related questions as well as questions based on common risk factors for burnout. Qualitative and quantitative analyses were performed. RESULTS The survey was distributed to 2200 CAR members, and a response rate of 23.3% was achieved. Most radiologists experienced frequent unexpected high workload with no statistically significant difference by the type of practice. Trainees experienced a statistically significantly (P < .0001) higher frequency of on-call shifts compared to staff radiologists. A statistically significant difference (P < .0001) was observed for perceived threats to career longevity dependent on length of career. Although support mechanisms for radiology were perceived as available, survey commentary suggested inefficiency in their usage and lack of prioritization, which was a trend observed across all types of practice. CONCLUSIONS While there is awareness for radiology needs, changes are required at the workplace level to reduce burnout symptoms at their source. Communication between radiologists and hospital administration, as well as among radiology group members, is key to prioritize radiology needs in our imaging-driven era of health care.
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Patel MM, Parikh JR. Patient Diversity in Breast Imaging: Barriers and Potential Solutions. JOURNAL OF BREAST IMAGING 2021; 3:98-105. [PMID: 38424834 DOI: 10.1093/jbi/wbaa092] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Indexed: 03/02/2024]
Abstract
Recent reports have highlighted disparities in breast cancer care related to patient diversity. Breast radiologists represent the face of breast imaging and are key players in advocating for patients to reduce these disparities. Diversity-related barriers for breast imaging patients, as they journey from screening to survivorship, include impediments to access and quality of care, gaps in communication, and lack of knowledge in both providers and patients. Potential strategies for overcoming these specific barriers include "culturally tailored" nurse navigators, mobile mammography, improved communication, patient and provider education, and breast radiologist involvement in advocacy efforts promoting diversity. As current trends in recommendations and guidelines for breast imaging include more numerous and advanced imaging modalities, it is important to acknowledge and address diversity-related disparities.
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Mahajan A, Sharma P. Psychological impact of COVID-19 on radiology: Emotional wellbeing versus psychological burnout. Indian J Radiol Imaging 2021; 31:S11-S14. [PMID: 33814756 PMCID: PMC7996701 DOI: 10.4103/ijri.ijri_579_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/20/2020] [Accepted: 09/12/2020] [Indexed: 02/05/2023] Open
Abstract
While the COVID-19 pandemics seem to be crippling the global health care system, it has caused enormous uncertainty and panic in the lives of the health care professionals with a significant impact on their productivity. A significant proportion of these affected health care individuals comprise of the working staff belonging to the Radiology department. Although the main focus of all health care individuals has constantly been to reduce the number of new cases by minimal transmission, save lives of the infected patients by findings effective cure and carry out meticulous research to develop preventive vaccine, we have been unknowingly giving very little consideration to critical issues relating to the psychological well-being of the front liners. It is of utmost necessity that the psychological impact of this pandemic needs to be recognized and dealt with, in a timely fashion. While planning interventions to fight the pandemic, mental health issues must not be sidelined instead considered pragmatically. The radiology departments must come up with a mitigation plan to combat the subsequent short-term and long-term adverse effects of COVID-19 on mental well-being of their staff members. This article discusses the psychological impact of COVID-19 on the radiology department.
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Kudo S, Inoue K, Fukushi M. [Review of Cohort Studies Among Radiologists, Radiological Technologists, and Nuclear Workers]. IGAKU BUTSURI : NIHON IGAKU BUTSURI GAKKAI KIKANSHI = JAPANESE JOURNAL OF MEDICAL PHYSICS : AN OFFICIAL JOURNAL OF JAPAN SOCIETY OF MEDICAL PHYSICS 2021; 41:180-193. [PMID: 34955501 DOI: 10.11323/jjmp.41.4_180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A number of epidemiological studies have been conducted to investigate the health effects of low-dose radiation. The author reviewed epidemiological studies among radiologists, radiological technologists, and nuclear workers. Because the results of many epidemiological studies on these subjects have been published, and many studies have measured radiation doses, there is little uncertainty. In the studies among radiologists and radiological technologists, high risks for leukemia, skin cancer, and breast cancer were found in populations that began work before around 1950, but not seen such a tendency for those starting work recent years. The results of the studies among nuclear workers were inconsistent with some reporting that a risk was seen, while others reported no risk. The reason for this may be due to the different analysis methods among the studies.
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Mercy NC, Bwanga O. Experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom. Int J Health Sci (Qassim) 2021; 15:9-16. [PMID: 33456437 PMCID: PMC7786445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of the study was to explore the experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom (UK). METHODS The study used a qualitative research design. Data were collected using semi-structured interviews from eight purposively selected consultant breast radiographers across the UK. Interviews were recorded, transcribed, and analyzed by themes. RESULTS Four themes emerged: Reasons for the introduction of breast consultancy role in radiography, education and training, domain of practice, and autonomy and support. This study found that participants were carrying out roles similar to those performed by consultant breast radiologists and that they had been performing such roles even before they were appointed. The study further revealed that the creation of consultancy posts came because of an increase in demand for breast imaging services and the shortage of radiologists. Four domains of practice were clinical expert, professional leadership, research and evaluation, and education and training. Participants worked independently with adequate support from fellow consultants and non-radiology staff. CONCLUSION Consultant breast radiographers are performing most of the consultancy roles stated in their scope of practice, except for research and evaluation, which they are mainly unable to do due to clinical workload. Therefore, there is a need to provide protected time for research and evaluation activities so that consultant breast radiographers can utilize their full potential. The findings have provided baseline information for countries planning to extend the scope of practice of radiographers in breast imaging.
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Koyama T, Yoshiike S, Suganuma K, Shiroto K, Miyauchi N, Shinchu S, Aoki Y. A study of the usefulness of inspection of radiology reports in the emergency room. Acute Med Surg 2020; 7:e606. [PMID: 33318803 PMCID: PMC7726616 DOI: 10.1002/ams2.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/01/2020] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of this study was to better understand the usefulness of retrospective inspection of radiology reports of CT (computed tomography) or MRI (magnetic resonance imaging) by emergency doctors in the emergency room. Methods Between April 2018 and March 2019, patients who went home after CT or MRI who needed to change their treatment plans and subsequent corresponding procedures after inspection of radiology reports by emergency doctors were reviewed. Results Among 7,661 CT or MRIs performed on 5,917 patients, there were 131 patients (133 CT or MRI or 1.7% among 7,661 examinations) who required a change in their treatment plans after inspection of radiology reports. Of the 133 CT or MRI performed, there were 51 (38.3% among 133 CT or MRI, 0.7% among 7,661 examinations) CT or MRI performed, which indicated findings to suspect a tumor (11.8% in the head, 41.2% in the chest, 35.3% in the abdomen, and 11.8% in others). With the need to make important changes in treatment plans, making appointments for outpatient clinics was necessary for 52 CT or MRI findings, and requiring the patients to return to the clinic or be admitted was necessary for 9 (totally 61; 0.8% among 7,661 examinations). Conclusion Data from this study suggest that inspection of radiology reports of CT or MRI by emergency doctors after patients went home is useful in finding characteristics suggestive of tumors in 0.7% of all radiology reports and is necessary to identify important changes that should be made in treatment plans in 0.8% of all radiology reports.
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Necas M, Shen Y, Ong QH, Prout K, Wackrow W. Do radiologists need to review abdominal ultrasound examinations reported as 'normal' by the sonographer? Australas J Ultrasound Med 2020; 23:167-175. [PMID: 34760596 PMCID: PMC8411718 DOI: 10.1002/ajum.12202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. METHODS This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. RESULTS The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients' age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1-21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. CONCLUSION Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.
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Martin CT, Polly DW, Takahashi T. Surgeon Preference for Radiologist Interpretation of Deformity Radiographs-A Survey of Lumbar Spine Research Society Membership. Int J Spine Surg 2020; 14:527-533. [PMID: 32986573 DOI: 10.14444/7069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The radiologist interpretation of scoliosis films is non-standardized, with some practitioners providing detailed measurements of the deformity whereas others defer the interpretation of the deformity to the ordering surgeon. For radiologists, the standard of care is not clear, and this creates confusion in terms of how much interpretation is required. However, detailed radiologist reports sometimes conflict with the surgeon's interpretation, which can create confusion for patients who receive the reports, or in extreme cases can lead to insurance denials. Thus, the purpose of this study was to help establish a standard for interpretation of these films by surveying the ordering surgeons and documenting expert opinion about the amount and type of radiologist interpretation that is requested. METHODS We designed a SurveyMonkey survey which aimed to look at standard practice for radiologist dictation of scoliosis radiographs. Twelve questions were sent to Lumbar Spine Research Society membership via email with a description of the study. One follow-up email was also sent to non-responders. RESULTS The rate of completed surveys was 46 out of 185 Lumbar Spine Research Society members (25%). Thirty-seven respondents (80%) worked in academic institutions, 33 were orthopedists (71%), and 13 were neurosurgeons (28%). Fifty percent reported that radiologists' level of detail in dictations was inconsistent at their institution. Detailed numeric reporting was rare (6.5%). When the radiologist did provide numeric measurements, surgeons reported that they often differed from the surgeon's own measurements, with only 4% reporting that the measurements "rarely" differed from the surgeon's; 49% reported that the radiologist's measurements that differed from the surgeon's had led to insurance denials for their patients. The majority of respondents (70%) did not want the radiologist to provide detailed numeric measurements of the deformity, and 91% reported that the radiologist's measurements had no impact on their clinical decision making. CONCLUSIONS Detailed deformity measurements are time consuming for the radiologist, and would seem to have low clinical utility for the responding surgeons in this survey, with significant potential for discrepancies in interpretation to lead to insurance denials. LEVEL OF EVIDENCE IV.
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Zigman Suchsland M, Cruz MJ, Hardy V, Jarvik J, McMillan G, Brittain A, Thompson M. Qualitative study to explore radiologist and radiologic technologist perceptions of outcomes patients experience during imaging in the USA. BMJ Open 2020; 10:e033961. [PMID: 32690729 PMCID: PMC7375501 DOI: 10.1136/bmjopen-2019-033961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE We aimed to explore the patient-centred outcomes (PCOs) radiologists and radiologic technologists perceive to be important to patients undergoing imaging procedures. DESIGN We conducted a qualitative study of individual semi-structured interviews. PARTICIPANTS We recruited multiple types of radiologists including general, musculoskeletal neuroradiology, body and breast imagers as well as X-ray, ultrasound, CT or MRI radiologic technologists from Washington and Idaho. OUTCOME Thematic analysis was conducted to identify themes and subthemes related to PCOs of imaging procedures. RESULTS Ten radiologists and six radiology technologists participated. Four main domains of PCOs were identified: emotions, physical factors, knowledge and patient burden. In addition to these outcomes, we also identified patient and provider factors that can potentially moderate these outcomes. CONCLUSIONS Radiologists and technologists perceived outcomes related to the effect of imaging procedures on patients' emotions, physical well-being, knowledge and burden from financial and opportunity costs to be important to patients undergoing imaging procedures. There are opportunities for the radiology community to measure and use these PCOs in comparisons of imaging procedures and potentially identify areas where these outcomes can be leveraged to drive a more patient-centred approach to radiology.
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Almohiy HM, Hussein K, Alqahtani M, Elshiekh E, Loaz O, Alasmari A, Saad M, Adam M, Mukhtar E, Alelyani M, Alshahrani M, Abuhadi N, Alshumrani G, Almazzah A, Alsleem H, Almohiy N, Alrwaili A, Alam MM, Asiri A, Khalil M, Rawashdeh M, Saade C. Radiologists' Knowledge and Attitudes towards CT Radiation Dose and Exposure in Saudi Arabia-A Survey Study. Med Sci (Basel) 2020; 8:E27. [PMID: 32698332 PMCID: PMC7563332 DOI: 10.3390/medsci8030027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/20/2023] Open
Abstract
Computed tomography (CT) is a key imaging technique in diagnostic radiology, providing highly sensitive and specific information. While its use has increased dramatically in recent years, the quantity and associated risks of radiation from CT scans present major challenges, particularly in paediatrics. The fundamental principles of radiation protection require that radiation quantities be as low as reasonably achievable and CT use must be justified, particularly for paediatric patients. CT radiation knowledge is a key factor in optimising and minimising radiation risk. The objective of this study was to analyse knowledge level, expertise, and competency regarding CT radiation dose and its hazards in paediatrics among radiologists in Saudi Arabian hospitals. A self-reported, multiple-choice questionnaire assessed the attitudes and opinions of radiologists involved in imaging studies using ionising radiation. Among the total respondents, 65% ± 13.5% had a good comprehension of the dangers of carcinogenicity to the patient resulting from CT scans, with 80% presuming that cancer risks were elevated. However, only 48.5%, 56.5%, and 65% of the respondents were aware of specific radiation risks in head, chest, and abdominal paediatric examinations, respectively. Regular, frequent, and specific training courses are suggested to improve the fundamental knowledge of CT radiation among radiologists and other physicians.
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Chetty S, Venter D, Speelman A. Determining the Need for After-Hours Diagnostic Radiological Reporting in Emergency Departments at Public Hospitals in South Africa: Perceptions of Emergency Physicians in KwaZulu-Natal. J Med Imaging Radiat Sci 2020; 51:470-479. [PMID: 32654979 DOI: 10.1016/j.jmir.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Emergency departments in South African public hospitals have a high patient load after hours, with inadequate numbers of health care professionals available to satisfy patient influx. In addition, there is often no provision of after-hours diagnostic reporting services in public hospitals, to an extent that the emergency physician is responsible for interpreting all radiographic images requested themseves. Emergency physicians, in this study, can be described as any medical doctor registered with the Health Professions Council of South Africa and working in the emergency department as a registrar or consultant physician because there were no physicians specialized in emergency medicine working at the hospitals selected for this study. AIM The aim of this study was to determine the views of emergency physicians on whether there is a need for an after-hours diagnostic radiological reporting service in selected public hospitals in KwaZulu-Natal Province, South Africa. METHODS A descriptive cross-sectional quantitative research design was utilized, through means of a survey, to assess the emergency physicians' perceptions regarding the need for after-hours diagnostic radiological reporting. In addition, the study used a descriptive quantitative research design to record the number of conventional diagnostic radiographic examinations performed at the selected hospitals, after hours, and the proportional number of these radiographic examinations that were reported on by radiologists during office hours, the following day. The distribution of questionnaires and data collection, with regard to the number of examinations reported on, and those not reported on, were carried out simultaneously during the execution of this study. The study was conducted over a three-month period in 2017, at four public hospitals in KwaZulu-Natal-one of the nine provinces of South Africa. RESULTS This study found that, during the study period, between 0.1% and 0.6% of the conventional diagnostic radiographic examinations performed, after hours, were reported on by radiologists during office hours, the following day. The surveyed emergency physicians felt that the interpretation of diagnostic images took up valuable time that could be spent on patient management, and there was near-total agreement, whereby 92% (n = 36) of the physicians would have preferred after-hours reporting to be performed by a radiologist. Physicians agreed that having a radiologist or reporting radiographer to provide radiological reports would allow for more effective and efficient patient management. CONCLUSION The results of this study indicated that there is a need for after-hours radiographic reporting at the selected public hospitals and for the further training of emergency physicians in radiographic image interpretation. Based on the findings of this study, it is recommended that after-hours radiological reporting services be considered for public hospitals and that courses be offered to emergency physicians on the interpretation of diagnostic radiographic images. A hospital policy review may therefore be needed to adjust the focus of hospitals toward reducing the workload of emergency physicians, wherever possible, such as by incorporating support services like radiographic reporting and by providing further training on the interpretation of diagnostic radiographic images, which will both act to reduce the potential risk of misdiagnosis.
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Rosen MP, Norbash A, Kruskal J, Meltzer CC, Yee J, Thrall J. Impact of Coronavirus Disease 2019 (COVID-19) on the Practice of Clinical Radiology. J Am Coll Radiol 2020; 17:1096-1100. [PMID: 32721410 PMCID: PMC7346805 DOI: 10.1016/j.jacr.2020.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022]
Abstract
The speed at which coronavirus disease 2019 (COVID-19) spread quickly fractured the radiology practice model in ways that were never considered. In March 2020, most practices saw an unprecedented drop in their volume of greater than 50%. The profound changes that have interrupted the arc of the radiology narrative may substantially dictate how health care and radiology services are delivered in the future. We examine the impact of COVID-19 on the future of radiology practice across the following domains: employment, compensation, and practice structure; location and hours of work; workplace environment and safety; activities beyond the "usual scope" of radiology practice; and CME, national meetings, and professional organizations. Our purpose is to share ideas that can help inform adaptive planning.
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Gerlach KE, Phalak K, Parikh JR. Enhancing Quality Using the Inspection Program (EQUIP): A Primer for Radiologists. JOURNAL OF BREAST IMAGING 2020; 2:264-268. [PMID: 38424984 DOI: 10.1093/jbi/wbaa018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Indexed: 03/02/2024]
Abstract
The new Enhancing Quality Using the Inspection Program (EQUIP) law places more responsibility for quality assurance on the interpreting radiologists and the lead interpreting physician (LIP). Compliance with the law will require addressing three specific questions related to quality assurance and clinical image corrective action, continued compliance, and ensuring LIP oversight. This process enables the radiologist to exemplify added value through physician leadership, team integration, and improved patient care.
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Omofoye TS, Parikh JR. Role of Breast Imaging Radiologists as Advocates for Screening Mammography. JOURNAL OF BREAST IMAGING 2020; 2:259-263. [PMID: 38424976 DOI: 10.1093/jbi/wbaa017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Indexed: 03/02/2024]
Abstract
The objective of this article is to outline opportunities for breast imaging radiologists to advocate for screening mammography. Despite breast cancer being the second most common cancer in women and screening mammography's ability to reduce mortality from this disease, there remains suboptimal utilization in the community. The different guidelines for screening presented by respected organizations has created confusion for patients and referring clinicians and the eventual underutilization of screening mammography. As experts in the value of early detection, breast radiologists are well suited to take on the role of screening advocates. Using specific action steps and examples, we create a template for a radiologist to utilize in the promotion of screening among the breast imaging team, clinicians, administrators, and the community at large. By deliberately filling the role of screening mammography advocate, one can satisfy the mandate for radiologists to bring increased value to the health care team while contributing to community health and patient satisfaction.
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Fatahi N, Kustrimovic M, Elden H. Non-Medical Radiography Staff Experiences in Inter-Professional Communication: A Swedish Qualitative Focus Group Interview Study. J Multidiscip Healthc 2020; 13:393-401. [PMID: 32431507 PMCID: PMC7201006 DOI: 10.2147/jmdh.s231442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/21/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the experiences of non-medical discipline staff of difficulties and possibilities in inter-professional communication within the radiology department and remitting departments. Materials and Methods Three focus group interviews were conducted with 16 non-medical discipline staff in a radiology department at a university hospital in Sweden. Data were analysed using qualitative content analysis. Results The experiences of inter-professional communication by non-medical discipline staff within the radiology department and with remitting departments can be described in three categories, and six sub categories. The informants experienced difficulties in both oral and written inter-professional communication. Inadequate structures, incorrect information and unclear language in the referral forms, lack of feedback from clinicians and radiologists, and reduced face-to-face communication were described as factors that negatively influenced communication. Other difficulties were time shortage, inadequate routines and economy issues. The possibilities described were use of face-to-face communication, interpreters, and clear and well-structured referral forms. Conclusion Non-medical staff experience that quality in inter-professional communication has a significant impact on health outcomes and patient safety. They expressed a number of difficulties in both written and oral inter-professional communication. For example inadequate written and oral communication, as well as practical issues such as routine could negatively influence the quality of the outcome of inter-professional communication. Lack of feedback from clinicians and radiologists and reduced face-to-face communication were also mentioned as factors that influence oral communication. Possibilities described to improve inter-professional communication quality and thus patient safety were professional contact on both professional and personal levels, use of interpreters, and clear and well-structured referral forms. The results of this study add to our knowledge of the difficulties and possibilities in non-medical inter-professional communication, which may enhance both safety and health outcomes for patients if implemented. Future studies in interprofessional communication is needed. ![]()
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