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Parwani P, Chen T, Allen B, Kallianos K, Ng MY, Kozor R, Aremu OO, Farooqi KM, Secinaro A, Ricci F, Moharem-Elgamal S, Liberato G, Narang A, Ojha V, Ducci CB, Plein S, Ordovas KG. Challenges and opportunities for early career medical professionals in cardiovascular magnetic resonance (CMR) imaging: a white paper from the Society for Cardiovascular Magnetic Resonance. J Cardiovasc Magn Reson 2023; 25:65. [PMID: 37968709 PMCID: PMC10652595 DOI: 10.1186/s12968-023-00968-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 09/15/2023] [Indexed: 11/17/2023] Open
Abstract
The early career professionals in the field of Cardiovascular Magnetic Resonance (CMR) face unique challenges and hurdles while establishing their careers in the field. The Society for Cardiovascular Magnetic Resonance (SCMR) has expanded the role of the early career section within the society to foster the careers of future CMR leaders. This paper aims to describe the obstacles and available opportunities for the early career CMR professionals worldwide. Societal opportunities and actions targeted at the professional advancement of the early career CMR imagers are needed to ensure continuous growth of CMR as an imaging modality globally.
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Affiliation(s)
- Purvi Parwani
- Division of Cardiology, Department of Medicine, Loma Linda University Health, Loma Linda, CA, USA.
| | - Tiffany Chen
- Department of Clinical Medicine, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Bradley Allen
- Department of Radiology, Northwestern University, Chicago, IL, USA
| | - Kimberly Kallianos
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Ming-Yen Ng
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong Special Administrative Region, China
- Department of Medical Imaging, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Rebecca Kozor
- Cardiology Department, Royal North Shore Hospital and Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Olukayode O Aremu
- Division of Cardiology, Department of Medicine, University of Cape Town, Cape Town, South Africa
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Kanwal M Farooqi
- Department of Pediatrics, Division of Cardiology, Columbia University Medical Center, New York, NY, USA
| | - Aurelio Secinaro
- Advanced Cardiovascular Imaging Unit, Department of Imaging, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabrizio Ricci
- Institute of Advanced Biomedical Technologies, Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
- Clinical Research Center, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Sarah Moharem-Elgamal
- Cardiology Department, Liverpool Heart and Chest Hospital, Liverpool, UK
- Cardiology Department, National Heart Institute, Giza, Egypt
| | - Gabriela Liberato
- Diagnostic Imaging Department, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
- Department of Radiology, Sirio Libanês Hospital, São Paulo, Brazil
| | - Akhil Narang
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Vineeta Ojha
- Department of Radiology, Mahajan Imaging, Pushpawati Singhania Research Institute (PSRI), New Delhi, India
| | | | - Sven Plein
- Department of Biomedical Imaging Science, University of Leeds and Kings College London, London, UK
| | - Karen G Ordovas
- Department of Radiology, University of Washington, Seattle, WA, USA
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Vasan V, Hardigan TA, Ali M, Downes M, Devarajan A, Rossitto CP, Schuldt BR, Odland IC, Kellner CP, Fifi JT, Mocco J, Majidi S. Dysphagia after ischemic and hemorrhagic stroke: A propensity-matched 20-year analysis of the national inpatient sample. J Stroke Cerebrovasc Dis 2023; 32:107295. [PMID: 37544059 DOI: 10.1016/j.jstrokecerebrovasdis.2023.107295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 07/23/2023] [Accepted: 08/02/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE Dysphagia is a common symptom of acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH), but little is known surrounding national trends of this post-stroke condition. Hence, this study aimed to identify the risk factors for dysphagia following AIS and ICH and evaluate in-hospital outcomes in these patients. METHODS The 2000-2019 Nationwide Inpatient Sample was queried for patients admitted with AIS (ICD9 433, 43401, 43411, 43491, ICD-10 I63) and ICH (ICD9 431, 432.9, ICD-10 I61, I62.9). Univariate analysis with t-tests or chi-square performed as appropriate. A 1:1 nearest neighbor propensity score matched cohort was generated. Variables with standardized mean differences >0.1 were used in multivariable regression to generate adjusted odds ratios (AOR)/β-coefficients for the presence of dysphagia on outcomes. RESULTS Of 10,415,286 patients with AIS, 956,662 (9.2%) had in-hospital dysphagia. Total of 2,000,868 patients with ICH were identified; 203,511 (10.2%) had in-hospital dysphagia. Patients with dysphagia after AIS were less likely to experience in-hospital mortality (OR 0.61;95%CI: 0.60-0.63) or be discharged home (AOR 0.51;95%CI: 0.51-0.52), had increased length of stay (Beta-coefficient = 0.43 days; 95%CI: 0.36-0.50), and had increased hospital charges ($14411.96;95%CI: 13565.68-15257.44) (all p < 0.001). Patients with dysphagia after ICH were less likely to experience in-hospital mortality (AOR 0.39;95%CI: 0.37-0.4), less likely to be discharged home (AOR 0.59,95%CI:0.57-0.61), have longer hospital stay (Beta-coefficient = 1.99 days;95%CI: 1.78-2.21), and increased hospital charges ($28251.93; 95%CI: $25594.57-30909.28)(all p < 0.001). CONCLUSION This is the first study to report on national trends in patients with dysphagia after AIS and ICH. These patients had longer hospital LOS, worse functional outcomes at discharge, and higher hospital costs.
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Affiliation(s)
- Vikram Vasan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA.
| | - Trevor A Hardigan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Muhammad Ali
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Margaret Downes
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Alex Devarajan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Christina P Rossitto
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Braxton R Schuldt
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Ian C Odland
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Christopher P Kellner
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Johanna T Fifi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - J Mocco
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
| | - Shahram Majidi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY 10128, USA
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Hammer M, Mian M, Elhadad L, Li M, Roifman I. Appropriate utilization of cardiac computed tomography for the assessment of stable coronary artery disease. BMC Cardiovasc Disord 2021; 21:154. [PMID: 33771107 PMCID: PMC7995786 DOI: 10.1186/s12872-021-01957-z] [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] [Received: 07/08/2020] [Accepted: 03/15/2021] [Indexed: 11/23/2022] Open
Abstract
Background Appropriate use criteria (AUC) have been developed in response to growth in cardiac imaging utilization and concern regarding associated costs. Cardiac computed tomography angiography (CCTA) has emerged as an important modality in the evaluation of coronary artery disease, however its appropriate utilization in actual practice is uncertain. Our objective was to determine the appropriate utilization of CCTA in a large quaternary care institution and to compare appropriate utilization pre and post publication of the 2013 AUC guidelines. We hypothesized that the proportion of appropriate CCTA utilization will be similar to those of other comparable cardiac imaging modalities and that there would be a significant increase in appropriate use post AUC publication. Methods We employed a retrospective cohort study design of 2577 consecutive patients undergoing CCTA between January 1, 2012 and December 30, 2016. An appropriateness category was assigned for each CCTA. Appropriateness classifications were compared pre- and post- AUC publication via the chi-square test. Results Overall, 83.5% of CCTAs were deemed to be appropriate based on the AUC. Before the AUC publication, 75.0% of CCTAs were classified as appropriate whereas after the AUC publication, 88.0% were classified as appropriate (p < 0.001). The increase in appropriate utilization, when extrapolated to the Medicare population of the United States, was associated with potential cost savings of approximately $57 million per year. Conclusions We report a high rate of appropriate use of CCTA and a significant increase in the proportion of CCTAs classified as appropriate after the AUC publication.
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Affiliation(s)
- Michael Hammer
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Muhtashim Mian
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Levi Elhadad
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Mary Li
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada
| | - Idan Roifman
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada. .,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada. .,Medicine and Medical Imaging, Adjunct Scientist, Institute for Clinical Evaluative Sciences, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Room M315, Toronto, ON, M4N-3M5, Canada.
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