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Seely JM, Payant L, Zhang C, Aslanova R, Chothia S, MacIntyre A, Trop I, Yang Q, Garber G, Patlas M. Medico-Legal Cases in Breast Imaging in Canada: A Trend Analysis. Can Assoc Radiol J 2024; 75:369-376. [PMID: 37542396 DOI: 10.1177/08465371231193366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023] Open
Abstract
Purpose: Breast imaging accounts for a large proportion of medico-legal cases involving radiologists in several countries and may be a disincentive to breast imaging. As this has not been well studied in Canada, we evaluated the key medico-legal issues of breast imaging in Canada and their implications for health care providers and patient safety. Methods: In collaboration with Canadian Medical Protective Association (CMPA), we obtained information from the medico-legal repository, including civil-legal, medical regulatory authority (College) and hospital complaints occurring between 2002-2021. Canadian Classification of Health Interventions (CCI) codes were used for breast imaging and biopsy. Trend analysis was done comparing cases involving breast imaging/biopsy to all cases where a radiologist was named. Results: Radiologists were named in 3108 medico-legal cases, 188 (6%, 188/3108) of which were CCI coded for breast imaging or biopsy. Factors related to radiologists were most frequent (64%, 120/188), followed by team (23.4%, 44/188) and system (6.9%, 13/188). Equal representation of male and female radiologists was found (IRR = 1.22; 95% CI: .89, 1.56). In a 10-year test window from 2006 - 2015 we identified an increasing trend for all cases involving radiologists (P = 0,0128) but a decreasing trend for cases coded with breast imaging or biopsy (P = 0,0099). Conclusions: A significant decrease in cases involving breast imaging were found from 2006-2015, accounting for 6% of the medico-legal cases. The lower risk of breast imaging medico-legal issues may encourage more radiologists in breast imaging.
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Affiliation(s)
- Jean M Seely
- Division of Breast Imaging, Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Laura Payant
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Cathy Zhang
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Rana Aslanova
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Sharon Chothia
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Anna MacIntyre
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Isabelle Trop
- Department of Radiology, Radio-Oncology and Nuclear Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada
| | - Qian Yang
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
| | - Gary Garber
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael Patlas
- Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
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Kadom N, Lasiecka ZM, Nemeth AJ, Rykken JB, Lui YW, Seidenwurm D. Patient Engagement in Neuroradiology: A Narrative Review and Case Studies. AJNR Am J Neuroradiol 2024; 45:250-255. [PMID: 38216301 DOI: 10.3174/ajnr.a8077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/20/2023] [Indexed: 01/14/2024]
Abstract
The field of patient engagement in radiology is evolving and offers ample opportunities for neuroradiologists to become involved. The patient journey can serve as a model that inspires patient engagement initiatives. The patient journey in radiology may be viewed in 5 stages: 1) awareness that an imaging test is needed, 2) considering having a specific imaging test, 3) access to imaging, 4) imaging service delivery, and 5) ongoing care. Here, we describe patient engagement opportunities based on literature review and paired with case studies by practicing neuroradiologists.
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Affiliation(s)
- Nadja Kadom
- From the Emory University School of Medicine (N.K.), Children's Healthcare of Atlanta, Atlanta, Georgia
| | | | - Alexander J Nemeth
- Northwestern University, Feinberg School of Medicine, Northwestern Memorial Hospital (A.J.N.), Chicago, Illinois
| | | | - Yvonne W Lui
- New York University, Grossman School of Medicine (Y.W.L.), New York, New York
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3
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Thomassin-Naggara I, Rousset P, Touboul C, Razakamanantsoa L, Manganaro L. Reasons why it is time to change imaging guidelines on endometriosis. Eur Radiol 2024:10.1007/s00330-024-10595-w. [PMID: 38342800 DOI: 10.1007/s00330-024-10595-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/21/2023] [Accepted: 12/29/2023] [Indexed: 02/13/2024]
Abstract
In light of the rising number of patients referred for magnetic resonance imaging (MRI) due to suspected endometriosis and the high expectations of these patients, there is a need for new imaging guidelines to optimally protocol and indicate MRI and transvaginal ultrasonography (TVUS) examinations. This is crucial for accurately addressing the inquiries of gynecologists, encompassing complete mapping and preoperative staging, and facilitating effective communication with patients. In this context, the development of a standardized lexicon, as well as dedicated imaging classifications, is recommended to aid in the comprehensive management of patients. CLINICAL RELEVANCE STATEMENT: The radiologist should use a standardized lexicon and provide a score along with details about the specific compartments affected by endometriosis disease. This helps in offering clearer guidance to the surgeon. KEY POINTS: • An optimal staging is based on the combination of clinical examination, transvaginal US, and MRI. • MRI is able to detect location that is hidden at the beginning of a laparoscopic surgery and thus the need for dedicated MR classifications to correctly stage the disease. • Deep pelvic endometriosis index (dPEI) classification is externally validated and highly correlated with operating time, hospital stay, and postoperative complications.
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Affiliation(s)
- Isabelle Thomassin-Naggara
- Department of Radiology Imaging and Interventional Radiology (IRIS), Service IRIS, Tenon Hospital, APHP, Sorbonne University, 4 rue de la Chine, 75020, Paris, France.
- Saint-Antoine Research Cancer Center, Sorbonne University, INSERM UMR S 938, 75012, Paris, France.
| | | | - Cyril Touboul
- Saint-Antoine Research Cancer Center, Sorbonne University, INSERM UMR S 938, 75012, Paris, France
- APHP, Sorbonne University, Department of Gynaecological Surgery, Obstetrics and Reproductive Medicine, Tenon Hospital, Paris, France
| | - Leo Razakamanantsoa
- Department of Radiology Imaging and Interventional Radiology (IRIS), Service IRIS, Tenon Hospital, APHP, Sorbonne University, 4 rue de la Chine, 75020, Paris, France
- Saint-Antoine Research Cancer Center, Sorbonne University, INSERM UMR S 938, 75012, Paris, France
| | - Lucia Manganaro
- Department of Radiological, Oncological and Pathological Sciences, Policlinico Umberto I Hospital, University Spienza, Rome, Italia
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4
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Becker M. How to prepare for a bright future of radiology in Europe. Insights Imaging 2023; 14:168. [PMID: 37816908 PMCID: PMC10564684 DOI: 10.1186/s13244-023-01525-3] [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: 08/16/2023] [Accepted: 09/16/2023] [Indexed: 10/12/2023] Open
Abstract
Because artificial intelligence (AI)-powered algorithms allow automated image analysis in a growing number of diagnostic scenarios, some healthcare stakeholders have raised doubts about the future of the entire radiologic profession. Their view disregards not only the role of radiologists in the diagnostic service chain beyond reporting, but also the many multidisciplinary and patient-related consulting tasks for which radiologists are solicited. The time commitment for these non-reporting tasks is considerable but difficult to quantify and often impossible to fulfil considering the current mismatch between workload and workforce in many countries. Nonetheless, multidisciplinary, and patient-centred consulting activities could move up on radiologists' agendas as soon as AI-based tools can save time in daily routine. Although there are many reasons why AI will assist and not replace radiologists as imaging experts in the future, it is important to position the next generation of European radiologists in view of this expected trend. To ensure radiologists' personal professional recognition and fulfilment in multidisciplinary environments, the focus of training should go beyond diagnostic reporting, concentrating on clinical backgrounds, specific communication skills with referrers and patients, and integration of imaging findings with those of other disciplines. Close collaboration between the European Society of Radiology (ESR) and European national radiologic societies can help to achieve these goals. Although each adequate treatment begins with a correct diagnosis, many health politicians see radiologic procedures mainly as a cost factor. Radiologic research should, therefore, increasingly investigate the imaging impact on treatment and outcome rather than focusing mainly on technical improvements and diagnostic accuracy alone.Critical relevance statement Strategies are presented to prepare for a successful future of the radiologic profession in Europe, if AI-powered tools can alleviate the current reporting overload: engaging in multidisciplinary activities (clinical and integrative diagnostics), enhancing the value and recognition of radiologists' role through clinical expertise, focusing radiological research on the impact on diagnosis and outcome, and promoting patient-centred radiology by enhancing communication skills.Key points • AI-powered tools will not replace radiologists but hold promise to reduce the current reporting burden, enabling them to reinvest liberated time in multidisciplinary clinical and patient-related tasks.• The skills and resources for these tasks should be considered when recruiting and teaching the next generation of radiologists, when organising departments and planning staffing.• Communication skills will play an increasing role in both multidisciplinary activities and patient-centred radiology.• The value and importance of a correct and integrative diagnosis and the cost of an incorrect imaging diagnosis should be emphasised when discussing with non-medical stakeholders in healthcare.• The radiologic community in Europe should start now to prepare for a bright future of the profession for the benefit of patients and medical colleagues alike.
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Affiliation(s)
- Minerva Becker
- Unit of Head and Neck and Maxilofacial Radiology, Division of Radiology, Diagnostic Department, Geneva University Hospitals, University of Geneva, Rue Gabrielle Perret Gentil 4, Geneva 14, CH 1211, Switzerland.
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5
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Baalmann M, Müller L, Afat S, Molwitz I, Palm V, Rischen R. [Patient-centered vs. employee-centered radiology : Does this pose a conflict?]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:650-656. [PMID: 37566129 DOI: 10.1007/s00117-023-01195-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Patient-centered radiology and employee-centered radiology are being increasingly discussed as an extension of the established structure- and process-oriented management perspective. Concerning potential conflicts, it is unclear if and how these approaches should best be implemented in a radiology department. OBJECTIVE The aim of this narrative review is to identify and critically correlate underlying characteristics of patient-centered and employee-centered approaches including their similarities, conflicts, and synergies as applicable to the radiological work environment. MATERIALS AND METHODS Based on a literature search using PubMed, Scopus, Web of Science, and Google Scholar, the current body of knowledge regarding patient- and employee-centered radiology is presented. RESULTS Patient- and employee-centered radiology focus on the individual needs of patients and employees, respectively, and promise to improve patient satisfaction, healthcare outcomes, and organizational performance. Conflicts result from an increased organizational complexity and the concurrent utilization of limited resources, such as time, money, and staff. Overall, however, synergies outweigh the potential conflicts. CONCLUSIONS Successful implementation of patient- and employee-centered approaches in radiology requires a human-centered leadership approach and an overarching strategy with the execution of specific interventions in the processes. We provide specific recommendations to this effect.
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Affiliation(s)
- Markus Baalmann
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland.
| | - Lukas Müller
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Deutschland
| | - Saif Afat
- Abteilung für diagnostische und Interventionelle Radiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - Isabel Molwitz
- Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie und Nuklearmedizin, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland
| | - Viktoria Palm
- Klinik für diagnostische und Interventionelle Radiologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Robert Rischen
- Klinik für Radiologie, Universitätsklinikum Münster, Münster, Deutschland
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6
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Palm V, Molwitz I, Rischen R, Westphalen K, Kauczor HU, Schreyer AG. [Sustainability and climate protection : Implications on patient-centered care in radiology]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:672-678. [PMID: 37561161 DOI: 10.1007/s00117-023-01199-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/01/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Sustainability and patient-centered radiology (PCR) include a multivariant, complex network of synergic and opportunistic elements. PCR is a subfactor of the social element, climate protection is part of the ecological element, and sustainable economics are part of the financial element. OBJECTIVES We aimed to identify PCR-symbiotic and PCR-opposed elements of sustainability using literature research. This article will provide an overview of the core sustainability elements and innovative concepts for supporting PCR. MATERIALS AND METHODS A digital literature search was carried out to identify scientific publications about sustainability and PCR via Medline. Results are provided as a narrative summary. RESULTS In particular, the social component and parts of the ecological element of sustainability support PCR. Climate protection and a natural environment show a positive correlation with health and patient satisfaction. Patient contact improves the quality of the diagnostic report and promotes satisfaction of patients and radiologists. However, increasing economization is often conditionally compatible with the social core element of sustainability and especially with PCR. Digital tools can ease communication and improve reports in times of increasing workload. CONCLUSION Socially and environmentally sustainable radiology supports the well-being of both employees and patients. Innovative concepts are necessary to balance the ecological elements of sustainability with employees' and patients' interests.
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Affiliation(s)
- Viktoria Palm
- Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland.
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Deutschland.
- Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg, Heidelberg, Deutschland.
| | - Isabel Molwitz
- Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Deutschland
| | - Robert Rischen
- Clinic for Radiology, Muenster University Hospital, Münster, Deutschland
| | - Kerstin Westphalen
- Department of Diagnostic and Interventional Radiology, DRK Kliniken Berlin Köpenick, Berlin, Deutschland
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology (DIR), Heidelberg University Hospital, Im Neuenheimer Feld 420, 69120, Heidelberg, Deutschland
- Translational Lung Research Center (TLRC), German Center for Lung Research (DZL), University of Heidelberg, Heidelberg, Deutschland
- Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik Heidelberg, Heidelberg, Deutschland
| | - Andreas G Schreyer
- Institute of Diagnostic and Interventional Radiology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Brandenburg a. d. Havel, Deutschland
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7
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KI – Radiologe 3.0? Gespräch mit dem Patienten erhöht die diagnostische Güte. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/a-1754-6220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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8
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Transgender health and medicine – Are radiological devices prepared? Eur J Radiol 2022; 151:110320. [DOI: 10.1016/j.ejrad.2022.110320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 04/03/2022] [Accepted: 04/11/2022] [Indexed: 11/22/2022]
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9
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Kwee TC, Yakar D, Pennings JP, Kasalak Ö. Value-based radiology cannot thrive without reforms and research. Eur Radiol 2022; 32:4337-4339. [PMID: 35149909 DOI: 10.1007/s00330-022-08583-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 12/29/2021] [Accepted: 01/12/2022] [Indexed: 12/22/2022]
Abstract
KEY POINTS • A value-based system aims to achieve improved patient-relevant outcomes without increasing costs.• Value-based radiology cannot thrive as long as volume dominates as the most important metric to reward clinical performance.• Reforms and research are needed to enable radiologists to practice value-based healthcare.
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Affiliation(s)
- Thomas C Kwee
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.
| | - Derya Yakar
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Jan P Pennings
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Ömer Kasalak
- Medical Imaging Center, Departments of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands
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10
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Value-based radiology: what is the ESR doing, and what should we do in the future? Insights Imaging 2021; 12:108. [PMID: 34318401 PMCID: PMC8316510 DOI: 10.1186/s13244-021-01056-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 07/07/2021] [Indexed: 01/11/2023] Open
Abstract
Value-based radiology (VBR) is rapidly gaining ground as a means of considering the input of radiology practice into individual and societal healthcare, and represents a welcome move away from older metrics focused on counting studies performed, without consideration of whether these studies contributed positively to patient management or to society as a whole. Intrinsic to the process of considering whether radiology activity confers value is recognising the breadth of involvement of radiology in healthcare delivery; previous ESR and multi-society publications have explored this, and have sought to highlight the many ways in which our specialty contributes to patient welfare. This paper is intended to highlight some current ESR activities which already contribute substantially to value creation and delivery, and to outline a selection of practical steps which could be taken by the ESR in the future to enhance value. Patient summary Value-based radiology (VBR) is a conceptual means of looking at the benefits conferred on patients and on society as a whole by provision of radiology services, as opposed to older means of counting numbers of radiology studies performed, without consideration of whether or not those studies contributed overall value. VBR will become increasingly important in the future as a means of determining resources. The ESR has been a leader in advancing VBR concepts and educating radiologists about this novel way of looking at what we do. This paper is designed to highlight current ESR activities which contribute value to healthcare, and to consider other ways in which the ESR could potentially support value enhancement in the future.
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