Rescheduling Nonurgent Care in Radiology: Implementation During the Coronavirus Disease 2019 (COVID-19) Pandemic

Assessments of and Attitudes towards Specialist Teleconsultations among Nephrology and Posttransplant Outpatients during the COVID-19 Pandemic

In Poland, teleconsultations (TCs) were not legally regulated or even conducted until the COVID-19 pandemic, which necessitated their abrupt implementation and posed a challenge to patients and doctors. The aim of this study was to assess the quality of TCs and the satisfaction with this mode of consultation among nephrology and kidney transplant outpatients with a high risk of severe courses of SARS-CoV-2 infection. A self-designed questionnaire regarding patients' demographics; digital fluency; and participation in, satisfaction with, and attitude towards TCs was distributed among patients in the nephrology and posttransplant outpatient clinics at two hospitals in central Poland. The questionnaires were completed by 294 adult patients, of whom 72.1% (n = 212) had participated in TCs at one of the abovementioned clinics. Almost all (96.7%) of the TCs were conducted via phone, and in 94.8% of cases, they fulfilled the purpose of the consultation. The most commonly reported advantages were not having to leave home and the reduced risk of infection. Only a few patients felt that TCs offer no advantages. The patients' profiles and demographic data had no significant effect on their assessments of teleconsultations. Despite the overall positive rating given to TCs, patients unhesitatingly indicated that a face-to-face visit would be a preferable way to contact a specialist.

Evidence for an adverse impact of remote readouts on radiology resident productivity: Implications for training and clinical practice

After their rapid adoption at the onset of the coronavirus pandemic, remote case reviews (remote readouts) between diagnostic radiology residents and their attendings have persisted in an increasingly remote workforce, despite relaxing social distancing guidelines. Our objective was to evaluate the impact of the transition to remote readouts on resident case volumes after the recovery of institutional volumes. We tabulated radiology reports co-authored by first-to-third-year radiology residents (R1-R3) between July 1 and December 31 of the first pandemic year, 2020, and compared to the prior two pre-pandemic years. Half-years were analyzed because institutional volumes recovered by July 2020. Resident volumes were normalized to rotations, which were in divisions categorized by the location of the supervising faculty during the pandemic period; in 'remote' divisions, all faculty worked off-site, whereas 'hybrid' divisions had a mix of attendings working on-site and remotely. All residents worked on-site. Data analysis was performed with Student's t test and multivariate linear regression. The largest drops in total case volume occurred in the two remote divisions (38% [6,086 to 3,788], and 26% [11,046 to 8,149]). None of the hybrid divisions with both in-person and remote supervision decreased by more than 5%. With multivariate regression, a resident assigned to a standardized remote rotation in 2020 would complete 32% (253 to 172) fewer studies than in identical pre-pandemic rotations (coefficent of -81.6, p = .005) but would be similar for hybrid rotations. R1 residents would be expected to interpret 40% fewer (180 to 108) cases on remote rotations during the pandemic (coefficient of -72.3, p = .007). No significant effect was seen for R2 or R3 residents (p = .099 and p = .29, respectively). Radiology residents interpreted fewer studies during remote rotations than on hybrid rotations that included in-person readouts. As resident case volume is correlated with clinical performance and board pass rate, monitoring the readout model for downstream educational effects is essential. Until evidence shows that educational outcomes remain unchanged, radiology residencies may wish to preserve in-person resident readouts, particularly for junior residents.

Delayed Diagnosis of Shoulder Septic Arthritis and Osteomyelitis During the COVID-19 Pandemic: The Role of Point-of-Care Ultrasound

The diagnosis and treatment of septic arthritis are complex and require collaboration among multiple medical services, especially in the emergency department (ED). This case report highlights the difficulties in diagnosing shoulder septic arthritis, which is a rare condition in adults and can present with subtle symptoms. The patient was eventually diagnosed with septic arthritis of the left shoulder. However, the diagnosis was delayed due to the impact of the COVID-19 pandemic on obtaining an outpatient MRI and a previous shoulder injury that added confusion. Delays in diagnosis and treatment can lead to a rapid destruction of the affected joint, causing significant morbidity and mortality. This case report also highlights the importance of alternative diagnostic tools, such as point-of-care ultrasound (POCUS), which is quick, inexpensive, and may lead to earlier detection of joint effusions and prompt arthrocentesis.

Evolving operational guidance and experiences for radiology and nuclear medicine facilities in response to and beyond the COVID-19 pandemic

The resulting pandemic from the novel severe acute respiratory coronavirus 2, SARS-CoV-2 (COVID-19), continues to exert a strain on worldwide health services due to the incidence of hospitalization and mortality associated with infection. The aim of clinical services throughout the period of the pandemic and likely beyond to endemic infections as the situation stabilizes is to enhance safety aspects to mitigate transmission of COVID-19 while providing a high quality of service to all patients (COVID-19 positive and negative) while still upholding excellent medical standards. In order to achieve this, new strategies of clinical service operation are essential. Researchers have published peer-reviewed reference materials such as guidelines, experiences and advice to manage the resulting issues from the unpredictable challenges presented by the pandemic. There is a range of international guidance also from professional medical organizations, including best practice and advice in order to help imaging facilities adjust their standard operating procedures and workflows in line with infection control principles. This work provides a broad review of the main sources of advice and guidelines for radiology and nuclear medicine facilities during the pandemic, and also of rapidly emerging advice and local/national experiences as facilities begin to resume previously canceled non-urgent services as well as effects on imaging research.

Imaging volumes during COVID-19: A Victorian health service experience

BACKGROUND

The World Health Organisation declared the coronavirus disease 2019 (COVID-19) a pandemic on March 11, 2020. While globally, the relative caseload has been high, Australia’s has been relatively low. During the pandemic, radiology services have seen significant changes in workflow across modalities and a reduction in imaging volumes.

AIM

To investigate differences in modality imaging volumes during the COVID-19 pandemic across a large Victorian public health network.

METHODS

A retrospective analysis from January 2019 to December 2020 compared imaging volumes across two periods corresponding to the pandemic’s first and second waves. Weekly volumes across patient class, modality and mobile imaging were summed for periods: wave 1 (weeks 11 to 16 for 2019; weeks 63 to 68 for 2020) and wave 2 (weeks 28 to 43 for 2019; weeks 80 to 95 for 2020). Microsoft Power Business Intelligence linked to the radiology information system was used to mine all completed examinations.

RESULTS

Summed weekly data during the pandemic’s first wave showed the greatest decrease of 29.8% in adult outpatient imaging volumes and 46.3% in paediatric emergency department imaging volumes. Adult nuclear medicine demonstrated the greatest decrease of 37.1% for the same period. Paediatric nuclear medicine showed the greatest decrease of 47.8%, with angiography increasing by 50%. The pandemic’s second wave demonstrated the greatest decrease of 23.5% in adult outpatient imaging volumes, with an increase of 18.2% in inpatient imaging volumes. The greatest decrease was 28.5% in paediatric emergency department imaging volumes. Nuclear medicine showed the greatest decrease of 37.1% for the same period. Paediatric nuclear medicine showed the greatest decrease of 36.7%. Mobile imaging utilisation increased between 57.8% and 135.1% during the first and second waves. A strong correlation was observed between mobile and non-mobile imaging in the emergency setting (Spearman’s correlation coefficient = -0.743, P = 0.000). No correlation was observed in the inpatient setting (Spearman’s correlation coefficient = -0.059, P = 0.554).

CONCLUSION

Nuclear medicine was most impacted, while computed tomography and angiography were the least affected by the pandemic. The impact was less during the pandemic’s second wave. Mobile imaging shows continuous growth during both waves.

Quality of the Healthcare Services During COVID-19 Pandemic in Selected European Countries

Background

There are several definitions of the quality of healthcare services. It may be defined as a level of value provided by any health care resource, as determined by some measurement. Scientists use a variety of quality measures to attempt to determine health care quality. They use special indicators or based on a patients' or healthcare professional's perception. This article aims to provide a short review of the available data on the quality of healthcare services in selected European countries during the COVID-19 pandemic.

Methodology

The research was done by the use of online databases such as PubMed, Google Scholar, and Science Direct. All the studies focused on the quality of healthcare services, yet the studies used different methods to measure this quality. In addition, the results of the authors' survey on the assessment of the quality of healthcare services before and during the COVID-19 pandemic were presented.

Results

Among twelve studies, four were from the United Kingdom and one each of Catalonia, Italy, Sweden, Poland, Netherlands, France, Germany, Belgium. Patients in the United Kingdom felt that the quality of services was good during the pandemic, whereas the quality declined in the other studies cited. The results of our research also revealed a decrease in the quality of healthcare services provided.

Conclusions

Nevertheless the development of telemedicine has had a positive impact on the quality of healthcare services. The COVID-19 pandemic has undoubtedly affected most European countries' quality of healthcare services.

Accessibility to Non-COVID Health Services in the World During the COVID-19 Pandemic: Review

Background: COVID-19 pandemic caused by SARS-CoV2 has seriously impacted the global economy. Medical facilities around the world were not prepared for the enormous challenges posed by the growing number of patients each day, the shortage of personal protective equipment, and insufficient numbers of medical staff. Governments have tried to counteract the impact of the pandemic, but the measures taken have not always been sufficient to maintain access to and quality of health services at the same level as before the pandemic. The disruption of health services has resulted in more and more research reports from different parts of the world on the accessibility of health services during the COVID-19 pandemic. Methodology: This review article presents 21 selected scientific studies on access to health services in different regions of the world. Articles were found in PubMed, GoogleScholar, Medline, and ScienceDirect databases, then grouped, and significant data were extracted from each article. The results were summarized in a table. Results: The range of limited health services included a variety of specialties, including primary care, psychiatry, orthopedics, cardiology, neurosurgery, and more. Methods used in the studies were based on retrospective analysis or on the subjective assessment of patients in the form of a questionnaire or interview. Most authors claimed a decrease in accessibility to health services during the COVID-19 pandemic compared to the pre-pandemic period, including a decrease in planned surgeries, doctor appointments, patient admission to hospital or ER, and access to medicines. Additionally, some authors observed an increase in the mortality rate. One of the few medical services that have expanded rapidly during the pandemic was online appointments. Conclusions: The COVID-19 pandemic has most certainly affected the accessibility of health services worldwide. Lessons should be learned to prevent inaccessibility to medical services, especially as experts predict another wave of COVID-19 cases.

Trends in Pediatric Appendicitis and Imaging Strategies During Covid-19 in the United States

RATIONALE AND OBJECTIVES

To determine if, during the first wave of the COVID-19 pandemic, 1) the proportion of complicated appendicitis changed, and 2) if imaging strategies for appendicitis in children changed.

MATERIALS AND METHODS

Retrospective cross-sectional study using administrative data from the Pediatric Health Information System, inclusive of pediatric patients diagnosed with appendicitis from March to May in 2017, 2018, 2019 and 2020. We compared trends during COVID-19 pandemic (March-May 2020) with corresponding pre-COVID-19 periods in 2017-201.9 Study outcomes were the proportion of complicated appendicitis and trends in imaging for appendicitis explained by patient-level variables.

RESULTS

The proportion of complicated appendicitis cases increased by 4.4 percentage points, from 46.5% pre-COVID-19 (2017-2019) to 50.9% during COVID-19 (2020), p < 0.001. Mean count of uncomplicated acute appendicitis cases decreased from pre-COVID-19 to the 2020 COVID-19 period (2017: n = 2555; 2018: n = 2679; 2019: n = 2722; 2020: n = 2231). Mean count of complicated appendicitis was unchanged between study periods (2017: n = 2189; 2018: n = 2302, 2019: n = 2442; 2020: n = 2311). Imaging approaches were largely unchanged between study periods; ultrasound was the most utilized modality in both study periods (68.3%, 70.2%; p = 0.033).

CONCLUSION

During the first wave of the COVID-19 pandemic, the proportion of complicated appendicitis cases increased without an absolute increase in the number of complicated appendicitis cases, but instead a decrease in the number of uncomplicated acute appendicitis diagnoses.

Automatic Patient-Level Detection of Coronavirus Disease (COVID-19) Using Convolutional Neural Network from Lung CT Scans

The outbreak of 2019 novel coronavirus (COVID-19) has caused more than 176 million confirmed cases by June 14, 2021, and this number will continue to grow. Automatic and accurate COVID-19 detection/evaluation from the computed tomography (CT) scans is of great significance for COVID-19 diagnosis and treatment. Due to individual variations of patients and the influx of a large number of patients, the current clinical practices remain subject to shortcomings of potential high-risk and time-consumption issues from radiologists. In this paper, we propose a computer aided detection system to relieve the clinical physicians from tediously reading the CT images of COVID-19 patients. Particularly, a COVID-19 detection network (COVIDNet) is proposed using deep convolutional neural networks (DCNNs) for patient-level COVID-19 detection to distinguish infected and non-infected patients. The underlying method complementarily and comprehensively extract multi-level interplane volumetric correlation features of typical ground glass opacities (GGOs) lesions using 3D multi-Scale Network (MSN). To cover more GGO lesion features and reduce intra-class differences, a Phase Ensemble (PE) is proposed for aggregation of different phases in one CT scan. The proposed method is evaluated on a clinically established COVID-19 database with five-fold cross-validation. Experimental results show that the proposed framework achieves classification performance with the specificity of 1.0000, sensitivity of 0.9700, accuracy of 0.9850, precision of 1.0000, and Area Under the Curve (AUC) of 0.9980. All of these indicate that our method enables an efficient, accurate and reliable patient-level COVID-19 detection for clinical diagnosis. This can significantly improve the work efficiency of clinical physicians on COVID-19 patient diagnosis and evaluation in hospitals and clinics. Impact statement—The proposed method can automatically and accurately distinguish the COVID-19 patients from patient-level CT scan images. On a clinically established large-scale COVID-19 database with five-fold cross-validation, the experimental results show that the proposed framework achieves a classification performance with the specificity of 1.0000, sensitivity of 0.9700, accuracy of 0.9850, precision of 1.0000, and Area Under the Curve (AUC) of 0.9980. It can relieve the clinical physicians from tediously reading the CT images of COVID-19 patients. Thus, it can significantly improve the work efficiency of clinical physicians on COVID-19 patient diagnosis and evaluation in hospitals and clinics, particularly in the pandemic period of COVID-19.

Rationing and Disparities in Health Care: Implications for Radiology Clinical Practice Guidelines

We examine the relationship between the rationing of health care resources and disparities in health care delivery and the specific implications for radiologic resource allocation frameworks such as the ACR Appropriateness Criteria. We explore what rationing is in this context and how it is manifested in radiology. We review how rationing has taken many forms and how rationing has influenced the development of disparities in access and outcomes within health care and specifically within the context of radiology. We describe how the relationship between rationing and health care delivery disparities manifested during the coronavirus disease 2019 pandemic and the corrective measures that were proposed to established rationing frameworks to facilitate more equitable pandemic-related resource distribution. We offer suggestions regarding how such solutions might be brought into radiologic resource allocation schemes to help mitigate disparities in radiologic care in the future.

Prioritizing breast imaging services during the COVID pandemic: A survey of breast imaging facilities within the Breast Cancer Surveillance Consortium

The COVID-19 pandemic disrupted breast cancer screening and diagnostic imaging in the United States. We sought to evaluate how medical facilities prioritized breast imaging services during periods of reduced capacity or upon re-opening after closures. In fall 2020, we surveyed 77 breast imaging facilities within the Breast Cancer Surveillance Consortium in the United States. The survey ascertained the pandemic's impact on clinical practices during March-September 2020. Nearly all facilities (97%) reported closing or operating at reduced capacity at some point during this period. All facilities were open by August 2020, though 14% were still operating at reduced capacity in September 2020. During periods of re-opening or reduced capacity, 93% of facilities reported prioritizing diagnostic breast imaging over breast cancer screening. For diagnostic imaging, facilities prioritized based on rescheduling canceled appointments (89%), specific indication for diagnostic imaging (89%), patient demand (84%), individual characteristics and risk factors (77%), and time since last imaging examination (72%). For screening mammography, facilities prioritized based on rescheduled cancelations (96%), patient demand (83%), individual characteristics and risk factors (73%), and time since last mammogram (71%). For biopsy services, more than 90% of facilities reported prioritization based on rescheduling of canceled exams, patient demand, patient characteristics and risk factors and level of suspicion on imaging. The observed patterns from this large and geographically diverse sample of facilities in the United States indicate that multiple factors were commonly used to prioritize breast imaging services during periods of reduced capacity.

The impact of the COVID-19 pandemic on diagnostic imaging services in Australia

Introduction

The COVID‐19 pandemic is driving unprecedented changes in healthcare services worldwide. This study aimed to quantify the impact of the first wave of the COVID‐19 pandemic on diagnostic imaging services in Australia using an interrupted time series model.

Methods

Monthly data were extracted from the Australian Medicare Benefits Schedule for all diagnostic imaging services performed between January 2016 and December 2019. Holt‐Winters forecasting models were developed for total imaging services as well as for each imaging modality. The models were used to predict monthly data between January 2020 and June 2020 with a 95% confidence interval (P < 0.05). Absolute and percentage residual differences (RD) between observed and predicted services for this time period were calculated.

Results

There were statistically significant reductions in total imaging services performed in March 2020 (RD: −332260, −13.1%, 95% CI: −17.5% to −8.4%), April 2020 (RD: −716957, −32.4%, 95% CI: −36.2% to −28.1%) and May 2020 (RD: −571634, −21.4%, 95% CI: −25.1% to −17.3%). Nuclear medicine and CT services were relatively less impacted than general radiography, ultrasound, and MRI services. There was also a statistically significant increase in nuclear medicine and CT services performed in June 2020 compared to predicted values.

Conclusions

During the first wave of COVID‐19 in Australia, there was a significant reduction in total diagnostic imaging services, with variable impacts on different imaging modalities. These findings may have significant public health implications and can be used to inform evidence‐based strategies in the recovery phase of the pandemic.

Challenges and optimization strategies in medical imaging service delivery during COVID-19

In coronavirus disease 2019 (COVID-19), medical imaging plays an essential role in the diagnosis, management and disease progression surveillance. Chest radiography and computed tomography are commonly used imaging techniques globally during this pandemic. As the pandemic continues to unfold, many healthcare systems worldwide struggle to balance the heavy strain due to overwhelming demand for healthcare resources. Changes are required across the entire healthcare system and medical imaging departments are no exception. The COVID-19 pandemic had a devastating impact on medical imaging practices. It is now time to pay further attention to the profound challenges of COVID-19 on medical imaging services and develop effective strategies to get ahead of the crisis. Additionally, preparation for operations and survival in the post-pandemic future are necessary considerations. This review aims to comprehensively examine the challenges and optimization of delivering medical imaging services in relation to the current COVID-19 global pandemic, including the role of medical imaging during these challenging times and potential future directions post-COVID-19.

Impact of COVID-19 Workflow Changes on Patient Throughput at Outpatient Imaging Centers

Rationale and Objectives

To determine the impact of COVID-19 workflow changes on patient throughput at the outpatient imaging facilities of a large healthcare system in New York City.

Materials and Methods

COVID-19 workflow changes to permit social distancing and patient and staff safety included screening at the time of scheduling, encouraging patients to use our digital platform to complete registration/safety forms prior to appointments, stationing screeners at all entrances, limiting waiting room capacity, implementing a texting system to notify patients of delays, limiting dressing room use by encouraging patients to wear exam-appropriate clothing, and accelerating MRI protocols without reducing image quality. We assessed patients’ pre-exam wait times, MR exam times, overall time spent on site, and registration for and use of the digital portal before (February 2020) and after (June 2020) implementation of these measures.

Results

Across 17 outpatient imaging centers, workflow changes resulted in a 23.1% reduction (-6.8 minutes) in all patients’ pre-exam wait times (p <0.00001). Pre-exam wait times for MRI, CT, ultrasound, x-ray, and mammography decreased 28.4% (-10.3 minutes), 16.5% (-6.7 minutes), 25.3% (-7.7 minutes), 22.8% (-3.7 minutes), and 23.9% (-5.0 minutes), respectively (p < 0.00001 for all). MR exam times decreased 9.7% (-3.5 minutes) and patients’ overall time on site decreased 15.2% (-8.0 minutes). The proportions of patients actively using the digital patient portal (56.1%–70.1%) and completing forms electronically prior to arrival (24.9%–47.1%) increased (p < 0.0001 for both).

Conclusion

Workflow changes necessitated by the COVID-19 pandemic to ensure safety of patients and staff have permitted higher outpatient throughput.

Population-level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures

BACKGROUND

To understand how health care delays may affect breast cancer detection, the authors quantified changes in breast‐related preventive and diagnostic care during the coronavirus disease 2019 (COVID‐19) pandemic.

METHODS

Eligible women (N = 39,444) were aged ≥18 years and received a screening mammogram, diagnostic mammogram, or breast biopsy between January 1, 2019 and September 30, 2020, at 7 academic and community breast imaging facilities in North Carolina. Changes in the number of mammography or breast biopsy examinations after March 3, 2020 (the first COVID‐19 diagnosis in North Carolina) were evaluated and compared with the expected numbers based on trends between January 1, 2019 and March 2, 2020. Changes in the predicted mean monthly number of examinations were estimated using interrupted time series models. Differences in patient characteristics were tested using least squares means regression.

RESULTS

Fewer examinations than expected were received after the pandemic's onset. Maximum reductions occurred in March 2020 for screening mammography (−85.1%; 95% CI, −100.0%, −70.0%) and diagnostic mammography (−48.9%; 95% CI, −71.7%, −26.2%) and in May 2020 for biopsies (−40.9%; 95% CI, −57.6%, −24.3%). The deficit decreased gradually, with no significant difference between observed and expected numbers by July 2020 (diagnostic mammography) and August 2020 (screening mammography and biopsy). Several months after the pandemic's onset, women who were receiving care had higher predicted breast cancer risk (screening mammography, P < .001) and more commonly lacked insurance (diagnostic mammography, P < .001; biopsy, P < .001) compared with the prepandemic population.

CONCLUSIONS

Pandemic‐associated deficits in the number of breast examinations decreased over time. Utilization differed by breast cancer risk and insurance status, but not by age or race/ethnicity. Long‐term studies are needed to clarify the contribution of these trends to breast cancer disparities.

In this observational study, the use of screening mammography, diagnostic mammography, and breast biopsy is significantly lower than expected after the onset of the COVID‐19 pandemic in North Carolina, but the deficits decrease over time. Health insurance status and predicted breast cancer risk are identified as predictors of mammography and biopsy receipt during the pandemic.

Impact of COVID-19 social distancing regulations on outpatient diagnostic imaging volumes and no-show rates

Background

The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted outpatient radiology practices, necessitating change in practice infrastructure and workflow.

Objective

The purpose of this study was to assess the consequences of social distancing regulations on 1) outpatient imaging volume and 2) no-show rates per imaging modality.

Methods

Volume and no-show rates of a large, multicenter metropolitan healthcare system outpatient practice were retrospectively stratified by modality including radiography, CT, MRI, ultrasonography, PET, DEXA, and mammography from January 2 to July 21, 2020. Trends were assessed relative to timepoints of significant state and local social distancing regulatory changes.

Results

The decline in imaging volume and rise in no-show rates was first noted on March 10, 2020 following the declaration of a state of emergency in New York State (NYS). Total outpatient imaging volume declined 85% from baseline over the following 5 days. Decreases varied by modality: 88% for radiography, 75% for CT, 73% for MR, 61% for PET, 80% for ultrasonography, 90% for DEXA, and 85% for mammography. Imaging volume and no-show rate recovery preceded the mask mandate of April 15, 2020, and further trended along with New York City's reopening phases. No-show rates recovered within 2 months of the height of the pandemic, however, outpatient imaging volume has yet to recover to baseline after 3 months.

Conclusion

The total outpatient imaging volume declined alongside an increase in the no-show rate following the declaration of a state of emergency in NYS. No-show rates recovered within 2 months of the height of the pandemic with imaging volume yet to recover after 3 months.

Clinical impact

Understanding the impact of social distancing regulations on outpatient imaging volume and no-show rates can potentially aid other outpatient radiology practices and healthcare systems in anticipating upcoming changes as the COVID-19 pandemic evolves.

Does CT help in reducing RT-PCR false negative rate for COVID-19?

BACKGROUND

Early detection is the key to contain the ongoing pandemic. The current gold standard to detect SARS CoV2 is RT-PCR. However, it has a high false negative rate and long turnaround time.

PURPOSE

In view of the high sensitivity of CT in detection of lower respiratory tract pathologies, a study of 2581 patients comparing RT-PCR status with CT findings was undertaken to see if it augments the diagnostic performance.

MATERIALS AND METHODS

A multi centre prospective study of consecutive cases was conducted. All CT studies suggestive of COVID 19 pneumonia were collated and evaluated independently by three Radiologists to confirm the imaging diagnosis of COVID-19 pneumonia. The RT-PCR values were retrospectively obtained, based on the RT-PCR values, CT studies were categorised into three subgroups, positive, negative and unknown. CT features from all three groups were compared to evaluate any communality or discordance.

RESULTS

Out of the 2581 patients with positive CT findings for COVID pneumonia, 825 were females and 1,756 were males in a wide age group of 28-90 years. Predominant CT features observed in all the subgroups were Ground glass densities 94.8%, in mixed distribution (peripheral and central) (59.12%), posterior segments in 92% and multilobar involvement in 70.9%. The CT features across the three subgroups were statistically significant with a P value <0.001.

CONCLUSION

There was a communality of CT findings regardless of RT-PCR status. In a pandemic setting ground glass densities in a subpleural, posterior and basal distribution are indicative of COVID 19. Thus CT chest in conjunction to RT PCR augments the diagnosis of COVID 19 pneumonia; utilization of CT chest may just be the missing link in closing this pandemic.

Recover Wisely From COVID-19: Responsible Resumption of Nonurgent Radiology Services

Rationale and Objectives

Following state and institutional guidelines, our Radiology department launched the “Recover Wisely” for all nonurgent radiology care on May 4, 2020. Our objective is to report our practice implementation and experience of COVID-19 recovery during the resumption of routine imaging at a tertiary academic medical center.

Materials and Methods

We used the SQUIRE 2.0 guidelines for this practice implementation. Recover Wisely focused on a data driven, strategic rescheduling and redesigning patient flow process. We used scheduling simulations and meticulous monitoring and control of outpatient medical imaging volumes to achieve a linear restoration to our pre-COVID imaging studies. We had a tiered plan to address the backlog of rescheduled patients with gradual opening of our imaging facilities, while maintaining broad communication with our patients and referring clinicians.

Results

Recover Wisely followed our anticipated linear modeling. Considering the last 10 weeks in the recovery, outpatient growth was linear with an increase of approximately 172 cases per week, (R² =0.97). We achieved an overall recovery of 102% in week 10, as compared to average weekly pre-COVID outpatient volumes. The modalities recovered as follows in outpatient volumes: CT (113%), MRI (101%), nuclear medicine including PET (138%), mammograms (97%), ultrasound (99%) and interventional radiology (106%). When compared to identical 2019 calendar weeks (May 4, 2020–July 10, 2020), the total 2020 radiology volume was 11% reduced from the 2019 volume. The reduction in total weighted relative value units was 8% in this time period, as compared to 2019.

Conclusion

Our department utilized a data-driven, team approach based on our guiding principles to “Recover Wisely.” We created and implemented a methodology that achieved a linear increase in outpatient studies over a 10-week recovery period.

Audiology in the time of COVID-19: practices and opinions of audiologists in the UK

OBJECTIVE

To document changes in audiology practice resulting from COVID-19 restrictions and to assess audiologists' opinions about teleaudiology.

DESIGN

A survey consisting of closed-set and open-ended questions that assessed working practices during the COVID-19 restrictions and audiologists' attitudes towards teleaudiology.

SAMPLE

About 120 audiologists in the UK recruited via snowball sampling through social media and emails.

RESULTS

About 30% of respondents said they had used teleaudiology prior to COVID-19 restrictions; 98% had done at the time of survey completion, and 86% said they would continue to do so even when restrictions are lifted. Reasons for prior non-use of teleaudiology were associated with clinical limitations/needs, available infrastructure and patient preferences. Respondents believe teleaudiology will improve travel, convenience, flexibility and scheduling, that it will have little/no impact on satisfaction and quality of care, but that it will negatively impact personal interactions. Concerns about teleaudiology focussed on communication, inability to conduct some clinical procedures and technology.

CONCLUSIONS

Respondents' experience with teleaudiology has generally been positive however improvements to infrastructure and training are necessary, and because many procedures must be conducted in-person, it will always be necessary to have hybrid-care pathways available.

Operational Radiology Recovery in Academic Radiology Departments After the COVID-19 Pandemic: Moving Toward Normalcy

This article presents a current snapshot in time, describing how radiology departments around the country are planning recovery from the baseline of the coronavirus disease 2019 pandemic, with a focus on different domains of recovery such as managing appointment availability, patient safety and workflow changes, and operational data and analytics. An e-mail survey was sent through the Society of Chairs of Academic Radiology Departments list server to 114 academic radiology departments. On the basis of data reported by the 38 survey respondents, best practices and shared experience are described for three key areas: (1) planning for recovery, (2) creating a new normal, and (3) measuring and forecasting. Radiology practices should be aware of the common approaches and preparations academic radiology departments have taken to reopening imaging in the post-coronavirus disease 2019 world. This should all be done when maintaining a safe and patient-centric environment and preparing to minimize the impact of future outbreaks or pandemics.