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Rainey C. Artificial intelligence and radiographer preliminary image evaluation: What might the future hold for radiographers providing x-ray interpretation in the acute setting? J Med Radiat Sci 2024. [PMID: 39304330 DOI: 10.1002/jmrs.821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Accepted: 08/19/2024] [Indexed: 09/22/2024] Open
Abstract
In a stretched healthcare system, radiographer preliminary image evaluation in the acute setting can be a means to optimise patient care by reducing error and increasing efficiencies in the patient journey. Radiographers have shown impressive accuracies in the provision of these initial evaluations, however, barriers such as a lack of confidence and increased workloads have been cited as a reason for radiographer reticence in engagement with this practice. With advances in Artificial Intelligence (AI) technology for assistance in clinical decision-making, and indication that this may increase confidence in diagnostic decision-making with reporting radiographers, the author of this editorial wonders what the impact of this technology might be on clinical decision-making by radiographers in the provision of Preliminary Image Evaluation (PIE).
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Affiliation(s)
- Clare Rainey
- School of Health Sciences, Ulster University, Belfast, UK
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Ding K, Makanjee C. Radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters: a qualitative study. BMC Geriatr 2024; 24:205. [PMID: 38418965 PMCID: PMC10900639 DOI: 10.1186/s12877-024-04792-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Within a diagnostic medical imaging context, an interaction encompasses communication, physical contact and emotional support. These intricacies are an integral part in achieving a successful medical imaging outcome. An increasing ageing population presents unique challenges and leads to a higher demand for medical imaging services. There is a paucity of literature exploring the specialised knowledge and skills required by radiographers to service optimal person-centred care for elderly patients. The purpose of the study was to explore radiographers' perspectives on interactional processes during older persons diagnostic medical imaging encounters. METHODS The study used a qualitative exploratory research design with a descriptive approach to gain insights from 12 purposively sampled Australian radiographers, through open-ended interviews conducted online or by telephone. Verbatim transcripts were produced, and a thematic analysis employed until data saturation had been reached. RESULTS The three themes that emerged from the data analysis were: (1) optimising care and communication, (2) expectations and preconceptions and (3) physical and emotional comfort and safety. Generally, the approach to undertaking older persons examinations entailed more adaptive and flexible competencies and skills in comparison to the familiarised routine diagnostic medical imaging encounters with the younger cohort. Radiographers shared aspects on striking a balance between efficiency and proficiency with the elderly patient needs, preferences, values, safety and well-being considerations. This required swift, complex decision-making and judgement calls due to the unpredictable nature of the context in which the elderly person was situated. The result was the adaptation of examination protocols through equipment manipulation, with minimal disruptions to emotional and physical comfort, achieved through interventions and support strategies. CONCLUSION The results highlight the many considerations for radiographers during a short clinical interaction. There is optimism in adding value to the elderly persons experience through a complex interactional process. It is anticipated that the identified skills will inform on best practice principles to achieve an elderly person-centred care medical imaging outcome.
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Affiliation(s)
- Kevin Ding
- Department of Medical Radiation Science, University of Canberra, University Drive, 2617, Bruce, ACT, Australia
| | - Chandra Makanjee
- Department of Medical Radiation Science, University of Canberra, University Drive, 2617, Bruce, ACT, Australia.
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Lu P, Mian M, Yii M, McArdle DJT, Rhodes A, Sreedharan S. Rising use of diagnostic imaging in Australia: An analysis of Medicare-funded radiology services between 2000 and 2021. J Med Imaging Radiat Oncol 2024; 68:50-56. [PMID: 37797195 DOI: 10.1111/1754-9485.13591] [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: 03/06/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023]
Abstract
INTRODUCTION The use of diagnostic imaging services is increasing worldwide. This has important impacts on healthcare resource allocation and potential risks to the population. This study aimed to quantify trends in medical imaging in Australia over the past two decades. METHODS Data were extracted from the Australian Medicare Benefits Schedule (MBS) between 2000 and 2021. Simple linear regression analyses were performed to assess changes in absolute utilisation and utilisation rate per 100,000 population of total imaging services as well as by each imaging modality. Logistic regression analysis was performed to assess changes in total imaging services as a proportion of total Medicare services over time. Chi-squared test was used to assess for change in modality composition of imaging services. RESULTS There were 436,255,500 imaging studies performed between 2000 and 2021. The absolute utilisation of total imaging services increased annually by an average of 864,404 (95% CI: 808,235-920,573, p < 0.001). For each consecutive year, the proportion of total Medicare services attributed to total imaging services increased by 0.01% (95% CI: 0.01-0.01, p < 0.01). There was also a statistically significant increase in the utilisation rates of imaging services per 100,000 population for each imaging modality. The number of imaging services per radiologist increased on average by 74 (95% CI: 26-122, p < 0.05) annually. CONCLUSION The utilisation of diagnostic imaging services has increased in Australia between 2000 and 2021, outpacing the population growth, total healthcare services, and the radiologist workforce.
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Affiliation(s)
- Patrick Lu
- Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Mustafa Mian
- Department of Oral and Maxillofacial Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Matthew Yii
- Department of Ear, Nose and Throat Surgery, Alfred Hospital, Melbourne, Victoria, Australia
| | | | - Alexander Rhodes
- Department of Radiology, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Radiology, University of Melbourne, Parkville, Victoria, Australia
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Yen TY, Ho CS, Chen YP, Pei YC. Diagnostic Accuracy of Deep Learning for the Prediction of Osteoporosis Using Plain X-rays: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:207. [PMID: 38248083 PMCID: PMC10814351 DOI: 10.3390/diagnostics14020207] [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: 11/17/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 01/23/2024] Open
Abstract
(1) Background: This meta-analysis assessed the diagnostic accuracy of deep learning model-based osteoporosis prediction using plain X-ray images. (2) Methods: We searched PubMed, Web of Science, SCOPUS, and Google Scholar from no set beginning date to 28 February 2023, for eligible studies that applied deep learning methods for diagnosing osteoporosis using X-ray images. The quality of studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 criteria. The area under the receiver operating characteristic curve (AUROC) was used to quantify the predictive performance. Subgroup, meta-regression, and sensitivity analyses were performed to identify the potential sources of study heterogeneity. (3) Results: Six studies were included; the pooled AUROC, sensitivity, and specificity were 0.88 (95% confidence interval [CI] 0.85-0.91), 0.81 (95% CI 0.78-0.84), and 0.87 (95% CI 0.81-0.92), respectively, indicating good performance. Moderate heterogeneity was observed. Mega-regression and subgroup analyses were not performed due to the limited number of studies included. (4) Conclusion: Deep learning methods effectively extract bone density information from plain radiographs, highlighting their potential for opportunistic screening. Nevertheless, additional prospective multicenter studies involving diverse patient populations are required to confirm the applicability of this novel technique.
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Affiliation(s)
- Tzu-Yun Yen
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (T.-Y.Y.); (C.-S.H.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
| | - Chan-Shien Ho
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (T.-Y.Y.); (C.-S.H.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
| | - Yueh-Peng Chen
- Center for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Linkou No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan;
- Master of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
| | - Yu-Cheng Pei
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan; (T.-Y.Y.); (C.-S.H.)
- School of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Master of Science Degree Program in Innovation for Smart Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Center of Vascularized Tissue Allograft, Gung Memorial Hospital, Linkou No. 5, Fuxing Street, Guishan District, Taoyuan City 333, Taiwan
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Dollard J, Edwards J, Yadav L, Gaget V, Tivey D, Maddern GJ, Visvanathan R. Mobile X-ray services in nursing homes as an enabler to healthcare-in-place for residents: informal carers' views. BMC Geriatr 2023; 23:458. [PMID: 37491218 PMCID: PMC10369836 DOI: 10.1186/s12877-023-04130-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/24/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Informal carers (ICs) of residents living in nursing homes (NH) have a key role in the care of residents, including making decisions about and providing care. As radiology has a role in decision making about care, it is important to understand IC's perspectives about resident's use of mobile X-ray services (MXS). The aim was to explore the perspectives of ICs of residents living in nursing homes about the use of MXS. METHODS From November 2020 to February 2021, twenty ICs of residents living in four nursing homes in different areas of one Australian city participated. Their perspectives of MXS, including benefits and barriers, were explored in semi-structured interviews. Data were analysed using thematic analysis. RESULTS ICs were resident's children (80%) and spouses (20%). One resident had received a MXS. Four themes were developed: (1) a priority for resident well-being, where ICs were positive about using MXS, because residents could receive healthcare without transfer; (2) MXS could reduce carer burden; (3) economic considerations, where MXS could reduce health system burden but the MXS call-out fee could result in health inequities; and (4) pathways to translation, including the need to improve consumer awareness of MXS, ensure effective processes to using MXS,, consider nursing home staff levels to manage MXS and ICs expectations about quality and availability of MXS. CONCLUSIONS ICs consider MXS can benefit resident well-being by potentially reducing transfers to hospital or radiology facilities and advocated equitable access. ICs cautioned that the quality and safety of healthcare delivered in nursing homes should equal what they would receive in hospitals.
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Affiliation(s)
- Joanne Dollard
- Adelaide Geriatrics and Training with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, South Australia, Australia.
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, South Australia, Australia.
| | - Jane Edwards
- Adelaide Geriatrics and Training with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
| | - Lalit Yadav
- Adelaide Geriatrics and Training with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
| | - Virginie Gaget
- Discipline of Surgery, The Queen Elizabeth Hospital, The University of Adelaide Surgical Specialties, University of Adelaide, Woodville South, South Australia, Australia
| | - David Tivey
- Discipline of Surgery, The Queen Elizabeth Hospital, The University of Adelaide Surgical Specialties, University of Adelaide, Woodville South, South Australia, Australia
- Royal Australasian College of Surgeons, Adelaide, South Australia, Australia
| | - Guy J Maddern
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
- Discipline of Surgery, The Queen Elizabeth Hospital, The University of Adelaide Surgical Specialties, University of Adelaide, Woodville South, South Australia, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
| | - Renuka Visvanathan
- Adelaide Geriatrics and Training with Aged Care (GTRAC) Centre, Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Woodville South, South Australia, Australia
- Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
- Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville South, South Australia, Australia
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Gaget V, Inacio MC, Tivey DR, Jorissen RN, Babidge WJ, Visvanathan R, Maddern GJ. Trends in utilisation of ultrasound by older Australians (2010-2019). BMC Geriatr 2023; 23:50. [PMID: 36707769 PMCID: PMC9883967 DOI: 10.1186/s12877-023-03771-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Older people have increasingly complex healthcare needs, often requiring appropriate access to diagnostic imaging, an essential component of their health and disease management planning. Ultrasound is a safe imaging tool used to diagnose several conditions commonly experienced by older people such as deep vein thrombosis. PURPOSE To evaluate the utilisation of major ultrasound services by Australians ≥ 65 years old between 2009- and 2019. METHODS This population-based and yearly cross-sectional study of ultrasound utilisation per 1,000 Australians ≥ 65 years old was conducted using publicly available data sources. Overall, examination site and age- and sex-specific incidence rate (IR) of ultrasound per 1,000 people, adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using negative binomial regression models. RESULTS Over the study period, the crude utilisation of ultrasound increased by 83% in older Australians. Most ultrasound examinations were conducted on extremities (39%) and the chest (21%), with 25% of all ultrasounds investigating the vascular system. More men than women use ultrasounds of the chest (184/1,000 vs 268/1,000 people), particularly echocardiograms (177/1,000 vs 261/1,000 people), and abdomen (88/1,000 vs 92/1,000 people), especially in those ≥ 85 years old. Hip and pelvic ultrasound were used more by women than men (212/1,000 vs 182/1,000 people). There were increases in vascular abdominal (IRR:1.07, 95%CI:1.06-1.08) and extremeties (IRR:1.06, 95%CI:1.05-1.07) ultrasounds over the study period, particularly in ≥ 75 years old men. CONCLUSIONS Ultrasound is a common and increasingly used diagnostic tool for conditions commonly experienced by older Australians.
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Affiliation(s)
- Virginie Gaget
- grid.1010.00000 0004 1936 7304Surgical Specialities, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia 5011 Australia
| | - Maria C. Inacio
- grid.430453.50000 0004 0565 2606Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA 5001 Australia ,grid.1026.50000 0000 8994 5086UniSA Allied Health and Human Movement, University of South Australia, Adelaide, Australia
| | - David R. Tivey
- grid.1010.00000 0004 1936 7304Surgical Specialities, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia 5011 Australia ,grid.419296.10000 0004 0637 6498Royal Australasian College of Surgeons, Adelaide, SA 5001 Australia
| | - Robert N. Jorissen
- grid.430453.50000 0004 0565 2606Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, SA 5001 Australia
| | - Wendy J. Babidge
- grid.1010.00000 0004 1936 7304Surgical Specialities, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia 5011 Australia ,grid.419296.10000 0004 0637 6498Royal Australasian College of Surgeons, Adelaide, SA 5001 Australia
| | - Renuka Visvanathan
- grid.1010.00000 0004 1936 7304Adelaide Geriatrics Training and Research With Aged Care Centre (GTRAC), Faculty of Health and Medical Sciences, University of Adelaide, Woodville, SA 5011 Australia ,Aged & Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, Woodville, SA 5011 Australia
| | - Guy J. Maddern
- grid.1010.00000 0004 1936 7304Surgical Specialities, University of Adelaide, The Queen Elizabeth Hospital, Woodville, South Australia 5011 Australia ,grid.419296.10000 0004 0637 6498Royal Australasian College of Surgeons, Adelaide, SA 5001 Australia
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The Utilization and National Variation of Plain X-Ray Services by Australian Residents of Long-Term Care Facilities. J Am Med Dir Assoc 2022; 23:1564-1572.e9. [PMID: 35667412 DOI: 10.1016/j.jamda.2022.05.004] [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: 12/20/2021] [Revised: 04/26/2022] [Accepted: 05/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To (1) estimate incidence, trends, and determinants of government-subsidized diagnostic radiography (ie, plain x-ray) services utilization by Australian long-term care facility (LTCF) residents between 2009 and 2016; (2) examine national variation in services use. DESIGN A repeated cross-sectional study. SETTING AND PARTICIPANTS Australian LTCF residents who were ≥65 years old. METHODS Medicare Benefits Schedule subsidized plain x-rays employed for diagnosing fall-related injuries, pneumonia, heart failure, and acute abdomen or bowel obstruction were identified. Yearly sex- and age-standardized utilization rates were calculated. Poisson and negative binomial regression models were employed. Facility-level variation was examined graphically. Overall and examination site-specific analyses were conducted. RESULTS A total of 521,497 LTCF episodes for 453,996 individuals living in 3018 LTCFs were examined. The median age was 84 years (interquartile range 79-88), 65% (n = 339,116) were women, and 53.9% (n = 281,297) had dementia. In addition, 34.5% (n = 341,6863) of episodes had at least 1 x-ray service. Overall, there was a 12% increase in utilization between 2009 and 2016 (from 535/1000 in 2009 to 602/1000 person-years in 2016, incidence rate ratio=1.02, 95% CI 1.02-1.02). Factors associated with x-ray use included being 80-89 years old, being a man, not having dementia, having multiple health conditions (4-6 or ≥7 compared to 0-3), being at a smaller facility (0-24 bed compared to 50-74), facility located in the Australian state of New South Wales, or in major cities (compared to regional areas). National variation in x-ray service use, with largest differences observed by state, was detected. CONCLUSIONS AND IMPLICATIONS Plain x-ray service utilization by LTCF residents increased 12% between 2009 and 2016. Sex, age, dementia status, having multiple health conditions as well as facility size, and location were associated with plain x-ray use in LTCFs and use varied geographically. Differences in x-ray service utilization by residents highlight lack of consistent access and potential over- or underutilization.
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