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Bhyat F, Makkink A, Henrico K. Holistic Person-Centered Care in Radiotherapy: Protocol for a Scoping Review. JMIR Res Protoc 2024; 13:e51338. [PMID: 38569177 PMCID: PMC11024745 DOI: 10.2196/51338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/11/2023] [Accepted: 12/17/2023] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Several types of health care professionals are responsible for the care of patients with cancer throughout their engagement with the health care system. One such type is the radiotherapist. The radiotherapist not only administers treatment but is also directly involved with the patient during treatment. Despite this direct contact with the patient, the narrative tends to focus more on technical tasks than the actual patient. This task-focused interaction is often due to the highly sophisticated equipment and complex radiotherapy treatment processes involved. This often results in not meeting the psychosocial needs of the patient, and patients have acknowledged noncompliance and delayed treatment as a result. OBJECTIVE The scoping review aims to explore, chart, and map the available literature on holistic person-centered care in radiotherapy and to identify and present key concepts, definitions, methodologies, knowledge gaps, and evidence related to holistic person-centered care in radiotherapy. METHODS This protocol was developed using previously described methodological frameworks for scoping studies. The review will include both peer-reviewed and gray literature regarding holistic, person-centered care in radiotherapy. A comprehensive search strategy has been developed for MEDLINE (Ovid), which will be translated into the other included databases: Scopus, CINAHL (EBSCO), MEDLINE (PubMed), Embase (Elsevier), Cochrane Library, and the Directory of Open Access Journals. Gray literature searching will include Google (Google Books and Google Scholar), ProQuest, the WorldWideScience website, the OpenGrey website, and various university dissertation and thesis repositories. The title and abstract screening, full-text review, and relevant data extraction will be performed independently by all 3 reviewers using the Covidence (Veritas Health Innovation) software, which will also be used to guide the resolution of conflicts. Sources selected will be imported into ATLAS.ti (ATLAS.ti Scientific Software Development GmbH) for analysis, which will consist of content analysis, narrative analysis, and descriptive synthesis. Results will be presented using narrative, diagrammatic, and tabular formats. RESULTS The review is expected to identify research gaps that will inform current and future holistic, person-centered care in radiotherapy. The review commenced in November 2023, and the formal literature search was completed by the end of February 2024. Final results are expected to be published in a peer-reviewed journal by 2025. CONCLUSIONS The findings of this review are expected to provide a wide variety of strategies aimed at providing holistic, person-centered care in radiotherapy, as well as to identify some gaps in the literature. These findings will be used to inform future studies aimed at designing, developing, evaluating, and implementing strategies toward improved holistic, person-centered care in radiotherapy. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51338.
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Affiliation(s)
- Fatima Bhyat
- Department of Medical Imaging and Radiation Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Andrew Makkink
- Department of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa
| | - Karien Henrico
- Department of Emergency Medical Care, University of Johannesburg, Johannesburg, South Africa
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Dodelzon K, Milch HS, Mullen LA, Dialani V, Jacobs S, Parikh JR, Grimm LJ. Factors Contributing to Disproportionate Burnout in Women Breast Imaging Radiologists: A Review. J Breast Imaging 2024; 6:124-132. [PMID: 38330442 DOI: 10.1093/jbi/wbad104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Indexed: 02/10/2024]
Abstract
Physician burnout continues to increase in prevalence and disproportionately affects women physicians. Breast imaging is a woman-dominated subspeciality, and therefore, worsening burnout among women physicians may have significant repercussions on the future of the breast imaging profession. Systemic and organizational factors have been shown to be the greatest contributors to burnout beyond individual factors. Based on the Mayo Model, we review the evidence regarding the 7 major organizational contributors to physician burnout and their potential disproportionate impacts on women breast radiologists. The major organizational factors discussed are work-life integration, control and flexibility, workload and job demands, efficiency and resources, finding meaning in work, social support and community at work, and organizational culture and values. We also propose potential strategies for institutions and practices to mitigate burnout in women breast imaging radiologists. Many of these strategies could also benefit men breast imaging radiologists, who are at risk for burnout as well.
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Affiliation(s)
- Katerina Dodelzon
- Department of Radiology, Weill Cornell Medicine at NewYork-Presbyterian, New York, NY, USA
| | - Hannah S Milch
- Department of Radiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Lisa A Mullen
- Division of Breast Imaging, The Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Vandana Dialani
- Division of Breast Imaging, Department of Radiology, Beth Israel Lahey Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sarah Jacobs
- New Ulm Medical Center Radiology, Allina Health, New Ulm, MN, USA
| | - Jay R Parikh
- Department of Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lars J Grimm
- Department of Radiology, Duke University Medical Center, Durham, NC, USA
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Al Mohammad B, Aldaradkeh A, Gharaibeh M, Reed W. Assessing radiologists' and radiographers' perceptions on artificial intelligence integration: opportunities and challenges. Br J Radiol 2024; 97:763-769. [PMID: 38273675 PMCID: PMC11027289 DOI: 10.1093/bjr/tqae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 09/30/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES The objective of this study was to evaluate radiologists' and radiographers' opinions and perspectives on artificial intelligence (AI) and its integration into the radiology department. Additionally, we investigated the most common challenges and barriers that radiologists and radiographers face when learning about AI. METHODS A nationwide, online descriptive cross-sectional survey was distributed to radiologists and radiographers working in hospitals and medical centres from May 29, 2023 to July 30, 2023. The questionnaire examined the participants' opinions, feelings, and predictions regarding AI and its applications in the radiology department. Descriptive statistics were used to report the participants' demographics and responses. Five-points Likert-scale data were reported using divergent stacked bar graphs to highlight any central tendencies. RESULTS Responses were collected from 258 participants, revealing a positive attitude towards implementing AI. Both radiologists and radiographers predicted breast imaging would be the subspecialty most impacted by the AI revolution. MRI, mammography, and CT were identified as the primary modalities with significant importance in the field of AI application. The major barrier encountered by radiologists and radiographers when learning about AI was the lack of mentorship, guidance, and support from experts. CONCLUSION Participants demonstrated a positive attitude towards learning about AI and implementing it in the radiology practice. However, radiologists and radiographers encounter several barriers when learning about AI, such as the absence of experienced professionals support and direction. ADVANCES IN KNOWLEDGE Radiologists and radiographers reported several barriers to AI learning, with the most significant being the lack of mentorship and guidance from experts, followed by the lack of funding and investment in new technologies.
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Affiliation(s)
- Badera Al Mohammad
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Afnan Aldaradkeh
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Monther Gharaibeh
- Department of Special Surgery, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan
| | - Warren Reed
- Discipline of Medical Imaging Science, Faculty of Medicine and Health, University of Sydney 2006, Sydney, NSW, Australia
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Winkler S, Herbst B, Kafchitsas K, Wohlmuth P, Hoffstetter P, Rueth MJ. Pre-operative Assessment of Shoulder Pathologies on MRI by a Radiologist and an Orthopaedic Surgeon. Malays Orthop J 2024; 18:42-50. [PMID: 38638663 PMCID: PMC11023335 DOI: 10.5704/moj.2403.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/03/2023] [Indexed: 04/20/2024] Open
Abstract
Introduction Pathologies of the shoulder, i.e. rotator cuff tears and labral injuries are very common. Most patients receive MRI examination prior to surgery. A correct assessment of pathologies is significant for a detailed patient education and planning of surgery. Materials and methods Sixty-nine patients were identified, who underwent both, a standardised shoulder MRI and following arthroscopic shoulder surgery in our hospital. For this retrospective comparative study, the MRIs were pseudonymised and evaluated separately by an orthopaedic surgeon and a radiologist. A third rater evaluated images and reports of shoulder surgery, which served as positive control. Results of all raters were then compared. The aim was an analysis of agreement rates of diagnostic accuracy of preoperative MRI by a radiologist and an orthopaedic surgeon. Results The overall agreement with positive control of detecting transmural cuff tears was high (84% and 89%) and lower for partial tears (70-80%). Subscapularis tears were assessed with moderate rates of agreement (60 - 70%) compared to intra-operative findings. Labral pathologies were detected mostly correctly. SLAP lesions and pulley lesions of the LHB were identified with only moderate agreement (66.4% and 57.2%) and had a high inter-rater disagreement. Conclusion This study demonstrated that tears of the rotator cuff (supraspinatus, infraspinatus) and labral pathologies can be assessed in non-contrast pre-operative shoulder MRI images with a high accuracy. This allows a detailed planning of surgery and aftercare. Pathologies of the subscapularis tendon, SLAP lesions and biceps instabilities are more challenging to detect correctly. There were only small differences between a radiologic and orthopaedic interpretation of the images.
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Affiliation(s)
- S Winkler
- Department of Orthopaedic Surgery, Asklepios Hospital Lindenlohe, Schwandorf, Germany
| | - B Herbst
- Department of Orthopaedic Surgery, Asklepios Hospital Lindenlohe, Schwandorf, Germany
| | - K Kafchitsas
- Department of Orthopaedic Surgery, Asklepios Hospital Lindenlohe, Schwandorf, Germany
| | - P Wohlmuth
- Department of Research, ASKLEPIOS Proresearch, Hamburg, Germany
| | - P Hoffstetter
- Department of Radiology, University of Regensburg, Regensburg, Germany
| | - M J Rueth
- Department Sports Clinic, Sportklinik Fichtelgebirge, Markredwitz, Germany
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Gajiwala P, Eckhardt K, Sheikh A, Abbas K, Davies E, Parker W. Automated MRI Protocolling and Scheduling: A Multi-Institutional Survey and Results. Can Assoc Radiol J 2024; 75:196-199. [PMID: 37211618 DOI: 10.1177/08465371231176550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/23/2023] Open
Affiliation(s)
- Pratik Gajiwala
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Kyle Eckhardt
- Department of Lower Mainland Medical Imaging, Fraser Health, Vancouver, BC, Canada
| | - Adnan Sheikh
- Department of Musculoskeletal Imaging and Intervention, The University of British Columbia, Vancouver, BC, Canada
| | - Khaldon Abbas
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Emily Davies
- Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
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Sipos D, Kövesdi O, Raposa B, Ferkai L, Deutsch K, Pandur A, Kovács Á, Csima MP. Occupational Stress Levels among Radiologists and Radiographers in Hungary during the COVID-19 Era. Healthcare (Basel) 2024; 12:160. [PMID: 38255049 PMCID: PMC10815895 DOI: 10.3390/healthcare12020160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
The COVID-19 pandemic has heightened stress levels, potentially affecting the occupational wellbeing of radiographers and radiologists. Our study aimed to assess occupational stress levels within the radiology department and identify contributing factors. A cross-sectional survey was conducted between September and November 2022, with participants comprising radiographers and radiologists affiliated with the Hungarian Society of Radiographers and the Hungarian Society of Radiologists. The online survey collected socio-demographic and COVID-19 data, and the participants completed an effort-reward imbalance questionnaire. The analysis of 406 responses revealed significantly higher effort-reward imbalance (ERI) levels among the radiologists compared to the radiographers (p < 0.05). The healthcare professionals with over 30 years of experience exhibited significantly lower ERI levels than those with 1-9 years, 10-19 years, or 20-29 years of experience (p < 0.05). Additionally, the individuals aged 31-40 demonstrated higher ERI levels compared to their counterparts aged 19-30, 41-50, and over 51 (p < 0.05). The respondents cohabiting with a spouse/partner reported significantly higher stress levels than their single colleagues (p < 0.05), while the dog owners exhibited significantly lower ERI levels (p < 0.05). Elevated occupational stress highlights specific groups requiring targeted interventions to reduce stress and mitigate burnout among radiologists and radiographers.
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Affiliation(s)
- David Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, “Moritz Kaposi” Teaching Hospital, Guba Sándor Str. 40, 7400 Kaposvár, Hungary
| | - Orsolya Kövesdi
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
| | - Bence Raposa
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Institute of Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pécs, Hungary
| | - Luca Ferkai
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Institute of Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pécs, Hungary
| | - Krisztina Deutsch
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Institute of Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pécs, Hungary
| | - Attila Pandur
- Institute of Pedagogy of Health and Nursing Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pécs, Hungary
| | - Árpád Kovács
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Nagyerdei 98, 4032 Debrecen, Hungary
| | - Melinda Petőné Csima
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Vörösmarty Str. 4, 7621 Pẻcs, Hungary
- Institute of Education, Hungarian University of Agriculture and Life Sciences, Guba Sándor Str. 40, 7400 Kaposvár, Hungary
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Khoshpouri P, Khalili N, Khalili N, Sherbaf FG, Glastonbury CM, Yousem DM. Visa Opportunities for International Medical Graduates Applying for U.S. Academic Radiology Department Faculty Positions: A National Survey. AJR Am J Roentgenol 2024; 222:e2330008. [PMID: 37910038 DOI: 10.2214/ajr.23.30008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
BACKGROUND. International medical graduates (IMGs) are a source of physicians who could help alleviate radiologist workforce shortages in the United States. However, IMGs may face barriers in obtaining appropriate visas (e.g., H-1B or O-1 visas) to allow faculty employment. OBJECTIVE. The purpose of this study was to assess the policies and experiences of U.S. academic radiology departments in offering visas to IMGs applying for faculty positions. METHODS. A web-based survey on policies and experiences in offering visas to IMG faculty candidates was distributed to chairs of U.S. radiology departments with a diagnostic radiology training program recognized by the National Resident Matching Program. Individual survey questions were optional. The initial survey and subsequent reminders were sent from October 7, 2022, through November 7, 2022. RESULTS. The survey response rate was 81% (143/177). A total of 24% (28/115), 38% (44/115), 17% (20/115), and 20% (23/115) of departments offered H-1B visas to IMG faculty frequently, sometimes, rarely, and never, respectively; 3% (3/113), 27% (31/113), 22% (25/113), and 48% (54/113) of departments offered O-1 visas frequently, sometimes, rarely, and never, respectively. However, 41% (46/113) and 5% (6/113) of departments had default policies of offering H-1B and O-1 visas for IMG faculty candidates, respectively. The most common reasons given for why departments did not offer visas included, for both H-1B and O-1 visas, the time-consuming process, lack of reliability of candidates' starting time, and the expense of the visa application; for O-1 visas, the reasons given also included lack of expertise. A total of 15% (16/108) of departments set their own visa policies, 75% (81/108) followed institutional policies, and 10% (11/108) followed policies set by other entities (e.g., state government). CONCLUSION. Although to at least some extent most U.S. academic radiology departments offer H-1B and O-1 visas for IMGs seeking faculty positions, use of such visas typically is not the departments' default policy. A variety of barriers contributed to visas not being offered. The departments' visa policies were primarily determined at the institutional level. CLINICAL IMPACT. The identified barriers faced by U.S. academic radiology departments in offering visas to IMG faculty candidates impact the role of IMGs in helping to address radiologist workforce shortages.
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Affiliation(s)
- Parisa Khoshpouri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD
| | | | - Neda Khalili
- Children's Hospital of Philadelphia, Philadelphia, PA
| | - Farzaneh G Sherbaf
- Department of Radiology, University of California San Diego School of Medicine, La Jolla, CA
| | - Christine M Glastonbury
- Department of Radiology & Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA 94117
| | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, Baltimore, MD
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Xi M, Zheng R, Wang M, Shi X, Chen C, Qian J, Gu X, Zhou J. Ultrasonographic diagnosis of ovarian tumors through the deep convolutional neural network. Ginekol Pol 2023:VM/OJS/J/94956. [PMID: 37842987 DOI: 10.5603/gpl.94956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/03/2023] [Accepted: 08/21/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES The objective of this study was to develop and validate an ovarian tumor ultrasonographic diagnostic model based on deep convolutional neural networks (DCNN) and compare its diagnostic performance with that of human experts. MATERIAL AND METHODS We collected 486 ultrasound images of 192 women with malignant ovarian tumors and 617 ultrasound images of 213 women with benign ovarian tumors, all confirmed by pathological examination. The image dataset was split into a training set and a validation set according to a 7:3 ratio. We selected 5 DCNNs to develop our model: MobileNet, Xception, Inception, ResNet and DenseNet. We compared the performance of the five models through the area under the curve (AUC), sensitivity, specificity, and accuracy. We then randomly selected 200 images from the validation set as the test set. We asked three expert radiologists to diagnose the images to compare the performance of radiologists and the DCNN model. RESULTS In the validation set, AUC of DenseNet was 0.997 while AUC was 0.988 of ResNet, 0.987 of Inception, 0.968 of Xception and 0.836 of MobileNet. In the test set, the accuracy was 0.975 with the DenseNet model versus 0.825 (p < 0.0001) with the radiologists, and sensitivity was 0.975 versus 0.700 (p < 0.0001), and specificity was 0.975 versus 0.908 (p < 0.001). CONCLUSIONS DensNet performed better than other DCNNs and expert radiologists in identifying malignant ovarian tumors from benign ovarian tumors based on ultrasound images, a finding that needs to be further explored in clinical trials.
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Affiliation(s)
- Min Xi
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
| | - Runan Zheng
- Suzhou MicroClear Medical Ltd., Suzhou City, China.
| | - Mingyue Wang
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
| | - Xiu Shi
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
| | - Chaomei Chen
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
| | - Jun Qian
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
| | - Xinxian Gu
- Dushu Lake Hospital Affiliated to Soochow University, Suzhou City, China
| | - Jinhua Zhou
- The First Affiliated Hospital of Soochow University, Suzhou City, China, China
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Darwich A, Nörenberg D, Adam J, Hetjens S, Schilder A, Obertacke U, Gravius S, Jawhar A. A Multi-Disciplinary MRI Assessment May Optimize the Evaluation of Chondral Lesions in Acute Ankle Fractures: A Prospective Study. Diagnostics (Basel) 2023; 13:3220. [PMID: 37892043 PMCID: PMC10605548 DOI: 10.3390/diagnostics13203220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
Chondral lesions (CL) in the ankle following acute fractures are frequently overlooked immediately after the injury or diagnosed at a later stage, leading to persistent symptoms despite successful surgery. The literature presents a wide range of discrepancies in the reported incidence of CLs in acute ankle fractures. The objective of this prospective study is to provide a precise assessment of the occurrence of chondral lesions (CLs) in acute ankle fractures through MRI scans conducted immediately after the trauma and prior to scheduled surgery. Furthermore, the study aims to highlight the disparities in the interpretation of these MRI scans, particularly concerning the size and extent of chondral damage, between radiologists and orthopedic surgeons. Over the period of three years, all patients presenting with an unstable ankle fracture that underwent operative treatment were consecutively included in this single-center prospective study. Preoperative MRIs were obtained for all included patients within 10 days of the trauma and were evaluated by a trauma surgeon and a radiologist specialized in musculoskeletal MRI blinded to each other's results. The location of the lesions was documented, as well as their size and ICRS classification. Correlations and kappa coefficients as well as the p-values were calculated. A total of 65 patients were included, with a mean age of 41 years. The evaluation of the orthopedic surgeon showed CLs in 52.3% of patients. CLs occurred mainly on the tibial articular surface (70.6%). Most talar lesions were located laterally (11.2%). The observed CLs were mainly ICRS grade 4. According to the radiologist, 69.2% of the patients presented with CLs. The most common location was the talar dome (48.9%), especially laterally. Most detected CLs were graded ICRS 3a. The correlation between the two observers was weak/fair regarding the detection and classification of CLs and moderate regarding the size of the detected CLs. To enhance the planning of surgical treatment for ankle chondral lesions (CLs), it may be beneficial to conduct an interdisciplinary preoperative assessment of the performed scans. This collaborative approach can optimize the evaluation of ankle CLs and improve overall treatment strategies.
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Affiliation(s)
- Ali Darwich
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
| | - Dominik Nörenberg
- Department of Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany;
| | - Julia Adam
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
| | - Svetlana Hetjens
- Institute of Medical Statistics and Biomathematics, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany;
| | - Andreas Schilder
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
| | - Udo Obertacke
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
| | - Sascha Gravius
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
| | - Ahmed Jawhar
- Department of Orthopedic and Trauma Surgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167 Mannheim, Germany; (J.A.); (A.S.); (U.O.); (S.G.); (A.J.)
- Department of Orthopedics, Traumatology and Sports Medicine, Marienhaus Hospital Hetzelstift/Teaching Hospital University Mainz, Stiftstraße 10, 67434 Neustadt an der Weinstraße, Germany
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Güldoğan N, Ulus S, Kovan Ö, Aksan A, Tokmakçıoğlu K, Camgöz Akdağ H, Yılmaz E, Türk EB, Arıbal E. Evaluating Efficiency of Time Use and Operational Costs in a Breast Clinic Workflow: A Comparative Analysis Between Automated Breast Ultrasound and Handheld Ultrasound. Eur J Breast Health 2023; 19:311-317. [PMID: 37795005 PMCID: PMC10546795 DOI: 10.4274/ejbh.galenos.2023.2023-8-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/02/2023] [Indexed: 10/06/2023]
Abstract
Objective The aim of this study was to evaluate efficiency of time use for radiologists and operational costs of automated breast ultrasound (ABUS) versus handheld breast ultrasound (HHUS). Materials and Methods This study was approved by the Institutional Review Board, and informed consent was waived. One hundred and fifty-three patients, aged 21-81 years, underwent both ABUS and HHUS. The time required for the ABUS scanning and radiologist interpretation and the combined scanning and interpretation time for HHUS were recorded for screening and diagnostic exams. One-Way ANOVA test was used to compare the methods, and Cohen Kappa statistics were used to achieve the agreement levels. Finally, the cost of the methods and return of interest were compared by completing a cost analysis. Results The overall mean ± standard deviation examination time required for ABUS examination was 676.2±145.42 seconds while mean scan time performed by radiographers was 411.76±67.79 seconds, and the mean radiologist time was 234.01±81.88 seconds. The overall mean examination time required for HHUS was 452.52±171.26 seconds, and the mean scan time and radiologist time were 419.62±143.24 seconds. The reduced time translated into savings of 7.369 TL/month, and savings of 22% in operational costs was achieved with ABUS. Conclusion The radiologist's time was reduced with ABUS in both screening and diagnostic scenarios. Although a second-look HHUS is required for diagnostic cases, ABUS still saves radiologists time by enabling a focused approach instead of a complete evaluation of both breasts. Thus, ABUS appears to save both medical staff time and operational costs.
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Affiliation(s)
- Nilgün Güldoğan
- Clinic of Breast Health, Acıbadem Altunizade Hospital, İstanbul, Turkey
| | - Sıla Ulus
- Clinic of Radiology, Acıbadem Ataşehir Hospital, İstanbul, Turkey
| | - Özge Kovan
- Medical Imaging Techniques Program, Acıbadem Mehmet Ali Aydinlar University Vocational School of Health Services, İstanbul, Turkey
| | - Aslıgül Aksan
- Department of Management Engineering, İstanbul Technical University Faculty of Management, İstanbul, Turkey
| | - Kaya Tokmakçıoğlu
- Department of Management Engineering, İstanbul Technical University Faculty of Management, İstanbul, Turkey
| | - Hatice Camgöz Akdağ
- Department of Management Engineering, İstanbul Technical University Faculty of Management, İstanbul, Turkey
| | - Ebru Yılmaz
- Clinic of Breast Health, Acıbadem Altunizade Hospital, İstanbul, Turkey
| | - Ebru Banu Türk
- Clinic of Breast Health, Acıbadem Altunizade Hospital, İstanbul, Turkey
| | - Erkin Arıbal
- Clinic of Breast Health, Acıbadem Altunizade Hospital, İstanbul, Turkey
- Department of Radiology, Acıbadem Mehmet Ali Aydınlar University Faculty of Medicine, İstanbul, Turkey
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11
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Eltawil FA, Atalla M, Boulos E, Amirabadi A, Tyrrell PN. Analyzing Barriers and Enablers for the Acceptance of Artificial Intelligence Innovations into Radiology Practice: A Scoping Review. Tomography 2023; 9:1443-1455. [PMID: 37624108 PMCID: PMC10459931 DOI: 10.3390/tomography9040115] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES This scoping review was conducted to determine the barriers and enablers associated with the acceptance of artificial intelligence/machine learning (AI/ML)-enabled innovations into radiology practice from a physician's perspective. METHODS A systematic search was performed using Ovid Medline and Embase. Keywords were used to generate refined queries with the inclusion of computer-aided diagnosis, artificial intelligence, and barriers and enablers. Three reviewers assessed the articles, with a fourth reviewer used for disagreements. The risk of bias was mitigated by including both quantitative and qualitative studies. RESULTS An electronic search from January 2000 to 2023 identified 513 studies. Twelve articles were found to fulfill the inclusion criteria: qualitative studies (n = 4), survey studies (n = 7), and randomized controlled trials (RCT) (n = 1). Among the most common barriers to AI implementation into radiology practice were radiologists' lack of acceptance and trust in AI innovations; a lack of awareness, knowledge, and familiarity with the technology; and perceived threat to the professional autonomy of radiologists. The most important identified AI implementation enablers were high expectations of AI's potential added value; the potential to decrease errors in diagnosis; the potential to increase efficiency when reaching a diagnosis; and the potential to improve the quality of patient care. CONCLUSIONS This scoping review found that few studies have been designed specifically to identify barriers and enablers to the acceptance of AI in radiology practice. The majority of studies have assessed the perception of AI replacing radiologists, rather than other barriers or enablers in the adoption of AI. To comprehensively evaluate the potential advantages and disadvantages of integrating AI innovations into radiology practice, gathering more robust research evidence on stakeholder perspectives and attitudes is essential.
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Affiliation(s)
- Fatma A. Eltawil
- Department of Medical Imaging, University of Toronto, Toronto, ON M5S 1A1, Canada; (F.A.E.); (M.A.); (E.B.)
| | - Michael Atalla
- Department of Medical Imaging, University of Toronto, Toronto, ON M5S 1A1, Canada; (F.A.E.); (M.A.); (E.B.)
| | - Emily Boulos
- Department of Medical Imaging, University of Toronto, Toronto, ON M5S 1A1, Canada; (F.A.E.); (M.A.); (E.B.)
| | - Afsaneh Amirabadi
- Diagnostic Imaging Department, The Hospital for Sick Children, Toronto, ON M5G 1E8, Canada;
| | - Pascal N. Tyrrell
- Department of Medical Imaging, University of Toronto, Toronto, ON M5S 1A1, Canada; (F.A.E.); (M.A.); (E.B.)
- Department of Statistical Sciences, University of Toronto, Toronto, ON M5G 1Z5, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
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12
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Wang H, Yao R, Zhang X, Chen C, Wu J, Dong M, Jin C. Corrigendum: Visual expertise modulates resting-state brain network dynamics in radiologists: a degree centrality analysis. Front Neurosci 2023; 17:1241073. [PMID: 37483348 PMCID: PMC10361561 DOI: 10.3389/fnins.2023.1241073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fnins.2023.1152619.].
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Affiliation(s)
- Hongmei Wang
- Department of Radiology, First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, China
- Department of Medical Imaging, Inner Mongolia People's Hospital, Hohhot, China
| | - Renhuan Yao
- Department of Nuclear Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Xiaoyan Zhang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Chao Chen
- PLA Funding Payment Center, Beijing, China
| | - Jia Wu
- School of Foreign Languages, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
- Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Chenwang Jin
- Department of Radiology, First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, China
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13
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Wang H, Yao R, Zhang X, Chen C, Wu J, Dong M, Jin C. Visual expertise modulates resting-state brain network dynamics in radiologists: a degree centrality analysis. Front Neurosci 2023; 17:1152619. [PMID: 37266545 PMCID: PMC10229894 DOI: 10.3389/fnins.2023.1152619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 04/26/2023] [Indexed: 06/03/2023] Open
Abstract
Visual expertise reflects accumulated experience in reviewing domain-specific images and has been shown to modulate brain function in task-specific functional magnetic resonance imaging studies. However, little is known about how visual experience modulates resting-state brain network dynamics. To explore this, we recruited 22 radiology interns and 22 matched healthy controls and used resting-state functional magnetic resonance imaging (rs-fMRI) and the degree centrality (DC) method to investigate changes in brain network dynamics. Our results revealed significant differences in DC between the RI and control group in brain regions associated with visual processing, decision making, memory, attention control, and working memory. Using a recursive feature elimination-support vector machine algorithm, we achieved a classification accuracy of 88.64%. Our findings suggest that visual experience modulates resting-state brain network dynamics in radiologists and provide new insights into the neural mechanisms of visual expertise.
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Affiliation(s)
- Hongmei Wang
- Department of Radiology, First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, China
- Department of Medical Imaging, Inner Mongolia People's Hospital, Hohhot, China
| | - Renhuan Yao
- Department of Nuclear Medicine, Inner Mongolia People's Hospital, Hohhot, China
| | - Xiaoyan Zhang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Chao Chen
- PLA Funding Payment Center, Beijing, China
| | - Jia Wu
- School of Foreign Languages, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
- Xi'an Key Laboratory of Intelligent Sensing and Regulation of Trans-Scale Life Information, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Chenwang Jin
- Department of Radiology, First Affiliated Hospital of Xi'an, Jiaotong University, Xi'an, China
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14
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Parikh JR. Innovative Approaches to Address Burnout in Radiology. J Am Coll Radiol 2023; 20:477-478. [PMID: 36934888 PMCID: PMC10167699 DOI: 10.1016/j.jacr.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023]
Affiliation(s)
- Jay R Parikh
- Professor, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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15
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Liu DS, Abu-Shaban K, Halabi SS, Cook TS. Changes in Radiology Due to Artificial Intelligence That Can Attract Medical Students to the Specialty. JMIR Med Educ 2023; 9:e43415. [PMID: 36939823 PMCID: PMC10131993 DOI: 10.2196/43415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 02/19/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
The role of artificial intelligence (AI) in radiology has grown exponentially in the recent years. One of the primary worries by medical students is that AI will cause the roles of a radiologist to become automated and thus obsolete. Therefore, there is a greater hesitancy by medical students to choose radiology as a specialty. However, it is in this time of change that the specialty needs new thinkers and leaders. In this succinct viewpoint, 2 medical students involved in AI and 2 radiologists specializing in AI or clinical informatics posit that not only are these fears false, but the field of radiology will be transformed in such a way due to AI that there will be novel reasons to choose radiology. These new factors include greater impact on patient care, new space for innovation, interdisciplinary collaboration, increased patient contact, becoming master diagnosticians, and greater opportunity for global health initiatives, among others. Finally, since medical students view mentorship as a critical resource when deciding their career path, medical educators must also be cognizant of these changes and not give much credence to the prevalent fearmongering. As the field and practice of radiology continue to undergo significant change due to AI, it is urgent and necessary for the conversation to expand from expert to expert to expert to student. Medical students should be encouraged to choose radiology specifically because of the changes brought on by AI rather than being deterred by it.
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Affiliation(s)
- David Shalom Liu
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Kamil Abu-Shaban
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Safwan S Halabi
- Department of Medical Imaging, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Tessa Sundaram Cook
- Department of Radiology, Hospital of the University of Pennsylvania, Pennsylvania, PA, United States
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16
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Abstract
Background. Immersive virtual reality (iVR) facilitates surgical decision-making by enabling surgeons to interact with complex anatomic structures in realistic 3-dimensional environments. With emerging interest in its applications, its effects on patients and providers should be clarified. This systematic review examines the current literature on iVR for patient-specific preoperative planning. Materials and Methods. A literature search was performed on five databases for publications from January 1, 2000 through March 21, 2021. Primary studies on the use of iVR simulators by surgeons at any level of training for patient-specific preoperative planning were eligible. Two reviewers independently screened titles, abstracts, and full texts, extracted data, and assessed quality using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD). Results were qualitatively synthesized, and descriptive statistics were calculated. Results. The systematic search yielded 2,555 studies in total, with 24 full-texts subsequently included for qualitative synthesis, representing 264 medical personnel and 460 patients. Neurosurgery was the most frequently represented discipline (10/24; 42%). Preoperative iVR did not significantly improve patient-specific outcomes of operative time, blood loss, complications, and length of stay, but may decrease fluoroscopy time. In contrast, iVR improved surgeon-specific outcomes of surgical strategy, anatomy visualization, and confidence. Validity, reliability, and feasibility of patient-specific iVR models were assessed. The mean QATSDD score of included studies was 32.9%. Conclusions. Immersive VR improves surgeon experiences of preoperative planning, with minimal evidence for impact on short-term patient outcomes. Future work should focus on high-quality studies investigating long-term patient outcomes, and utility of preoperative iVR for trainees.
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Affiliation(s)
- Lucy Lan
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada,Lucy Lan, Michael G. DeGroote School of
Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8N 3Z5,
Canada.
| | - Randi Q. Mao
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada
| | - Reva Y. Qiu
- Michael G. DeGroote School of
Medicine, McMaster University, Hamilton, ON, Canada
| | - Jeffrey Kay
- Division of Orthopaedic Surgery,
Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Darren de Sa
- Division of Orthopaedic Surgery,
Department of Surgery, McMaster University, Hamilton, ON, Canada
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17
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Vasilenok AV, Buyanova NM, Maryasheva SV. [The comparative analysis of professional standards of specialists with higher and secondary medical professional education]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2022; 30:1345-1350. [PMID: 36541320 DOI: 10.32687/0869-866x-2022-30-6-1345-1350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Indexed: 06/17/2023]
Abstract
In 2020, the Mintrud of Russia approved a number of professional standards for specialists with secondary professional medical education. The implementation of professional standards is called to actualize outdated normative base concerning functions of medical workers, including assurance of separation of labor functions and actions of physicians and medical nurses, facilitation of development of job descriptions, and minimizing number of conflicts that occur during process of work activities at personnel functions crossing. The medical organization, focusing on requirements established by professional standards, can more competently develop personnel policy, make timely changes in staff list, establish progressive remuneration system. In this regard, it is useful to learn to what extent approved professional standards facilitate solution of practical problems of medical organizations.The article presents results of comparative analysis of three pairs of professional standards for paramedical personnel and specialists with higher education in comparable specialties. Certain contradictions and inaccuracies were esnablished too.
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Affiliation(s)
- A V Vasilenok
- The Federal State Budget Professional Educational Institution "The Medical College"
- The Federal State Budget Educational Institution of Higher Education "N. I. Pirogov Russian National Research Medical University" of Minzdrav of Russia
| | - N M Buyanova
- The Federal State Budget Professional Educational Institution "The Medical College"
- The Federal State Budget Educational Institution of Higher Education "N. I. Pirogov Russian National Research Medical University" of Minzdrav of Russia
| | - S V Maryasheva
- The Federal State Budget Professional Educational Institution "The Medical College"
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18
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Issa PP, Mueller L, Hussein M, Albuck A, Shama M, Toraih E, Kandil E. Radiologist versus Non-Radiologist Detection of Lymph Node Metastasis in Papillary Thyroid Carcinoma by Ultrasound: A Meta-Analysis. Biomedicines 2022; 10:biomedicines10102575. [PMID: 36289838 PMCID: PMC9599420 DOI: 10.3390/biomedicines10102575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common thyroid cancer worldwide and is known to spread to adjacent neck lymphatics. Lymph node metastasis (LNM) is a known predictor of disease recurrence and is an indicator for aggressive resection. Our study aims to determine if ultrasound sonographers’ degree of training influences overall LNM detection. PubMed, Embase, and Scopus articles were searched and screened for relevant articles. Two investigators independently screened and extracted the data. Diagnostic test parameters were determined for all studies, studies reported by radiologists, and studies reported by non-radiologists. The total sample size amounted to 5768 patients and 10,030 lymph nodes. Radiologists performed ultrasounds in 18 studies, while non-radiologists performed ultrasounds in seven studies, corresponding to 4442 and 1326 patients, respectively. The overall sensitivity of LNM detection by US was 59% (95%CI = 58–60%), and the overall specificity was 85% (95%CI = 84–86%). The sensitivity and specificity of US performed by radiologists were 58% and 86%, respectively. The sensitivity and specificity of US performed by non-radiologists were 62% and 78%, respectively. Summary receiver operating curve (sROC) found radiologists and non-radiologists to detect LNM on US with similar accuracy (p = 0.517). Our work suggests that both radiologists and non-radiologists alike detect overall LNM with high accuracy on US.
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Affiliation(s)
- Peter P. Issa
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Lauren Mueller
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Mohammad Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Aaron Albuck
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Mohamed Shama
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Eman Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Emad Kandil
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Correspondence: ; Tel.: +1-504-988-7407; Fax: +1-504-988-4762
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19
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Warman R, Warman A, Warman P, Degnan A, Blickman J, Chowdhary V, Dash D, Sangal R, Vadhan J, Bueso T, Windisch T, Neves G. Deep Learning System Boosts Radiologist Detection of Intracranial Hemorrhage. Cureus 2022; 14:e30264. [PMID: 36381767 PMCID: PMC9653089 DOI: 10.7759/cureus.30264] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Intracranial hemorrhage (ICH) requires emergent medical treatment for positive outcomes. While previous artificial intelligence (AI) solutions achieved rapid diagnostics, none were shown to improve the performance of radiologists in detecting ICHs. Here, we show that the Caire ICH artificial intelligence system enhances a radiologist's ICH diagnosis performance. METHODS A dataset of non-contrast-enhanced axial cranial computed tomography (CT) scans (n=532) were labeled for the presence or absence of an ICH. If an ICH was detected, its ICH subtype was identified. After a washout period, the three radiologists reviewed the same dataset with the assistance of the Caire ICH system. Performance was measured with respect to reader agreement, accuracy, sensitivity, and specificity when compared to the ground truth, defined as reader consensus. RESULTS Caire ICH improved the inter-reader agreement on average by 5.76% in a dataset with an ICH prevalence of 74.3%. Further, radiologists using Caire ICH detected an average of 18 more ICHs and significantly increased their accuracy by 6.15%, their sensitivity by 4.6%, and their specificity by 10.62%. The Caire ICH system also improved the radiologist's ability to accurately identify the ICH subtypes present. CONCLUSION The Caire ICH device significantly improves the performance of a cohort of radiologists. Such a device has the potential to be a tool that can improve patient outcomes and reduce misdiagnosis of ICH.
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Affiliation(s)
| | | | | | - Andrew Degnan
- Radiology, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, Pittsburgh, USA
| | | | | | - Dev Dash
- Emergency Medicine, Stanford University, Stanford, USA
| | - Rohit Sangal
- Emergency Medicine, Yale School of Medicine, New Haven, USA
| | - Jason Vadhan
- Emergency Medicine, The University of Texas Southwestern (UTSW), Dallas, USA
| | - Tulio Bueso
- Neurology, The Texas Tech University Health Sciences Center (TTUHSC), Lubbock, USA
| | | | - Gabriel Neves
- Neurology, The Texas Tech University Health Sciences Center (TTUHSC), Lubbock, USA
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20
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Horowitz JM, Choe MJ, Dienes K, Cameron KA, Agarwal G, Yaghmai V, Carr JC. Team Approach to Improving Radiologist Wellness: A Case-Based Methodology. Curr Probl Diagn Radiol 2022; 51:806-812. [PMID: 35365374 PMCID: PMC9356970 DOI: 10.1067/j.cpradiol.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 02/08/2022] [Accepted: 02/27/2022] [Indexed: 09/03/2023]
Abstract
Radiologist wellness is important on an individual and group/institutional level and helps to promote a strong and healthy working environment, which can improve radiologist retention and engagement. This paper will discuss case examples of radiologist wellness improvements in a single academic institution over a 3-year period using the DMAIC (Define, Measure, Analyze, Improve, and Control) model. Leveraging this framework led to the implementation of reading room assistants, reduction in work-related injuries by improvements in ergonomics, and the formation of a faculty mentorship program.
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Affiliation(s)
- Jeanne M Horowitz
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Michael J Choe
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Katelyn Dienes
- Director, Project Management Office, Northwestern Memorial Health Care, Chicago, IL
| | - Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics / Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Gaurava Agarwal
- Department of Psychiatry, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Vahid Yaghmai
- Department of Radiological Sciences, University of California, Irvine, UCI Health, Dept of Radiology, University of California Irvine, Orange, CA
| | - James C Carr
- Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Wong GJ, Das S, Sheth SA. Securing a Training Position as an Interventional Neurologist: How to Overcome the Barriers. Stroke 2022; 53:e158-e161. [PMID: 35240859 DOI: 10.1161/strokeaha.121.036311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Gregory J Wong
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA (G.J.W.)
| | - Saurav Das
- Department of Neurology, University of Kentucky College of Medicine, Lexington (S.D.)
| | - Sunil A Sheth
- UTHealth McGovern Medical School, Department of Neurology, Houston, TX (S.A.S.)
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22
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Burnett-Hartman AN, Carroll NM, Honda SA, Joyce C, Mitra N, Neslund-Dudas C, Olaiya O, Rendle KA, Schnall MD, Vachani A, Ritzwoller DP. Community-based Lung Cancer Screening Results in Relation to Patient and Radiologist Characteristics: The PROSPR Consortium. Ann Am Thorac Soc 2022; 19:433-41. [PMID: 34543590 DOI: 10.1513/AnnalsATS.202011-1413OC] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Rationale: Lung-RADS classification was developed to standardize reporting and management of lung cancer screening using low-dose computed tomographic (LDCT) imaging. Although variation in Lung-RADS distribution between healthcare systems has been reported, it is unclear if this is explained by patient characteristics, radiologist experience with lung cancer screening, or other factors. Objectives: Our objective was to determine if patient or radiologist factors are associated with Lung-RADS score. Methods: In the Population-based Research to Optimize the Screening Process (PROSPR) Lung consortium, we conducted a study of patients who received their first screening LDCT imaging at one of the five healthcare systems in the PROSPR Lung Research Center from May 1, 2014, through December 31, 2017. Data on LDCT scans, patient factors, and radiologist characteristics were obtained via electronic health records. LDCT scan findings were categorized using Lung-RADS (negative [1], benign [2], probably benign [3], or suspicious [4]). We used generalized estimating equations with a multinomial distribution to compare the odds of Lung-RADS 3, and separately Lung-RADS 4, versus Lung-RADS 1 or 2 and estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between Lung-RADS assignment and patient and radiologist characteristics. Results: Analyses included 8,556 patients; 24% were assigned Lung-RADS 1, 60% Lung-RADS 2, 10% Lung-RADS 3, and 5% Lung-RADS 4. Age was positively associated with Lung-RADS 3 (OR, 1.02; 95% CI, 1.01-1.03) and 4 (OR, 1.03; 95% CI, 1.01-1.05); chronic obstructive pulmonary disease (COPD) was positively associated with Lung-RADS 4 (OR, 1.78; 95% CI, 1.45-2.20); obesity was inversely associated with Lung-RADS 3 (OR, 0.70; 95% CI, 0.58-0.84) and 4 (OR, 0.58; 95% CI, 0.45-0.75). There was no association between sex, race, ethnicity, education, or smoking status and Lung-RADS assignment. Radiologist volume of interpreting screening LDCT scans, years in practice, and thoracic specialty were also not associated with Lung-RADS assignment. Conclusions: Healthcare systems that are comprised of patients with an older age distribution or higher levels of COPD will have a greater proportion of screening LDCT scans with Lung-RADS 3 or 4 findings and should plan for additional resources to support appropriate and timely management of noted positive findings.
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Srirambhatla A, Arora AJ. COVID-19 Pandemic: An Indian radiologist' perspective. Indian J Public Health 2022; 66:74-76. [PMID: 35381721 DOI: 10.4103/ijph.ijph_1448_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
During the COVID-19 pandemic, differences in health-care system and policies among countries worldwide meant that each country had to come up with their own strategies for containment, diagnosis, and treatment of the disease - "no one size fits all." India being the second populous country in the world with modern and traditional systems of health care has its own challenges to face during the pandemic. Among the increased cacophony of information regarding the COVID-19 disease and controversies surrounding the usage of various radiological modalities for its diagnosis, we are trying to present a sane perspective from an Indian radiologist viewpoint. Knowing the strengths and shortcomings of the Indian health-care system, we have suggested plausible solutions which may be the answers to the issues raised by the Indian media.
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Affiliation(s)
- Annapurna Srirambhatla
- Associate Professor, Department of Radio Diagnosis, All India Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Abhishek J Arora
- Additional Professor, Department of Radio Diagnosis, All India Institute of Medical Sciences, Hyderabad, Telangana, India
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24
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Gowda V, Jordan SG, Oliveira A, Cook TS, Enarson C. Support From Within: Coaching to Enhance Radiologist Well-Being and Practice. Acad Radiol 2021; 29:1255-1258. [PMID: 34924280 PMCID: PMC9272464 DOI: 10.1016/j.acra.2021.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 11/08/2021] [Accepted: 11/18/2021] [Indexed: 01/13/2023]
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Li T, Gandomkar Z, Trieu PDY, Lewis SJ, Brennan PC. Differences in lesion interpretation between radiologists in two countries: Lessons from a digital breast tomosynthesis training test set. Asia Pac J Clin Oncol 2021; 18:441-447. [PMID: 34811880 DOI: 10.1111/ajco.13686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In many western countries, there is good evidence documenting the performance of radiologists reading digital breast tomosynthesis (DBT) images. However, the diagnostic efficiency of Chinese radiologists using DBT, particularly type of errors being made and type of cancers being missed, is understudied. This study aims to investigate the pattern of diagnostic errors across different lesion types produced by Chinese radiologists diagnosing from DBT images. Australian radiologists will be used as a benchmark. METHODS Twelve Chinese radiologists read a DBT test set and located each perceived cancer lesion. True positives, false positives (FP), true negatives and false negatives (FN) were generated. The same test set was also read by 14 Australian radiologists. Z-scores and Pearson correlations were used to compare interpretation of lesions and identification of normal appearances between two groups of radiologists. RESULTS Architectural distortions (p < .001) and stellate masses (p = .02) were more difficult for Chinese radiologists to correctly diagnose compared to their Australian counterparts. Chinese readers categorised more FPs as discrete masses (p < .001) and fewer FPs as architectural distortions (p < .001) comparing with Australian radiologists. The percentages of FN for each cancer case were not correlated (r = 0.37, p = .18) but the percentages of FP for each normal case were moderately correlated (r = 0.52, p = .02) between two groups of readers. CONCLUSIONS Architectural distortions and stellate masses were challenging to Chinese radiologists when reading DBT. Our findings proposed the need of development of training and education programs focussing on imaging cases tailored for specific groups of readers with certain interpretation patterns.
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Affiliation(s)
- Tong Li
- BreastScreen Reader Assessment Strategy, Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Ziba Gandomkar
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Phuong Dung Yun Trieu
- BreastScreen Reader Assessment Strategy, Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Sarah J Lewis
- BreastScreen Reader Assessment Strategy, Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Patrick C Brennan
- Medical Imaging Science, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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26
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Walker MJ, Hartman K, Majpruz V, Leung YW, Fienberg S, Rabeneck L, Chiarelli AM. The Impact of Radiologist Screening Mammogram Reading Volume on Performance in the Ontario Breast Screening Program. Can Assoc Radiol J 2021; 73:362-370. [PMID: 34423685 DOI: 10.1177/08465371211031186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Although some studies have shown increasing radiologists' mammography volumes improves performance, there is a lack of evidence specific to digital mammography and breast screening program performance targets. This study evaluates the relationship between digital screening volume and meeting performance targets. METHODS This retrospective cohort study included 493 radiologists in the Ontario Breast Screening Program who interpreted 1,762,173 screening mammograms in participants ages 50-90 between 2014 and 2016. Associations between annual screening volume and meeting performance targets for abnormal call rate, positive predictive value (PPV), invasive cancer detection rate (CDR), sensitivity, and specificity were modeled using mixed-effects multivariate logistic regression. RESULTS Most radiologists read 500-999 (36.7%) or 1,000-1,999 (31.0%) screens annually, and 18.5% read ≥2,000. Radiologists who read ≥2,000 annually were more likely to meet abnormal call rate (OR = 3.85; 95% CI: 1.17-12.61), PPV (OR = 5.36; 95% CI: 2.53-11.34), invasive CDR (OR = 4.14; 95% CI: 1.50-11.46), and specificity (OR = 4.07; 95% CI: 1.89-8.79) targets versus those who read 100-499 screens. Radiologists reading 1,000-1,999 screens annually were more likely to meet PPV (OR = 2.32; 95% CI: 1.22-4.40), invasive CDR (OR = 3.36; 95% CI: 1.49-7.59) and specificity (OR = 2.00; 95% CI: 1.04-3.84) targets versus those who read 100-499 screens. No significant differences were observed for sensitivity. CONCLUSIONS Annual reading volume requirements of 1,000 in Canada are supported as screening volume above 1,000 was strongly associated with achieving performance targets for nearly all measures. Increasing the minimum volume to 2,000 may further reduce the potential limitations of screening due to false positives, leading to improvements in overall breast screening program quality.
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Affiliation(s)
- Meghan J Walker
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Krystal Hartman
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Vicky Majpruz
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Yvonne W Leung
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada
| | - Samantha Fienberg
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.,Radiology, McMaster University, Hamilton, Ontario, Canada.,Medical Imaging, Grand River Hospital, Kitchener, Ontario, Canada
| | - Linda Rabeneck
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada.,IC/ES, Toronto, Ontario, Canada
| | - Anna M Chiarelli
- Prevention and Cancer Control, 573450Ontario Health (Cancer Care Ontario), Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Abstract
The 2018 Annual Workforce Survey conducted by the ACR Commission on Human Resources demonstrated that, although the majority of radiology practice leaders acknowledge radiologist burnout as a significant problem, only about one in five leaders responded that their practices were either extremely or very effective at addressing physician burnout. Moving forward, leaders will be increasingly held accountable and expected to describe to their teams their reasons for not addressing burnout. In this article, common misperceptions that may contribute to radiology practice leaders not addressing burnout are described, followed by outlining practical skills that leaders should develop to effectively address burnout.
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Affiliation(s)
- Jay R Parikh
- Professor of Radiology, Division Wellness Lead, Division of Diagnostic Imaging, The University MD Anderson Cancer Center, Houston, Texas.
| | - Claire E Bender
- Professor, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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28
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Cozens NJA. A radiologist's perspective of the value of ultrasound-guided fine needle aspiration cytology in the assessment of head and neck lesions. Cytopathology 2021; 32:394-396. [PMID: 34046968 DOI: 10.1111/cyt.12991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/10/2021] [Accepted: 04/18/2021] [Indexed: 11/29/2022]
Abstract
This viewpoint presents a radiologist's perspective of the value that can be added by close collaboration and teamwork with cytopathologist colleagues to maximise specimen quality, adequacy, and patient outcomes. Various models are discussed and service evolution through teamwork emphasised. The importance of utilising ultrasound guidance for fine needle aspiration in head and neck lesions and critical appraisal of the literature are reviewed.
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29
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Liu YQ, Yuan WF, Liu XY, Zhao XX. Floral-like enhancement might reflect an active liver tuberculous lesion to avoid systemic hematogenous dissemination by surgery: A case report. J Int Med Res 2021; 48:300060520940158. [PMID: 32686532 PMCID: PMC7372627 DOI: 10.1177/0300060520940158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
After primary dissemination of Mycobacterium tuberculosis bacillus
infection that is localized in liver, disease progression and changes to immune function
in the body occur. Various forms of tuberculosis, including granuloma, caseous necrosis,
liquefactive necrosis, fibrosis, and calcification, occur that could be presented at
different stages, and imaging examination shows findings that are consistent with these
stages. Not all liver tuberculosis patients are suitable for liver resection, and
preoperative imaging examination and pathological immunohistochemical results could be
used to determine whether tuberculosis was active, avoid unnecessary liver resection, and
prevent the postoperative spread of tuberculosis. Here, we reported a case of miliary
tuberculosis, pelvic tuberculosis, and tuberculous abscess of the thigh muscle in a
51-year-old man after liver lesion resection. The liver lesion was confirmed to be
tuberculosis by surgical pathology, which is rare and has not been previously reported.
The purpose of this case report is to remind radiologists of the importance of the
floral-like enhancement and to estimate whether liver tuberculosis is active. This will
help to guide clinicians to determine the timing of surgery, avoid unnecessary liver
resection, and avoid hematogenous transmission.
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Affiliation(s)
- Yong-Qian Liu
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wei-Feng Yuan
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Xin-Yi Liu
- Department of Radiology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Xin-Xiang Zhao
- Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Ghobadi K, Hager G, Krieger A, Levin S, Unberath M. Responding to a Pandemic: COVID-19 Projects in the Malone Center. Surg Innov 2021; 28:208-213. [PMID: 33980097 PMCID: PMC8685579 DOI: 10.1177/15533506211018446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As the scope and scale of the COVID-19 pandemic became clear in early March of 2020, the faculty of the Malone Center engaged in several projects aimed at addressing both immediate and long-term implications of COVID-19. In this article, we briefly outline the processes that we engaged in to identify areas of need, the projects that emerged, and the results of those projects. As we write, some of these projects have reached a natural termination point, whereas others continue. We identify some of the factors that led to projects that moved to implementation, as well as factors that led projects to fail to progress or to be abandoned.
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Affiliation(s)
- Kimia Ghobadi
- Malone Center for Engineering in Healthcare, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Greg Hager
- Malone Center for Engineering in Healthcare, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Axel Krieger
- Malone Center for Engineering in Healthcare, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Scott Levin
- Malone Center for Engineering in Healthcare, 1466Johns Hopkins University, Baltimore, MD, USA
| | - Mathias Unberath
- Malone Center for Engineering in Healthcare, 1466Johns Hopkins University, Baltimore, MD, USA
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31
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Mohamed Ali AM, El-Alali E, Weltz AS, Rehrig ST. Thoracic Point-of-Care Ultrasound: A SARS-CoV-2 Data Repository for Future Artificial Intelligence and Machine Learning. Surg Innov 2021; 28:214-219. [PMID: 33960853 DOI: 10.1177/15533506211018671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Current experience suggests that artificial intelligence (AI) and machine learning (ML) may be useful in the management of hospitalized patients, including those with COVID-19. In light of the challenges faced with diagnostic and prognostic indicators in SARS-CoV-2 infection, our center has developed an international clinical protocol to collect standardized thoracic point of care ultrasound data in these patients for later AI/ML modeling. We surmise that in the future AI/ML may assist in the management of SARS-CoV-2 patients potentially leading to improved outcomes, and to that end, a corpus of curated ultrasound images and linked patient clinical metadata is an invaluable research resource.
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Affiliation(s)
| | - Emran El-Alali
- Department of Internal Medicine, 1267Anne Arundel Medical Center, Annapolis, MD, USA
| | - Adam S Weltz
- Department of Surgery, 1267Anne Arundel Medical Center, Annapolis, MD, USA
| | - Scott T Rehrig
- Department of Surgery, 1267Anne Arundel Medical Center, Annapolis, MD, USA
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32
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Abstract
Lung cancer is still the deadliest cancer in men and women worldwide. This high mortality is related to diagnosis in advanced stages, when curative treatment is no longer an option. Large randomized controlled trials have shown that lung cancer screening (LCS) with low-dose computed tomography (CT) can detect lung cancers at earlier stages and reduce lung cancer-specific mortality. The recent publication of the significant reduction of cancer-related mortality by 26% in the Dutch-Belgian NELSON LCS trial has increased the likelihood that implementation of LCS in Europe will move forward. Radiologists are important stakeholders in numerous aspects of the LCS pathway. Their role goes beyond nodule detection and nodule management. Being part of a multidisciplinary team, radiologists are key players in numerous aspects of implementation of a high quality LCS program. In this non-systematic review we discuss the multifaceted role of radiologists in LCS.
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Affiliation(s)
- Annemiek Snoeckx
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Caro Franck
- Department of Radiology, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - Mario Silva
- Scienze Radiologiche, Department of Medicine and Surgery (DiMeC), University of Parma, Parma, Italy
| | - Mathias Prokop
- Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Marie-Pierre Revel
- Department of Radiology, Cochin Hospital, APHP Centre, Université de Paris, Paris, France
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33
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Parikh JR, Sun J, Mainiero MB. What Causes the Most Stress in Breast Radiology Practice? A Survey of Members of the Society of Breast Imaging. J Breast Imaging 2021; 3:332-342. [PMID: 34056593 PMCID: PMC8139609 DOI: 10.1093/jbi/wbab012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The objective of this study is to determine the major stressors affecting practicing breast radiologists. METHODS All members of the Society of Breast Imaging within the United States received an email invitation to complete an anonymous survey evaluating stressors that may contribute to physician burnout. Stressors evaluated included pace at work, work-life balance, care of dependents, job security, financial strain, decreasing reimbursement, new regulations, delivering bad news, fear of getting sued, and dealing with difficult patients, radiologists, and administrators. RESULTS The overall response rate was 13.5% (312/2308). For those who opened the email, response rate was 24.6% (312/1269). The most prevalent stressors reported were working too fast (222/312, 71.2%), balancing demands of work with personal life (209/312, 70.0%), fear of getting sued (164/312, 52.6%), and dealing with difficult administrators (156/312, 50%). Prevalence of stress related to new regulation requirements, job security, financial strain, decreased reimbursement, dependent care, call, delivering bad news, and dealing with difficult patients, difficult referrers, and difficult radiologists were present in fewer than 50% of respondents. CONCLUSION The most prevalent sources of stress in breast imaging radiologists relate to working too fast and balancing demands of work with time needed for personal life.
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Affiliation(s)
- Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
| | - Jia Sun
- University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX, USA
| | - Martha B Mainiero
- Alpert Medical School of Brown University, Department of Diagnostic Imaging, Providence, RI, USA
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Li J, Bu Y, Lu S, Pang H, Luo C, Liu Y, Qian L. Development of a Deep Learning-Based Model for Diagnosing Breast Nodules With Ultrasound. J Ultrasound Med 2021; 40:513-520. [PMID: 32770574 DOI: 10.1002/jum.15427] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Artificial intelligence (AI) has been an important addition to medicine. We aimed to explore the use of deep learning (DL) to distinguish benign from malignant lesions with breast ultrasound (BUS). METHODS The DL model was trained with BUS nodule data using a standard protocol (1271 malignant nodules, 1053 benign nodules, and 2144 images of the contralateral normal breast). The model was tested with 692 images of 256 breast nodules. We used the accuracy, precision, recall, harmonic mean of recall and precision, and mean average precision as the indices to assess the DL model. We used 100 BUS images to evaluate differences in diagnostic accuracy among the AI system, experts (>25 years of experience), and physicians with varying levels of experience. A receiver operating characteristic curve was generated to evaluate the accuracy for distinguishing between benign and malignant breast nodules. RESULTS The DL model showed 73.3% sensitivity and 94.9% specificity for the diagnosis of benign versus malignant breast nodules (area under the curve, 0.943). No significant difference in diagnostic ability was found between the AI system and the expert group (P = .951), although the physicians with lower levels of experience showed significant differences from the AI and expert groups (P = .01 and .03, respectively). CONCLUSIONS Deep learning could distinguish between benign and malignant breast nodules with BUS. On BUS images, DL achieved diagnostic accuracy equivalent to that of expert physicians.
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Affiliation(s)
- Jianming Li
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yunyun Bu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shuqiang Lu
- Department of Computer Science and Technology, Tsinghua University, Beijing, China
| | - Hao Pang
- School of Software, Beijing University of Posts and Telecommunications, Beijing, China
| | - Chang Luo
- Department of Computer Science and Technology, Tsinghua University, Beijing, China
| | - Yujiang Liu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Linxue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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35
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Abstract
PURPOSE There is worsening of burnout symptoms experienced by radiologists and trainees. We explored potential factors that exacerbate burnout symptoms observed in the Canadian radiological community and currently available protective factors as next steps for establishing viable solutions for burnout. METHODS An 11-question electronic survey was distributed to Canadian radiologists and trainees through the Canadian Association of Radiologists (CAR). Approval from a local ethics board and the CAR were obtained. The survey contained demographics-related questions as well as questions based on common risk factors for burnout. Qualitative and quantitative analyses were performed. RESULTS The survey was distributed to 2200 CAR members, and a response rate of 23.3% was achieved. Most radiologists experienced frequent unexpected high workload with no statistically significant difference by the type of practice. Trainees experienced a statistically significantly (P < .0001) higher frequency of on-call shifts compared to staff radiologists. A statistically significant difference (P < .0001) was observed for perceived threats to career longevity dependent on length of career. Although support mechanisms for radiology were perceived as available, survey commentary suggested inefficiency in their usage and lack of prioritization, which was a trend observed across all types of practice. CONCLUSIONS While there is awareness for radiology needs, changes are required at the workplace level to reduce burnout symptoms at their source. Communication between radiologists and hospital administration, as well as among radiology group members, is key to prioritize radiology needs in our imaging-driven era of health care.
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Affiliation(s)
- Nanxi Zha
- Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Nick Neuheimer
- Canadian Association of Radiologists, Ottawa, Ontario, Canada
| | - Michael N Patlas
- Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada
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36
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Abstract
Recent reports have highlighted disparities in breast cancer care related to patient diversity. Breast radiologists represent the face of breast imaging and are key players in advocating for patients to reduce these disparities. Diversity-related barriers for breast imaging patients, as they journey from screening to survivorship, include impediments to access and quality of care, gaps in communication, and lack of knowledge in both providers and patients. Potential strategies for overcoming these specific barriers include "culturally tailored" nurse navigators, mobile mammography, improved communication, patient and provider education, and breast radiologist involvement in advocacy efforts promoting diversity. As current trends in recommendations and guidelines for breast imaging include more numerous and advanced imaging modalities, it is important to acknowledge and address diversity-related disparities.
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Affiliation(s)
- Miral M Patel
- The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
| | - Jay R Parikh
- The University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
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37
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Mahajan A, Sharma P. Psychological impact of COVID-19 on radiology: Emotional wellbeing versus psychological burnout. Indian J Radiol Imaging 2021; 31:S11-S14. [PMID: 33814756 PMCID: PMC7996701 DOI: 10.4103/ijri.ijri_579_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/20/2020] [Accepted: 09/12/2020] [Indexed: 02/05/2023] Open
Abstract
While the COVID-19 pandemics seem to be crippling the global health care system, it has caused enormous uncertainty and panic in the lives of the health care professionals with a significant impact on their productivity. A significant proportion of these affected health care individuals comprise of the working staff belonging to the Radiology department. Although the main focus of all health care individuals has constantly been to reduce the number of new cases by minimal transmission, save lives of the infected patients by findings effective cure and carry out meticulous research to develop preventive vaccine, we have been unknowingly giving very little consideration to critical issues relating to the psychological well-being of the front liners. It is of utmost necessity that the psychological impact of this pandemic needs to be recognized and dealt with, in a timely fashion. While planning interventions to fight the pandemic, mental health issues must not be sidelined instead considered pragmatically. The radiology departments must come up with a mitigation plan to combat the subsequent short-term and long-term adverse effects of COVID-19 on mental well-being of their staff members. This article discusses the psychological impact of COVID-19 on the radiology department.
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Affiliation(s)
| | - Prerit Sharma
- Sharma Diagnostic Centre, Wardha, Maharashtra, India
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38
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Kudo S, Inoue K, Fukushi M. [Review of Cohort Studies Among Radiologists, Radiological Technologists, and Nuclear Workers]. Igaku Butsuri 2021; 41:180-193. [PMID: 34955501 DOI: 10.11323/jjmp.41.4_180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A number of epidemiological studies have been conducted to investigate the health effects of low-dose radiation. The author reviewed epidemiological studies among radiologists, radiological technologists, and nuclear workers. Because the results of many epidemiological studies on these subjects have been published, and many studies have measured radiation doses, there is little uncertainty. In the studies among radiologists and radiological technologists, high risks for leukemia, skin cancer, and breast cancer were found in populations that began work before around 1950, but not seen such a tendency for those starting work recent years. The results of the studies among nuclear workers were inconsistent with some reporting that a risk was seen, while others reported no risk. The reason for this may be due to the different analysis methods among the studies.
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Affiliation(s)
- Shin'ichi Kudo
- Faculty of Health Sciences, School of Radiological Science, Tokyo Metropolitan University
- Institute of Radiation Epidemiology, Radiation Effects Association
| | - Kazumasa Inoue
- Faculty of Health Sciences, School of Radiological Science, Tokyo Metropolitan University
| | - Masahiro Fukushi
- Faculty of Health Sciences, School of Radiological Science, Tokyo Metropolitan University
- Department of Radiological Technology, Tsukuba International University
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Mercy NC, Bwanga O. Experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom. Int J Health Sci (Qassim) 2021; 15:9-16. [PMID: 33456437 PMCID: PMC7786445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of the study was to explore the experiences of consultant breast radiographers regarding breast imaging services in the United Kingdom (UK). METHODS The study used a qualitative research design. Data were collected using semi-structured interviews from eight purposively selected consultant breast radiographers across the UK. Interviews were recorded, transcribed, and analyzed by themes. RESULTS Four themes emerged: Reasons for the introduction of breast consultancy role in radiography, education and training, domain of practice, and autonomy and support. This study found that participants were carrying out roles similar to those performed by consultant breast radiologists and that they had been performing such roles even before they were appointed. The study further revealed that the creation of consultancy posts came because of an increase in demand for breast imaging services and the shortage of radiologists. Four domains of practice were clinical expert, professional leadership, research and evaluation, and education and training. Participants worked independently with adequate support from fellow consultants and non-radiology staff. CONCLUSION Consultant breast radiographers are performing most of the consultancy roles stated in their scope of practice, except for research and evaluation, which they are mainly unable to do due to clinical workload. Therefore, there is a need to provide protected time for research and evaluation activities so that consultant breast radiographers can utilize their full potential. The findings have provided baseline information for countries planning to extend the scope of practice of radiographers in breast imaging.
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Affiliation(s)
| | - Osward Bwanga
- Department of Radiology, Midland Regional Hospital, Tullamore, Co. Offaly, Ireland
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Koyama T, Yoshiike S, Suganuma K, Shiroto K, Miyauchi N, Shinchu S, Aoki Y. A study of the usefulness of inspection of radiology reports in the emergency room. Acute Med Surg 2020; 7:e606. [PMID: 33318803 PMCID: PMC7726616 DOI: 10.1002/ams2.606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/01/2020] [Indexed: 11/29/2022] Open
Abstract
Aim The aim of this study was to better understand the usefulness of retrospective inspection of radiology reports of CT (computed tomography) or MRI (magnetic resonance imaging) by emergency doctors in the emergency room. Methods Between April 2018 and March 2019, patients who went home after CT or MRI who needed to change their treatment plans and subsequent corresponding procedures after inspection of radiology reports by emergency doctors were reviewed. Results Among 7,661 CT or MRIs performed on 5,917 patients, there were 131 patients (133 CT or MRI or 1.7% among 7,661 examinations) who required a change in their treatment plans after inspection of radiology reports. Of the 133 CT or MRI performed, there were 51 (38.3% among 133 CT or MRI, 0.7% among 7,661 examinations) CT or MRI performed, which indicated findings to suspect a tumor (11.8% in the head, 41.2% in the chest, 35.3% in the abdomen, and 11.8% in others). With the need to make important changes in treatment plans, making appointments for outpatient clinics was necessary for 52 CT or MRI findings, and requiring the patients to return to the clinic or be admitted was necessary for 9 (totally 61; 0.8% among 7,661 examinations). Conclusion Data from this study suggest that inspection of radiology reports of CT or MRI by emergency doctors after patients went home is useful in finding characteristics suggestive of tumors in 0.7% of all radiology reports and is necessary to identify important changes that should be made in treatment plans in 0.8% of all radiology reports.
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Affiliation(s)
- Toru Koyama
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Shouichi Yoshiike
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Kazuki Suganuma
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Kosuke Shiroto
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Naoto Miyauchi
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Sayaka Shinchu
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
| | - Yoshihiro Aoki
- Department of Emergency and Critical Care Medicine Aizawa Hospital Nagano Japan
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Necas M, Shen Y, Ong QH, Prout K, Wackrow W. Do radiologists need to review abdominal ultrasound examinations reported as 'normal' by the sonographer? Australas J Ultrasound Med 2020; 23:167-175. [PMID: 34760596 PMCID: PMC8411718 DOI: 10.1002/ajum.12202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. METHODS This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. RESULTS The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients' age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1-21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. CONCLUSION Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.
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Affiliation(s)
- Martin Necas
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Yi Shen
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Qi Hao Ong
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Kara Prout
- Waikato HospitalPembroke StreetHamilton3204New Zealand
| | - Wendy Wackrow
- Waikato HospitalPembroke StreetHamilton3204New Zealand
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Martin CT, Polly DW, Takahashi T. Surgeon Preference for Radiologist Interpretation of Deformity Radiographs-A Survey of Lumbar Spine Research Society Membership. Int J Spine Surg 2020; 14:527-533. [PMID: 32986573 DOI: 10.14444/7069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The radiologist interpretation of scoliosis films is non-standardized, with some practitioners providing detailed measurements of the deformity whereas others defer the interpretation of the deformity to the ordering surgeon. For radiologists, the standard of care is not clear, and this creates confusion in terms of how much interpretation is required. However, detailed radiologist reports sometimes conflict with the surgeon's interpretation, which can create confusion for patients who receive the reports, or in extreme cases can lead to insurance denials. Thus, the purpose of this study was to help establish a standard for interpretation of these films by surveying the ordering surgeons and documenting expert opinion about the amount and type of radiologist interpretation that is requested. METHODS We designed a SurveyMonkey survey which aimed to look at standard practice for radiologist dictation of scoliosis radiographs. Twelve questions were sent to Lumbar Spine Research Society membership via email with a description of the study. One follow-up email was also sent to non-responders. RESULTS The rate of completed surveys was 46 out of 185 Lumbar Spine Research Society members (25%). Thirty-seven respondents (80%) worked in academic institutions, 33 were orthopedists (71%), and 13 were neurosurgeons (28%). Fifty percent reported that radiologists' level of detail in dictations was inconsistent at their institution. Detailed numeric reporting was rare (6.5%). When the radiologist did provide numeric measurements, surgeons reported that they often differed from the surgeon's own measurements, with only 4% reporting that the measurements "rarely" differed from the surgeon's; 49% reported that the radiologist's measurements that differed from the surgeon's had led to insurance denials for their patients. The majority of respondents (70%) did not want the radiologist to provide detailed numeric measurements of the deformity, and 91% reported that the radiologist's measurements had no impact on their clinical decision making. CONCLUSIONS Detailed deformity measurements are time consuming for the radiologist, and would seem to have low clinical utility for the responding surgeons in this survey, with significant potential for discrepancies in interpretation to lead to insurance denials. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Christopher T Martin
- The Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - David W Polly
- The Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Takashi Takahashi
- The Department of Radiology, University of Minnesota, Minneapolis, Minnesota
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Zigman Suchsland M, Cruz MJ, Hardy V, Jarvik J, McMillan G, Brittain A, Thompson M. Qualitative study to explore radiologist and radiologic technologist perceptions of outcomes patients experience during imaging in the USA. BMJ Open 2020; 10:e033961. [PMID: 32690729 PMCID: PMC7375501 DOI: 10.1136/bmjopen-2019-033961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE We aimed to explore the patient-centred outcomes (PCOs) radiologists and radiologic technologists perceive to be important to patients undergoing imaging procedures. DESIGN We conducted a qualitative study of individual semi-structured interviews. PARTICIPANTS We recruited multiple types of radiologists including general, musculoskeletal neuroradiology, body and breast imagers as well as X-ray, ultrasound, CT or MRI radiologic technologists from Washington and Idaho. OUTCOME Thematic analysis was conducted to identify themes and subthemes related to PCOs of imaging procedures. RESULTS Ten radiologists and six radiology technologists participated. Four main domains of PCOs were identified: emotions, physical factors, knowledge and patient burden. In addition to these outcomes, we also identified patient and provider factors that can potentially moderate these outcomes. CONCLUSIONS Radiologists and technologists perceived outcomes related to the effect of imaging procedures on patients' emotions, physical well-being, knowledge and burden from financial and opportunity costs to be important to patients undergoing imaging procedures. There are opportunities for the radiology community to measure and use these PCOs in comparisons of imaging procedures and potentially identify areas where these outcomes can be leveraged to drive a more patient-centred approach to radiology.
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Affiliation(s)
| | - Maria Jessica Cruz
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
| | - Victoria Hardy
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Jeffrey Jarvik
- Departments of Radiology, Neurological Surgery and Health Services, and the Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, Washington, USA
| | - Gianna McMillan
- Bioethics Institute, Loyola Marymount University, Los Angeles, California, USA
| | - Anne Brittain
- Quality Improvement and Outcomes Department, Inova Fairfax Medical Campus, Falls Church, Virginia, USA
| | - Matthew Thompson
- Department of Family Medicine, University of Washington, Seattle, Washington, USA
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Almohiy HM, Hussein K, Alqahtani M, Elshiekh E, Loaz O, Alasmari A, Saad M, Adam M, Mukhtar E, Alelyani M, Alshahrani M, Abuhadi N, Alshumrani G, Almazzah A, Alsleem H, Almohiy N, Alrwaili A, Alam MM, Asiri A, Khalil M, Rawashdeh M, Saade C. Radiologists' Knowledge and Attitudes towards CT Radiation Dose and Exposure in Saudi Arabia-A Survey Study. Med Sci (Basel) 2020; 8:E27. [PMID: 32698332 PMCID: PMC7563332 DOI: 10.3390/medsci8030027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 01/20/2023] Open
Abstract
Computed tomography (CT) is a key imaging technique in diagnostic radiology, providing highly sensitive and specific information. While its use has increased dramatically in recent years, the quantity and associated risks of radiation from CT scans present major challenges, particularly in paediatrics. The fundamental principles of radiation protection require that radiation quantities be as low as reasonably achievable and CT use must be justified, particularly for paediatric patients. CT radiation knowledge is a key factor in optimising and minimising radiation risk. The objective of this study was to analyse knowledge level, expertise, and competency regarding CT radiation dose and its hazards in paediatrics among radiologists in Saudi Arabian hospitals. A self-reported, multiple-choice questionnaire assessed the attitudes and opinions of radiologists involved in imaging studies using ionising radiation. Among the total respondents, 65% ± 13.5% had a good comprehension of the dangers of carcinogenicity to the patient resulting from CT scans, with 80% presuming that cancer risks were elevated. However, only 48.5%, 56.5%, and 65% of the respondents were aware of specific radiation risks in head, chest, and abdominal paediatric examinations, respectively. Regular, frequent, and specific training courses are suggested to improve the fundamental knowledge of CT radiation among radiologists and other physicians.
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Affiliation(s)
- Hussain M Almohiy
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Khalid Hussein
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Department of Medical Physics and Instrumentation, National Cancer Institute, University of Gezira, Wad Medani 20, Sudan
| | - Mohammed Alqahtani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Elhussaien Elshiekh
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Radiation Safety Institute, Sudan Atomic Energy Commission, Khartoum 1111, Sudan
| | - Omer Loaz
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Azah Alasmari
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Mohamed Saad
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
- Faculty of Science, Department of Physics, Mansoura University, Mansoura 35516, Egypt
| | - Mohamed Adam
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Emad Mukhtar
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Magbool Alelyani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (K.H.); (M.A.); (E.E.); (O.L.); (A.A.); (M.S.); (M.A.); (E.M.); (M.A.)
| | - Madshush Alshahrani
- Department of Radiology, Khamis Mushayt General Hospital, Khamis Mushayt 62457, Saudi Arabia;
| | - Nouf Abuhadi
- Diagnostic Radiology Department, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia;
| | - Ghazi Alshumrani
- Department of Radiology, College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | - Alaa Almazzah
- Department of Radiology, Asir Central Hospital, Abha 62523, Saudi Arabia;
| | - Haney Alsleem
- Department of Radiological Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia;
| | - Nadiayah Almohiy
- College of Medicine, King Khalid University, Abha 61421, Saudi Arabia;
| | | | - Mohammad Mahtab Alam
- Department of Basic Medical Sciences, College of Applied medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
| | - Abdullah Asiri
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammed Khalil
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia; (A.A.); (M.K.)
| | - Mohammad Rawashdeh
- Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Charbel Saade
- Department of Medical Imaging Sciences, American University of Beirut Medical Center, Beirut 11-0236, Lebanon;
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Chetty S, Venter D, Speelman A. Determining the Need for After-Hours Diagnostic Radiological Reporting in Emergency Departments at Public Hospitals in South Africa: Perceptions of Emergency Physicians in KwaZulu-Natal. J Med Imaging Radiat Sci 2020; 51:470-479. [PMID: 32654979 DOI: 10.1016/j.jmir.2020.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/11/2020] [Accepted: 06/11/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Emergency departments in South African public hospitals have a high patient load after hours, with inadequate numbers of health care professionals available to satisfy patient influx. In addition, there is often no provision of after-hours diagnostic reporting services in public hospitals, to an extent that the emergency physician is responsible for interpreting all radiographic images requested themseves. Emergency physicians, in this study, can be described as any medical doctor registered with the Health Professions Council of South Africa and working in the emergency department as a registrar or consultant physician because there were no physicians specialized in emergency medicine working at the hospitals selected for this study. AIM The aim of this study was to determine the views of emergency physicians on whether there is a need for an after-hours diagnostic radiological reporting service in selected public hospitals in KwaZulu-Natal Province, South Africa. METHODS A descriptive cross-sectional quantitative research design was utilized, through means of a survey, to assess the emergency physicians' perceptions regarding the need for after-hours diagnostic radiological reporting. In addition, the study used a descriptive quantitative research design to record the number of conventional diagnostic radiographic examinations performed at the selected hospitals, after hours, and the proportional number of these radiographic examinations that were reported on by radiologists during office hours, the following day. The distribution of questionnaires and data collection, with regard to the number of examinations reported on, and those not reported on, were carried out simultaneously during the execution of this study. The study was conducted over a three-month period in 2017, at four public hospitals in KwaZulu-Natal-one of the nine provinces of South Africa. RESULTS This study found that, during the study period, between 0.1% and 0.6% of the conventional diagnostic radiographic examinations performed, after hours, were reported on by radiologists during office hours, the following day. The surveyed emergency physicians felt that the interpretation of diagnostic images took up valuable time that could be spent on patient management, and there was near-total agreement, whereby 92% (n = 36) of the physicians would have preferred after-hours reporting to be performed by a radiologist. Physicians agreed that having a radiologist or reporting radiographer to provide radiological reports would allow for more effective and efficient patient management. CONCLUSION The results of this study indicated that there is a need for after-hours radiographic reporting at the selected public hospitals and for the further training of emergency physicians in radiographic image interpretation. Based on the findings of this study, it is recommended that after-hours radiological reporting services be considered for public hospitals and that courses be offered to emergency physicians on the interpretation of diagnostic radiographic images. A hospital policy review may therefore be needed to adjust the focus of hospitals toward reducing the workload of emergency physicians, wherever possible, such as by incorporating support services like radiographic reporting and by providing further training on the interpretation of diagnostic radiographic images, which will both act to reduce the potential risk of misdiagnosis.
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Affiliation(s)
- Seshree Chetty
- Master of Science Degree Programme, of Health and Wellness Sciences, Cape Peninsula University of Technology (CPUT), Bellville, Cape Town, South Africa.
| | - Dalene Venter
- Diagnostic Radiography, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa
| | - Aladdin Speelman
- Diagnostic Radiography, Faculty of Health and Wellness Sciences, Cape Peninsula University of Technology, Bellville, Cape Town, South Africa
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Rosen MP, Norbash A, Kruskal J, Meltzer CC, Yee J, Thrall J. Impact of Coronavirus Disease 2019 (COVID-19) on the Practice of Clinical Radiology. J Am Coll Radiol 2020; 17:1096-1100. [PMID: 32721410 PMCID: PMC7346805 DOI: 10.1016/j.jacr.2020.07.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022]
Abstract
The speed at which coronavirus disease 2019 (COVID-19) spread quickly fractured the radiology practice model in ways that were never considered. In March 2020, most practices saw an unprecedented drop in their volume of greater than 50%. The profound changes that have interrupted the arc of the radiology narrative may substantially dictate how health care and radiology services are delivered in the future. We examine the impact of COVID-19 on the future of radiology practice across the following domains: employment, compensation, and practice structure; location and hours of work; workplace environment and safety; activities beyond the "usual scope" of radiology practice; and CME, national meetings, and professional organizations. Our purpose is to share ideas that can help inform adaptive planning.
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Affiliation(s)
- Max P Rosen
- Chair of Radiology, Department of Radiology, UMass Memorial Medical Center & UMass Medical School, Worcester, Massachusetts.
| | - Alexander Norbash
- Chair of Radiology, UCSD School of Medicine and UC San Diego Health, San Diego, California
| | - Jonathan Kruskal
- Chair of Radiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Carolyn C Meltzer
- Chair of Radiology, Emory University School of Medicine, Atlanta, Georgia
| | - Judy Yee
- Chair of Radiology, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - James Thrall
- Massachusetts General Hospital, Boston, Massachusetts
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Gerlach KE, Phalak K, Parikh JR. Enhancing Quality Using the Inspection Program (EQUIP): A Primer for Radiologists. J Breast Imaging 2020; 2:264-268. [PMID: 38424984 DOI: 10.1093/jbi/wbaa018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Indexed: 03/02/2024]
Abstract
The new Enhancing Quality Using the Inspection Program (EQUIP) law places more responsibility for quality assurance on the interpreting radiologists and the lead interpreting physician (LIP). Compliance with the law will require addressing three specific questions related to quality assurance and clinical image corrective action, continued compliance, and ensuring LIP oversight. This process enables the radiologist to exemplify added value through physician leadership, team integration, and improved patient care.
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Affiliation(s)
- Karen E Gerlach
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
| | - Kanchan Phalak
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
| | - Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
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Abstract
The objective of this article is to outline opportunities for breast imaging radiologists to advocate for screening mammography. Despite breast cancer being the second most common cancer in women and screening mammography's ability to reduce mortality from this disease, there remains suboptimal utilization in the community. The different guidelines for screening presented by respected organizations has created confusion for patients and referring clinicians and the eventual underutilization of screening mammography. As experts in the value of early detection, breast radiologists are well suited to take on the role of screening advocates. Using specific action steps and examples, we create a template for a radiologist to utilize in the promotion of screening among the breast imaging team, clinicians, administrators, and the community at large. By deliberately filling the role of screening mammography advocate, one can satisfy the mandate for radiologists to bring increased value to the health care team while contributing to community health and patient satisfaction.
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Affiliation(s)
- Toma S Omofoye
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
| | - Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
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Fatahi N, Kustrimovic M, Elden H. Non-Medical Radiography Staff Experiences in Inter-Professional Communication: A Swedish Qualitative Focus Group Interview Study. J Multidiscip Healthc 2020; 13:393-401. [PMID: 32431507 PMCID: PMC7201006 DOI: 10.2147/jmdh.s231442] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/21/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the experiences of non-medical discipline staff of difficulties and possibilities in inter-professional communication within the radiology department and remitting departments. Materials and Methods Three focus group interviews were conducted with 16 non-medical discipline staff in a radiology department at a university hospital in Sweden. Data were analysed using qualitative content analysis. Results The experiences of inter-professional communication by non-medical discipline staff within the radiology department and with remitting departments can be described in three categories, and six sub categories. The informants experienced difficulties in both oral and written inter-professional communication. Inadequate structures, incorrect information and unclear language in the referral forms, lack of feedback from clinicians and radiologists, and reduced face-to-face communication were described as factors that negatively influenced communication. Other difficulties were time shortage, inadequate routines and economy issues. The possibilities described were use of face-to-face communication, interpreters, and clear and well-structured referral forms. Conclusion Non-medical staff experience that quality in inter-professional communication has a significant impact on health outcomes and patient safety. They expressed a number of difficulties in both written and oral inter-professional communication. For example inadequate written and oral communication, as well as practical issues such as routine could negatively influence the quality of the outcome of inter-professional communication. Lack of feedback from clinicians and radiologists and reduced face-to-face communication were also mentioned as factors that influence oral communication. Possibilities described to improve inter-professional communication quality and thus patient safety were professional contact on both professional and personal levels, use of interpreters, and clear and well-structured referral forms. The results of this study add to our knowledge of the difficulties and possibilities in non-medical inter-professional communication, which may enhance both safety and health outcomes for patients if implemented. Future studies in interprofessional communication is needed. ![]()
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Affiliation(s)
- Nabi Fatahi
- Department of Learning and Leadership for Health Care Professionals, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mirjana Kustrimovic
- Department of Radiography, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Helen Elden
- Department of Reproductive and Perinatal Health, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Abstract
OBJECTIVE Burnout is defined as a psychological syndrome arising as a response to chronic prolonged interpersonal job-related stress. Physician burnout has been increasingly recognized over the past decade as an epidemic within the United States. The goal of this study was to ascertain the prevalence of burnout amongst practicing breast imaging radiologists. METHODS A survey contained demographic questions based on workforce surveys carried out by the American College of Radiology and a validated condensed version of the Maslach Burnout Inventory (MBI) evaluating the three aspects of burnout. The radiologist members of the Society of Breast Imaging (SBI) received the survey internally from the SBI as a weekly e-mail with a web link to the survey from February 19, 2019, to March 13, 2019. The link allowed respondents to complete the survey anonymously. The authors were blinded to the SBI mailing list and the SBI was blinded to the responses. RESULTS A total of 370 breast imaging radiologists from the SBI responded to the survey. Overall, 290 out of 370 (78.4%) were highly burned out in at least 1 measured dimension of burnout; 197 out of 362 (54.4%) were highly burned out in at least 2 dimensions of burnout; and 27 out of 362 (7.5%) were highly burned out in all 3 dimensions of burnout. However, rates of personal accomplishment were high, with only 8.8% experiencing high burnout in the dimension of personal accomplishment. CONCLUSION Our study demonstrates a high prevalence of burnout amongst breast imaging radiologists. Burnout rates were highest in the youngest breast imaging radiologists.
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Affiliation(s)
- Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX
| | - Jia Sun
- University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX
| | - Martha B Mainiero
- Alpert Medical School of Brown University, Department of Diagnostic Imaging, Providence, RI
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