Building the body: active learning laboratories that emphasize practical aspects of anatomy and integration with radiology.

PubMed

Zumwalt, Ann C; Lufler, Rebecca S; Monteiro, Joseph; Shaffer, Kitt

2010-01-01

Active learning exercises were developed to allow advanced medical students to revisit and review anatomy in a clinically meaningful context. In our curriculum, students learn anatomy two to three years before they participate in the radiology clerkship. These educational exercises are designed to review anatomy content while highlighting its relevance to the study of radiology. Laboratory exercises were developed using inexpensive materials in the form of hands-on stations designed for use by students working together in small groups. Station exercises include model building, exploring relevant radiological imaging, and practicing clinical techniques. Students are encouraged to move from abstract conceptualization of the anatomy using models to applying knowledge to living tissues by using a portable ultrasound to explore superficial anatomy on each other. Stations are designed to integrate knowledge and reemphasize concepts in different contexts, so that upon completion students have a reinforced understanding of the three-dimensional anatomy of the region in question, the appearance of the anatomy on radiological images, and an appreciation of the relevance of the anatomy to radiological procedures. (c) 2010 American Association of Anatomists.

Towards case-based medical learning in radiological decision making using content-based image retrieval

PubMed Central

2011-01-01

Background Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. Methods We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. Results We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. Conclusions The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer. PMID:22032775

Towards case-based medical learning in radiological decision making using content-based image retrieval.

PubMed

Welter, Petra; Deserno, Thomas M; Fischer, Benedikt; Günther, Rolf W; Spreckelsen, Cord

2011-10-27

Radiologists' training is based on intensive practice and can be improved with the use of diagnostic training systems. However, existing systems typically require laboriously prepared training cases and lack integration into the clinical environment with a proper learning scenario. Consequently, diagnostic training systems advancing decision-making skills are not well established in radiological education. We investigated didactic concepts and appraised methods appropriate to the radiology domain, as follows: (i) Adult learning theories stress the importance of work-related practice gained in a team of problem-solvers; (ii) Case-based reasoning (CBR) parallels the human problem-solving process; (iii) Content-based image retrieval (CBIR) can be useful for computer-aided diagnosis (CAD). To overcome the known drawbacks of existing learning systems, we developed the concept of image-based case retrieval for radiological education (IBCR-RE). The IBCR-RE diagnostic training is embedded into a didactic framework based on the Seven Jump approach, which is well established in problem-based learning (PBL). In order to provide a learning environment that is as similar as possible to radiological practice, we have analysed the radiological workflow and environment. We mapped the IBCR-RE diagnostic training approach into the Image Retrieval in Medical Applications (IRMA) framework, resulting in the proposed concept of the IRMAdiag training application. IRMAdiag makes use of the modular structure of IRMA and comprises (i) the IRMA core, i.e., the IRMA CBIR engine; and (ii) the IRMAcon viewer. We propose embedding IRMAdiag into hospital information technology (IT) infrastructure using the standard protocols Digital Imaging and Communications in Medicine (DICOM) and Health Level Seven (HL7). Furthermore, we present a case description and a scheme of planned evaluations to comprehensively assess the system. The IBCR-RE paradigm incorporates a novel combination of essential aspects of diagnostic learning in radiology: (i) Provision of work-relevant experiences in a training environment integrated into the radiologist's working context; (ii) Up-to-date training cases that do not require cumbersome preparation because they are provided by routinely generated electronic medical records; (iii) Support of the way adults learn while remaining suitable for the patient- and problem-oriented nature of medicine. Future work will address unanswered questions to complete the implementation of the IRMAdiag trainer.

Post-deployment usability evaluation of a radiology workstation.

PubMed

Jorritsma, Wiard; Cnossen, Fokie; Dierckx, Rudi A; Oudkerk, Matthijs; Van Ooijen, Peter M A

2016-01-01

To determine the number, nature and severity of usability issues radiologists encounter while using a commercially available radiology workstation in clinical practice, and to assess how well the results of a pre-deployment usability evaluation of this workstation generalize to clinical practice. The usability evaluation consisted of semi-structured interviews and observations of twelve users using the workstation during their daily work. Usability issues and positive usability findings were documented. Each issue was given a severity rating and its root cause was determined. Results were compared to the results of a pre-deployment usability evaluation of the same workstation. Ninety-two usability issues were identified, ranging from issues that cause minor frustration or delay, to issues that cause significant delays, prevent users from completing tasks, or even pose a potential threat to patient safety. The results of the pre-deployment usability evaluation had limited generalizability to clinical practice. This study showed that radiologists encountered a large number and a wide variety of usability issues when using a commercially available radiology workstation in clinical practice. This underlines the need for effective usability engineering in radiology. Given the limitations of pre-deployment usability evaluation in radiology, which were confirmed by our finding that the results of a pre-deployment usability evaluation of this workstation had limited generalizability to clinical practice, it is vital that radiology workstation vendors devote significant resources to usability engineering efforts before deployment of their workstation, and to continue these efforts after the workstation is deployed in a hospital. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Balancing theory and practicality: engaging non-ethicists in ethical decision making related to radiological protection.

PubMed

Martinez, Nicole; Wueste, Daniel

2016-12-01

This paper discusses an approach for engaging radiation protection professionals in the ethical aspects of decision-making, with discussion on how this approach fits in with the existing system of radiological protection. It explores finding common ground between ethical and scientific theory, how to present relevant moral theory in accessible language, and provides a practical framework for dealing with real-world problems. Although establishing the ethical theory behind the system of radiological protection is an important ongoing endeavour within the community, it is equally important to communicate this information in a way that is useful to non-ethicists. Discussion of both ethical theory and a useful strategy for applying the theory makes ethics more accessible to those working in the field by providing them with the knowledge and confidence to apply ethical principles in decisions and practice.

The Interventional Radiology (IR) Gender Gap: A Prospective Online Survey by the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).

PubMed

Wah, Tze Min; Belli, Anna Maria

2018-05-22

A prospective online survey was conducted by the Cardiovascular Interventional Radiological Society of Europe (CIRSE) to evaluate the gender gap within interventional radiology (IR) and the barriers facing women in IR. A questionnaire ("Appendix") was devised by the authors and the CIRSE communication and publication team and sent electronically to 750 identifiable female members of CIRSE. Responses were collected from 7 August to 24 August 2017. The response rate was 19.9% (n = 149) with highest responses from UK (18%), Italy (11%), Germany (11%), Spain (7%), Netherlands (5%), France (5%), Sweden (4%), USA (4%). 91% of the respondents were between 31 and 46 years, 83% work full time, 62% spend > 50% of their working time in IR, and 67% practice in a university or tertiary referral institution. 85% were in the minority in their department. 52% had no leadership role in their department, but 67% expressed willingness to consider a leadership position. Their main concerns were work/family life balance, the risks of radiation exposure, the effect of pregnancy on training and practice and the male-dominated work environment. This survey highlights issues experienced by women in IR. Clear guidance on concerns regarding radiation exposure particularly during pregnancy is needed. Structured and supportive training is required for female IRs who may wish to train or work flexibly. The male-dominated environment is discouraging, and a scheme to promote female IRs would encourage women to take on senior leadership positions and attract more women into the specialty.

Teaching the Healthcare Economics Milestones to Radiology Residents: Our Pilot Curriculum Experience.

PubMed

Prober, Allen S; Mehan, William A; Bedi, Harprit S

2016-07-01

Since July 2013, the Accreditation Council for Graduate Medical Education (ACGME) has required radiology residency programs to implement a set of educational milestones to track residents' educational advancement in six core competencies, including Systems-based Practice. The healthcare economics subcompetency of Systems-based Practice has traditionally been relatively neglected, and given the new increased ACGME oversight, will specifically require greater focused attention. A multi-institutional health-care economics pilot curriculum combining didactic and practical components was implemented across five residency programs. The didactic portion included a package of online recorded presentations, reading, and testing materials developed by the American College of Radiology (ACR's) Radiology Leadership Institute. The practical component involved a series of local meetings led by program faculty with the production of a deliverable based on research of local reimbursement for a noncontrast head computed tomography. The capstone entailed the presentation of each program's deliverable during a live teleconference webcast with a Radiology Leadership Institute content expert acting as moderator and discussion leader. The pilot curriculum was well received by residents and faculty moderators, with 100% of survey respondents agreeing that the pilot met its objective of introducing how reimbursement works in American radiology in 2015 and how business terminology applies to their particular institutions. A health-care economics curriculum in the style of a Massive Open Online Course has strong potential to serve as many residency programs' method of choice in meeting the health-care economics milestones. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

What factors affect the productivity and efficiency of physician practices?

PubMed

Sunshine, Jonathan H; Hughes, Danny R; Meghea, Cristian; Bhargavan, Mythreyi

2010-02-01

Increasing the productivity and efficiency of physician practices could help relieve the rapid growth of US healthcare costs and the expected physician shortage. Radiology practices are an attractive specific focus for research on practices' productivity and efficiency because they are home to many purportedly productivity-enhancing operational technologies. This affords an opportunity to study the effect of production technology on physicians' output. As well, radiology is a leader in the general movement of physicians out of very small practices. And imaging is by the fastest-growing category of physician expenditure. Using data from 2003 to 2007 surveys of radiologists, we estimate a stochastic frontier model to study the effects of practice characteristics, such as work hours, practice size, and output mix, and technologies used in work production, on practices' productivity and efficiency. At the mean, the elasticities of output with respect to practice size and annual hours worked per full-time physician were 0.73 and 0.51, respectively. Some production technologies increase productivity by 15% to 20%; others generate no increase. Using "nighthawks"--ie, contracting out after-hours work to external firms that consolidate workflow--significantly increases practice efficiency. The general US trend toward larger practice size is unlikely to relieve cost or physician shortage pressures. The actual effect of purportedly productivity-enhancing operational technologies needs to be carefully evaluated before they are widely adopted. As the recently-developed innovations of nighthawks and hospitalists show, practices should give more attention to a possible choice to "buy," rather than "make," part of their output.

A practical description and student perspective of the integration of radiology into lower limb musculoskeletal anatomy.

PubMed

Davy, S; O'Keeffe, G W; Mahony, N; Phelan, N; Barry, D S

2017-05-01

Anatomy educators are increasing their utilisation of radiology in anatomy education in line with growing requirements for undergraduate radiology competency and clinical need. We aimed to evaluate student perceptions of radiology and to outline the technical and academic considerations underlying the integration of radiology into musculoskeletal practical anatomy sessions. The formal integration of radiology into anatomy practical sessions took place over a 5-week period during the lower limb musculoskeletal component of the anatomy course taught to first-year medical students. During practical sessions, students were required to rotate between aligned audio-visual radiology presentations, osteology/anatomical models, and prosection/dissection learning stations. After completing the course, students were invited to complete a survey to establish their opinions on radiology as a mode of learning and their satisfaction with radiological integration in anatomical practical sessions. Most students were not familiar with radiology prior to attending our university. All our students agreed or strongly agreed that learning to read radiographs in anatomy is important and most agreed that radiology is a valid assessment tool. Sixty percent stated that radiology facilitated their understanding of anatomy. The majority believed that radiology was best suited to clinically relevant anatomy and X-rays were their preferred learning tool. The practical approach to integrating radiology into undergraduate musculoskeletal anatomy described here did not place strain on existing academic resources. Most students agreed that radiology should be increased in anatomy education and that learning to understand radiographs in anatomy was important for clinical practice.

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology

PubMed Central

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-01-01

Objectives Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. Methods We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Results Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Conclusions Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments. PMID:29657683

Radiation Protection Knowledge, Attitude, and Practice (KAP) in Interventional Radiology.

PubMed

Shabani, Fatemeh; Hasanzadeh, Hadi; Emadi, Alireza; Mirmohammadkhani, Majid; Bitarafan-Rajabi, Ahmad; Abedelahi, Ali; Bokharaeian, Mitra; Masoumi, Hamed; Seifi, Danial; Khani, Tahereh; Sanchooli, Mohamad; Moshfegh, Shima; Ziari, Abbas

2018-03-01

Due to increasing cardiac disease and its mortality rate, the frequency of cardiac imaging has grown and, as a result, interventional cardiologists potentially receive high radiation doses in cardiac examinations. This study aimed to assess the knowledge, attitude, and practice (KAP) level of radiation protection (RP) among interventional radiology staff in Iranian health care centers across the country. We used a validated questionnaire survey consisting of 30 multiple-choice questions to perform a cross-sectional study. Participants were healthcare personnel working professionally with radiation at different levels (i.e., secretary, radiology technologists, nurse, and physician). The questionnaire was divided into three sections to assess KAP regarding RP. Significant differences exist in RP KAP mean scores based on educational age (p < 0.050). There was no significant difference in RP KAP mean scores when looking at sex, practice age, and hospital type (p > 0.050). We found a significant difference between RP KAP mean scores and different regions (p < 0.050). Educational and practice age, sex, type of hospital, and geographical region affect he KAP of interventional radiology staff regarding RP. Since many of the subjective radiation harms for both medical team and patients, this can be easily controlled and prevented; a checkup for personnel of interventional radiology departments, considering samples from different parts of the country with different levels of education, continuous training, and practical courses may help map the status of KAP. The results of this study may also help authorized health physics officers design strategic plans to enhance the quality of such services in radiation departments.

We have much in common: the similar inter-generational work preferences and career satisfaction among practicing radiologists.

PubMed

Moriarity, Andrew K; Brown, Manuel L; Schultz, Lonni R

2014-04-01

There are many reported generational differences regarding workplace motivators, but these have not been previously studied in radiologists. The aim of this study was to assess for generational differences in workplace satisfaction and desired workplace characteristics among practicing radiologists. An electronic survey distributed to ACR, Society of Chairs of Academic Radiology Departments, and Association of Program Directors in Radiology members generated 1,577 responses from baby boom (BG) and generation X (GX) radiologists in active practice. Nineteen workplace characteristics and their associations with workplace satisfaction were tested in a univariate analysis using χ(2) tests and in a multiple logistic regression model to test for associations with satisfaction. Workplace satisfaction among BG and GX radiologists was 78% and 80%, respectively. Both generations reported higher satisfaction if they were optimistic about the future of radiology (87% of BG vs 85% of GX radiologists), believed the difference in the desired versus expected age of retirement was narrow (1.5 ± 3.3 years for BG radiologists vs 3.0 ± 4.1 years for GX radiologists), felt that social interactions in the workplace were important (81% of BG vs 83% of GX radiologists), and believed that professionalism in their peers was important (79% of BG vs 82% of GX radiologists). BG radiologists were more satisfied if they valued staff diversity, while GX radiologists were more satisfied if they felt that job security and the amount of compensation were important. There was no significant association of satisfaction with generation, gender, practice setting, or additional administrative work. Workplace satisfaction among practicing radiologists remains high but has decreased compared with prior surveys. The two dominant generations of practicing radiologists have similar workplace satisfaction rates and desired workplace characteristics. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Clinical Utility of Quantitative Imaging

PubMed Central

Rosenkrantz, Andrew B; Mendiratta-Lala, Mishal; Bartholmai, Brian J.; Ganeshan, Dhakshinamoorthy; Abramson, Richard G.; Burton, Kirsteen R.; Yu, John-Paul J.; Scalzetti, Ernest M.; Yankeelov, Thomas E.; Subramaniam, Rathan M.; Lenchik, Leon

2014-01-01

Quantitative imaging (QI) is increasingly applied in modern radiology practice, assisting in the clinical assessment of many patients and providing a source of biomarkers for a spectrum of diseases. QI is commonly used to inform patient diagnosis or prognosis, determine the choice of therapy, or monitor therapy response. Because most radiologists will likely implement some QI tools to meet the patient care needs of their referring clinicians, it is important for all radiologists to become familiar with the strengths and limitations of QI. The Association of University Radiologists Radiology Research Alliance Quantitative Imaging Task Force has explored the clinical application of QI and summarizes its work in this review. We provide an overview of the clinical use of QI by discussing QI tools that are currently employed in clinical practice, clinical applications of these tools, approaches to reporting of QI, and challenges to implementing QI. It is hoped that these insights will help radiologists recognize the tangible benefits of QI to their patients, their referring clinicians, and their own radiology practice. PMID:25442800

Strategic planning and radiology practice management in the new health care environment.

PubMed

Sharpe, Richard E; Mehta, Tejas S; Eisenberg, Ronald L; Kruskal, Jonathan B

2015-01-01

Current comprehensive health care reform in the United States demands that policy makers, insurers, providers, and patients work in reshaping the health care system to deliver care that is both more affordable and of higher quality. A tectonic shift is under way that runs contrary to the traditional goal of radiology groups to perform and interpret large numbers of imaging examinations. In fact, radiology service requisitions now must be evaluated for their appropriateness, possibly resulting in a reduction in the number of imaging studies performed. To be successful, radiology groups will have to restructure their business practices and strategies to align with the emerging health care paradigm. This article outlines a four-stage strategic framework that has aided corporations in achieving their goals and that can be readily adapted and applied by radiologists. The four stages are (a) definition and articulation of a purpose, (b) clear definition of strategic goals, (c) prioritization of specific strategic enablers, and (d) implementation of processes for tracking progress and enabling continuous adaptation. The authors provide practical guidance for applying specific tools such as analyses of strengths, weaknesses, opportunities, and threats (so-called SWOT analyses), prioritization matrices, and balanced scorecards to accomplish each stage. By adopting and applying these tools within the strategic framework outlined, radiology groups can position themselves to succeed in the evolving health care environment. RSNA, 2015

Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures.

PubMed

Bernier, Marie Odile; Doody, Michele M; Van Dyke, Miriam E; Villoing, Daphné; Alexander, Bruce H; Linet, Martha S; Kitahara, Cari M

2018-05-02

Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Utilization of the Family and Medical Leave Act in Radiology Practices According to the 2016 ACR Commission on Human Resources Workforce Survey.

PubMed

Arleo, Elizabeth Kagan; Parikh, Jay R; Wolfman, Darcy; Gridley, Daniel; Bender, Claire; Bluth, Edward

2016-12-01

To assess gender utilization of the Family and Medical Leave Act (FMLA) in radiology practices across the United States. The Practice of Radiology Environment Database was utilized to identify U.S. practice leaders, who were asked to complete an electronic survey developed by the ACR Human Resources (HR) Commission. In 2016, new survey questions asked about number of radiologists in each practice who took FMLA, the reasons why, the average number of weeks taken, and how such absences were covered. Thirty-two percent (579/1815) of practice group leaders responded to the survey and of these, 73% (432/579) answered FMLA questions, with 15% of those (64/432) answering affirmatively that a radiologist in their practice had taken FMLA leave. Reasons for this in 2015 included to care for a newborn/adopted child (49%), because of a personal serious health condition (42%), to care for an immediate family member (8%), or for active military duty (1%). Women took a greater number of weeks of FMLA leave than men for all reasons (care of newborn/adopted child: 10.7 versus 4.7; personal serious health condition: 10.3 versus 8.0; care of immediate family member: 9.7 versus 8.7) except for military duty (24 weeks taken, all by men). At least 69% of leave time was paid, irrespective of reason for leave or gender of person taking it. Most practices (82%) made no workforce changes to cover FMLA leave. Both genders of radiologists needed absences from work for FMLA-sanctioned reasons. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Differential Motivations for Pursuing Diagnostic Radiology by Gender: Implications for Residency Recruitment.

PubMed

Grimm, Lars J; Lowell, Dorothy A; Cater, Sarah W; Yoon, Sora C

2017-10-01

The purpose of this study is to determine how the motivations to pursue a career in radiology differ by gender. In addition, the influence of medical school radiology education will be assessed. Radiology applicants to our institution from the 2015-2016 interview season were offered an online survey in February 2016. Respondents scored the influence of 24 aspects of radiology on their decision to pursue radiology. Comparisons were made between male and female respondents. Respondents were also asked the type of medical school radiology education they received and to score the influence this experience had on their decision to pursue radiology. There were 202 total respondents (202/657) including 47 women and 155 men. Compared to men, the following factors had a more negative impact on women: flexible work hours (P = 0.04), work environment (P = 0.04), lifestyle (P = 0.04), impact on patient care (P = 0.05), high current debt load (P = 0.02), gender distribution of the field (P = 0.04), and use of emerging/advanced technology (P = 0.02). In contrast, women felt more favorably about the opportunities for leadership (P = 0.04) and research (P < 0.01). Dedicated radiology exposure was as follows: 20% (n = 20) none, 48% (n = 96) preclinical exposure, 55% (n = 111) elective rotation, and 18% (n = 37) core rotation. More intensive radiology exposure via a core rotation had a significantly positive impact on the decision to pursue radiology (P < 0.01). Male and female radiology applicants are motivated by different aspects of radiology, which may influence residency recruitment practices. In addition, more intensive radiology exposure has a net positive impact on the decision to pursue radiology. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Haptic interface of web-based training system for interventional radiology procedures

NASA Astrophysics Data System (ADS)

Ma, Xin; Lu, Yiping; Loe, KiaFock; Nowinski, Wieslaw L.

2004-05-01

The existing web-based medical training systems and surgical simulators can provide affordable and accessible medical training curriculum, but they seldom offer the trainee realistic and affordable haptic feedback. Therefore, they cannot offer the trainee a suitable practicing environment. In this paper, a haptic solution for interventional radiology (IR) procedures is proposed. System architecture of a web-based training system for IR procedures is briefly presented first. Then, the mechanical structure, the working principle and the application of a haptic device are discussed in detail. The haptic device works as an interface between the training environment and the trainees and is placed at the end user side. With the system, the user can be trained on the interventional radiology procedures - navigating catheters, inflating balloons, deploying coils and placing stents on the web and get surgical haptic feedback in real time.

Cultivating Future Radiology Educators: Development and Implementation of a Clinician-Educator Track for Residents.

PubMed

Mendoza, Dexter; Peterson, Ryan; Ho, Christopher; Harri, Peter; Baumgarten, Deborah; Mullins, Mark E

2018-05-03

Effective and dedicated educators are critical to the preservation and advancement of the practice of radiology. The need for innovative and adaptable educators is increasingly being recognized, with several institutions granting academic promotions through clinician-educator tracks. The implementation of resident "clinician-educator tracks" or "teaching tracks" should better prepare residents aspiring to become academic radiologists focused on teaching. In this work, we describe our experience in the development and implementation of a clinician-educator track for diagnostic radiology residents at our institution. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The Impact of Nonphysician Providers on Diagnostic and Interventional Radiology Practices: Operational and Educational Implications.

PubMed

Hawkins, C Matthew; Bowen, Michael A; Gilliland, Charles A; Walls, D Gail; Duszak, Richard

2015-09-01

The numbers of nurse practitioners (NPs) and physician assistants (PAs) are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. The use of radiologist assistants is growing in some radiology practices as well. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside radiology departments warrants closer review, particularly with regard to their potential influence on radiology education and medical imaging resource utilization. In this article (the second in a two-part series), the authors review recent literature and offer recommendations for radiology practices regarding the impact NPs, PAs, and radiologist assistants may have on interventional and diagnostic radiology practices. Their potential impact on medical education is also discussed. Finally, staffing for radiology departments, as a result of an enlarging nonradiology NP and PA workforce ordering diagnostic imaging, is considered. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Fatal and nonfatal risk associated with recycle of D&D-generated concrete

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boren, J.K.; Ayers, K.W.; Parker, F.L.

1997-02-01

As decontamination and decommissioning activities proceed within the U.S. Department of Energy Complex, vast volumes of uncontaminated and contaminated concrete will be generated. The current practice of decontaminating and landfilling the concrete is an expensive and potentially wasteful practice. Research is being conducted at Vanderbilt University to assess the economic, social, legal, and political ramifications of alternate methods of dealing with waste concrete. An important aspect of this research work is the assessment of risk associated with the various alternatives. A deterministic risk assessment model has been developed which quantifies radiological as well as non-radiological risks associated with concrete disposalmore » and recycle activities. The risk model accounts for fatal as well as non-fatal risks to both workers and the public. Preliminary results indicate that recycling of concrete presents potentially lower risks than the current practice. Radiological considerations are shown to be of minor importance in comparison to other sources of risk, with conventional transportation fatalities and injuries dominating. Onsite activities can also be a major contributor to non-fatal risk.« less

Radiology practice in Latin America: a literature review.

PubMed

Teague, Jordan

2013-01-01

To discover the status and structure of radiology in Latin America with respect to the health care systems it is part of, the effects of socioeconomics, the equipment and technology used, technologists and their training, accreditation, and professional organizations. Health-related databases and Google Scholar were searched for articles concerning radiology practice in Latin America. Articles were selected based on relevance to the research scope. Many regions in Latin America offer little to no access to radiology. Where there is access, the equipment often is old or not functioning, with limited and costly service and maintenance. Most trained technologists live in urban areas. There are no standardized accreditation practices in Latin America. However, forming professional organizations would help promote the practice of radiology and accreditation standards. International cooperative organizations enhance radiology by providing resources and opportunities for cooperation between countries. The current status of radiology in Latin America must be determined. This knowledge will help us discover opportunities for cooperation and ways to improve radiology practice. The main need in Latin America is to extend coverage to the underserved population.

Design of an image-distribution service from a clinical PACS

NASA Astrophysics Data System (ADS)

Gehring, Dale G.; Persons, Kenneth R.; Rothman, Melvyn L.; Felmlee, Joel P.; Gerhart, D. J.; Hangiandreou, Nicholas J.; Reardon, Frank J.; Shirk, M.; Forbes, Glenn S.; Williamson, Byrn, Jr.

1994-05-01

A PACS system has been developed through a multi-phase collaboration between the Mayo Clinic and IBM/Rochester. The current system has been fully integrated into the clinical practice of the Radiology Department for the primary purpose of digital image archival, retrieval, and networked workstation review. Work currently in progress includes the design and implementation of a gateway device for providing digital image data to third-party workstations, laser printers, and other devices, for users both within and outside of the Radiology Department.

Serving, Following, and Leading in Health Care.

PubMed

Penny, Steven M

2017-07-01

Radiologic technologists often perform diverse roles throughout the workday, and they should have at least a minimal understanding of the responsibility and effects of these roles on the patient and organization. Although technologists can practice independently or as part of a work group, individuals should be prepared to improve patient care and to function as a servant, follower, and leader for the overall success of the organization. This article examines those roles, emphasizing servantship. ©2017 American Society of Radiologic Technologists.

What is the relation between number of sessions worked and productivity of radiologists-a pilot study?

PubMed

Khan, Shah H M; Hedges, William P

2016-04-01

Increasing workloads and the current austerity measures are putting UK radiology departments under considerable stress. We need to look at the most efficient ways to manage radiology departments in order to cope with increasing demand. Consequently, a system is needed that can compare productivity between radiologists with different jobs. We measured workload in a UK radiology department and compared the productivities of consultants working different numbers of sessions, which are called programmed activities (PAs), to identify the optimal job plan structure for reporting productivity. Reporting data was gathered from electronic records for 14 consultants working different numbers of PA during the period April 2010-March 2011. These were converted into relative value unit (RVU) scores using a modified RCSI RVU system. Crude and net workloads were calculated for each consultant by dividing their total RVU score by the number of PAs they were contracted for and how many they spent reporting. The consultants reported 118,001 imaging studies. There was statistically significant variation in productivity between consultants working different numbers of PAs on χ (2) analysis (p < 0.05). Consultants working 12 PAs were more productive than consultants working 11 PAs, with net workloads of 7636 RVU/PA/year versus net 6146 RVU/PA/year, p < 0.05. Although UK consultants working 12 PAs per week are more productive than their colleagues, the reasons why are unclear. We have identified a method that can be developed further to identify efficient working practices in UK radiology departments. However, a UK-specific RVU system would make this productivity analysis more accurate.

Canadian Association of Radiologists White Paper on Artificial Intelligence in Radiology.

PubMed

Tang, An; Tam, Roger; Cadrin-Chênevert, Alexandre; Guest, Will; Chong, Jaron; Barfett, Joseph; Chepelev, Leonid; Cairns, Robyn; Mitchell, J Ross; Cicero, Mark D; Poudrette, Manuel Gaudreau; Jaremko, Jacob L; Reinhold, Caroline; Gallix, Benoit; Gray, Bruce; Geis, Raym

2018-05-01

Artificial intelligence (AI) is rapidly moving from an experimental phase to an implementation phase in many fields, including medicine. The combination of improved availability of large datasets, increasing computing power, and advances in learning algorithms has created major performance breakthroughs in the development of AI applications. In the last 5 years, AI techniques known as deep learning have delivered rapidly improving performance in image recognition, caption generation, and speech recognition. Radiology, in particular, is a prime candidate for early adoption of these techniques. It is anticipated that the implementation of AI in radiology over the next decade will significantly improve the quality, value, and depth of radiology's contribution to patient care and population health, and will revolutionize radiologists' workflows. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI working group with the mandate to discuss and deliberate on practice, policy, and patient care issues related to the introduction and implementation of AI in imaging. This white paper provides recommendations for the CAR derived from deliberations between members of the AI working group. This white paper on AI in radiology will inform CAR members and policymakers on key terminology, educational needs of members, research and development, partnerships, potential clinical applications, implementation, structure and governance, role of radiologists, and potential impact of AI on radiology in Canada. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Thyroid cancer and employment as a radiologic technologist.

PubMed

Zabel, Erik W; Alexander, Bruce H; Mongin, Steven J; Doody, Michele M; Sigurdson, Alice J; Linet, Martha S; Freedman, D Michal; Hauptmann, Michael; Mabuchi, Kiyohiko; Ron, Elaine

2006-10-15

The association between chronic occupational ionizing radiation exposure in the medical field and thyroid cancer is not well characterized. Thyroid cancer incidence was ascertained for 2 periods in a cohort of radiologic technologists certified for a minimum 2 years and enumerated in 1983: (i) cases identified prospectively in 73,080 radiologic technologists who were free of thyroid cancer at the baseline survey and completed a second questionnaire a decade later (N = 121), and (ii) cases occurring prior to cohort enumeration among 90,245 technologists who completed the baseline survey and were thyroid cancer free 2 years after certification (N = 148). Survival analyses estimated risks associated with employment as a radiologic technologist, including duration of employment, period of employment, types of procedures and work practices. The only occupational history characteristic associated with prospectively identified thyroid cancer was a history of holding patients for X-ray procedures at least 50 times (HR = 1.47, 95% CI = 1.01-2.15). Total years worked as a radiologic technologist, years performing diagnostic, therapeutic, and nuclear medicine procedures, employment under age 20 and calendar period of first employment were not associated with thyroid cancer risk. Risk of thyroid cancers diagnosed before the baseline questionnaire was inversely associated with decade first employed as a technologist, and was elevated, albeit imprecisely, among those working more than 5 years prior to 1950 (HR = 3.04, 95% CI = 1.01-10.78). These data provide modest evidence of an association between employment as a radiologic technologist and thyroid cancer risk; however, the findings require confirmation with more accurate exposure models. Copyright 2006 Wiley-Liss, Inc.

75 FR 43178 - Medicare Program; Solicitation for Proposals for the Medicare Imaging Demonstration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-23

..., medical specialty societies, physician groups, integrated health care delivery systems, independent practice associations, radiology benefit managers, health plans, information technology vendors, and... societies. The Centers for Medicare & Medicaid Services (CMS) worked with medical specialty societies and...

[Marketing mix in a radiology department: challenges for future radiologists in management].

PubMed

Claikens, B

1998-08-01

Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Brien, Jeremy; Baerlocher, Mark Otto; Asch, Murray R.

2007-09-15

Purpose. To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods. An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results. Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200-500 (49%) or 500-1,000 (39%) beds. Procedures listed by respondents as most commonlymore » performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion. Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.« less

RADIOLOGY EDUCATION: A PILOT STUDY TO ASSESS KNOWLEDGE OF MEDICAL STUDENTS REGARDING IMAGING IN TRAUMA.

PubMed

Siddiqui, Saad; Saeed, Muhammad Anwar; Shah, Noreen; Nadeem, Naila

2015-01-01

Trauma remains one of the most frequent presentations in emergency departments. Imaging has established role in setting of acute trauma with ability to identify potentially fatal conditions. Adequate knowledge of health professionals regarding trauma imaging is vital for improved healthcare. In this work we try to assess knowledge of medical students regarding imaging in trauma as well as identify most effective way of imparting radiology education. This cross-sectional pilot study was conducted at Aga Khan University Medical College & Khyber Girls Medical College, to assess knowledge of medical students regarding imaging protocols practiced in initial management of trauma patients. Only 40 & 20% respectively were able to identify radiographs included in trauma series. Very few had knowledge of correct indication for Focused abdominal sonography in trauma. Clinical radiology rotation was reported as best way of learning radiology. Change in curricula & restructuring of clinical radiology rotation structure is needed to improve knowledge regarding Trauma imaging.

Development and initial evaluation of a training program for peripherally inserted central catheter (PICC) placement for radiology residents and technicians.

PubMed

Dabadie, A; Soussan, J; Mancini, J; Vidal, V; Bartoli, J M; Gorincour, G; Petit, P

2016-09-01

The goals of this study were to develop and evaluate a joint theoretical/practical training course for radiology residents and technicians and to start a collaborative practice agreement enabling radiology technicians to perform PICC placement under the responsibility of an interventional radiologist. A joint training session based on literature evidences and international recommendations was designed. Participants were assessed before and after training, and were also asked to evaluate the program one month after completion of the training course. Practical post-training mentoring guidelines were laid down for radiologists supervising technicians. From January to April 2014, 6 radiology residents and 12 radiology technicians from the two interventional radiology departments of the University hospitals in Marseille took part in the training program. For both residents and technicians, significant improvement was observed between pretraining and post-training assessment. The majority of participants were satisfied with the program. Our experience suggests that combined theoretical and practical training in PICC placement allows improving technical skill and yields high degrees of satisfaction for both radiology residents and technicians. A collaborative practice agreement is now formally established to enable radiologists to delegate PICC placement procedures to radiology technicians. Copyright © 2016 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

U.S.-CHINA RADIOLOGICAL SOURCE SECURITY PROJECT: CONTINUING AND EXPANDING BILATERAL COOPERATION

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhu, Zhixuan; Zhou, Qifu; Yang, Yaoyun

2009-10-07

The successful radiological security cooperation between the U.S. and China to secure at-risk sites near venues of the 2008 Beijing Summer Olympics has led to an expanded bilateral nonproliferation cooperation scope. The U.S. Department of Energy’s National Nuclear Security Administration, the Chinese Atomic Energy Authority and the China Ministry of Environmental Protection are continuing joint efforts to secure radiological sources throughout China under the U.S.-China Peaceful Uses of Nuclear Technology (PUNT) Agreement. Joint cooperation activities include physical security upgrades of sites with International Atomic Energy Agency (IAEA) Category 1 radiological sources, packaging, recovery, and storage of high activity transuranic andmore » beta gamma sources, and secure transportation practices for the movement of recovered sources. Expansion of cooperation into numerous provinces within China includes the use of integrated training workshops that will demonstrate methodologies and best practices between U.S. and Chinese radiological source security and recovery experts. The fiscal year 2009 expanded scope of cooperation will be conducted similar to the 2008 Olympic cooperation with the Global Threat Reduction Initiative taking the lead for the U.S., PUNT being the umbrella agreement, and Los Alamos, Sandia, and Oak Ridge National Laboratories operating as technical working groups. This paper outlines the accomplishments of the joint implementation and training efforts to date and discusses the possible impact on future U.S./China cooperation.« less

[Telecommunications, health and radiology: potential synergies for the new millennium].

PubMed

Lagalla, R

2001-01-01

Healthcare telematics, or telemedicine, is a new methodology that applies the potentialities of telecommunications technologies to the needs of medicine, thereby greatly contributing to improving the management of clinical data and medical information for the benefit of the individual patient and the community at large. The fields of application of Telemedicine are becoming increasingly vast, and this gives rise to technical problems (interconnections) as well as professional, ethical, medico-legal and legal problems. The dissemination of Telemedicine will require changes to be made to the organisation and delivery of the medical/administrative services connected to the management of patient data, the remote provision of care, and the impact of Telemedicine itself (e.g. need to standardise the nomenclature for telemedicine services). In addition, it will also call for a careful analysis of costs and benefits for both healthcare providers and patients. One of the most interesting experiences in terms of impact is Teleradiology. This is neither a new discipline nor a (sub)specialty: the practice of Teleradiology must comply with the rules regulating any radiological medical act, the primary aim of which is to contribute to establishing - rapidly and accurately - a diagnosis that will affect treatment strategies. It may be anticipated that in some situations Teleradiology will significantly change the working practices of Radiology Specialists and Radiology Technicians. Because it is better to anticipate problems rather than wait for them to arise, our Scientific Society, which is always sensitive to emerging issues, intends to propose the following recommendations/guidelines for the use of Teleradiology in the common interest of the community and healthcare workers. The invitation to take part in the initiative proposed by the Italian Society of Medical Radiology (SIRM), the Italian Association of Nuclear Medicine (AIMN) and the Italian Association of Neuroradiology (AINR) was received with great satisfaction and is proof that we are working towards common goals. As on other occasions, this was reflected in the excellent collaboration between the National Radiologists' Union (SNR), the Italian Association of Medical Physics (AIFM) and the National Federation of Radiology Technicians (F.N.C.TSRM) in drafting the document. The document aims to highlight the potentialities and limitations in the use of Teleradiology and to provide a set of recommendations/guidelines, which are not, however, to be intended as strict, absolute rules. Because this field is continually evolving both in structural and regulatory terms, and because it is very difficult to establish universal criteria to rigidly define behavioural models for implementing and managing Teleradiology-related activities (which in any case fall into the category of radiological medical acts), the recommendations/guidelines proposed necessarily have an informative rather than prescriptive nature. The document starts by defining the meaning of the following currently used terms: Teleconsultation; Telediagnosis; Teledidactics. It then goes on to analyse the following aspects of Teleradiology: Technological requirements; Qualifications and training of Medical Personnel; Qualifications, training and competences of Radiology Technicians. Based on the regulations in force in Italy, these recommendations are structured in terms of rationale and possible professional issues arising from the use of Teleradiology. A section is devoted to data security and confidentiality, including legal implications, an area which is currently evolving and being studied in Italy and abroad. Finally, the professional liabilities of all the healthcare providers involved in Teleradiology (imprudence, incompetence, negligence) are outlined, as well as the responsibilities related to the necessary maintenance of equipment. The aim of the document is to propose recommendations/guidelines for the correct use and validation of Teleradiology. The Scientific Societies SIRM-AIMN-AINR and the Academic Institutions, together with the SNR, AIFM and the F.N.C.TSRM, the Regional Bodies and the Italian National Health Trusts are required to make a positive and constructive commitment to this new field, which has become the object of considerable attention and interests. While confirming that, if used correctly, this methodology will no doubt increase the overall efficiency of Diagnostic Imaging - in the primary interest of the patient's right to health - it is felt that attention should also be paid to the working practices of the Radiology Specialists and Radiology Technicians and to the training of both. It is necessary to standardise training and practice, and to make an integrated and coherent use of resources with respect to the healthcare goals we wish to attain. Many have described the undisputed advantages of Teleradiology, but there have been relatively few reports on the related risks and recommendations for its use. It is certain that an improper use of the method (forced& interpretation of the bill on complementary diagnostic activities, operational misunderstandings between Radiology Specialists and Radiology Technicians, rarefaction of the relationship between Radiologist and Patient, obligation to use teleconsultation in all situations) will lead to considerable disadvantages for all those working in the field of Radiology, specialists and radiology technicians alike. Therefore, by adopting this document, which is by no means against Teleradiology but for a rational use of the method and full awareness of what it actually implies, the Scientific Society intends on the one hand to participate actively and concretely in the process of regulating all those aspects of Teleradiology for which it is competent - rather than waiting for regulations to be imposed from above - and, on the other, to provide, through its highly qualified Study Group (Specialists in Radiology, Nuclear Medicine, Legal Medicine, Medical Physics, and Radiology Technicians), Radiologists, Specialists in Nuclear Medicine, Neuroradiologists and Radiology Technicians with practical recommendations for use/guidelines for the correct and rational performance of their (tele)radiological acts. These indications and recommendations are also being submitted to the Italian Government. Teleradiology has attracted so much attention that, even as a result of pressure from Industry, an international consensus conference is needed to regulate the rational and informed use of this new methodology.

Continuous quality improvement programs provide new opportunities to drive value innovation initiatives in hospital-based radiology practices.

PubMed

Steele, Joseph R; Schomer, Don F

2009-07-01

Imaging services constitute a huge portion of the of the total dollar investment within the health care enterprise. Accordingly, this generates competition among medical specialties organized along service lines for their pieces of the pie and increased scrutiny from third-party payers and government regulators. These market and political forces create challenge and opportunity for a hospital-based radiology practice. Clearly, change that creates or builds greater value for patients also creates sustainable competitive advantage for a radiology practice. The somewhat amorphous concept of quality constitutes a significant value driver for innovation in this scenario. Quality initiatives and programs seek to define and manage this amorphous concept and provide tools for a radiology practice to create or build more value. Leadership and the early adoption of these inevitable programs by a radiology practice strengthens relationships with hospital partners and slows the attrition of imaging service lines to competitors.

Personal Branding: A Primer for Radiology Trainees and Radiologists.

PubMed

Kalia, Vivek; Patel, Amy K; Moriarity, Andrew K; Canon, Cheri L

2017-07-01

A radiologist's personal brand is a composite of many parts in one's professional life. In an age where work quality and digital footprints are tracked and measured more than ever before, it behooves radiologists to develop and curate their own individual brands in effective ways. Personal branding consists of the decisions we make, both consciously and unconsciously, which affect our reputation and the likelihood of seeking our services in the future for both patients and referring providers. As hospital systems are increasingly adjusting their systems to cater to better patient experiences, it is imperative that radiologists similarly adjust our practice patterns to accommodate the needs of the new paradigm of value-based care. It is no longer sufficient to only practice excellent clinical radiology; one's service experience to clinical providers, report quality, and digital presence must all be robust and compelling. Defining your brand and promoting your vision and quality standards have become as important to radiologists' future as keeping up with advancements in radiologic technology. One must select the proper platforms and types of interactions in which to engage from available social media options. Developing a consistent brand and presence in the work setting, on social media accounts, and in professional organizations at the local, national, and international levels is the ultimate goal. At present, very little, if any, formal training is provided on personal branding skills such as these in current residency curricula, and it is critical for radiologists to fill their gaps in knowledge through additional means. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Comprehensive Health Care Economics Curriculum and Training in Radiology Residency.

PubMed

Keiper, Mark; Donovan, Timothy; DeVries, Matthew

2018-06-01

To investigate the ability to successfully develop and institute a comprehensive health care economics skills curriculum in radiology residency training utilizing didactic lectures, case scenario exercises, and residency miniretreats. A comprehensive health care economics skills curriculum was developed to significantly expand upon the basic ACGME radiology residency milestone System-Based Practice, SBP2: Health Care Economics requirements and include additional education in business and contract negotiation, radiology sales and marketing, and governmental and private payers' influence in the practice of radiology. A health care economics curriculum for radiology residents incorporating three phases of education was developed and implemented. Phase 1 of the curriculum constituted basic education through didactic lectures covering System-Based Practice, SBP2: Health Care Economics requirements. Phase 2 constituted further, more advanced didactic lectures on radiology sales and marketing techniques as well as government and private insurers' role in the business of radiology. Phase 3 applied knowledge attained from the initial two phases to real-life case scenario exercises and radiology department business miniretreats with the remainder of the radiology department. A health care economics skills curriculum in radiology residency is attainable and essential in the education of future radiology residents in the ever-changing climate of health care economics. Institution of more comprehensive programs will likely maximize the long-term success of radiology as a specialty by identifying and educating future leaders in the field of radiology. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

78 FR 10174 - Agency Information Collection Activities; Proposed Collection; Public Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... specialties (internal medicine, radiology, cardiology, ophthalmology, and orthopedics) to gather information... Schedule, payments are based in part on the relative amount of physician work associated with each service... values are updated to reflect changes in medical practice, technology and physician productivity, some...

Subinternship in Radiology - A Practical Start to the Specialization?

PubMed

Kasch, R; Wirkner, J; Hosten, N; Hinz, P; Napp, M; Kessler, R

2016-11-01

Purpose: To identify factors influencing medical students to choose radiology in the four-month clinical elective in the final year of medical school following radiology subinternships. Materials and Methods: A subsample of medical students in a nationwide German online survey evaluated a subinternship in radiology (19 items). They were divided into four groups: Students who could imagine doing a clinical elective in radiology in the practical year based on their experiences during the subinternship ("yes, based on subinternship"), students who could not ("no, based on subinternship") and students who had made this decision prior to the subinternship ("yes, prior to subinternship" and "no, prior to subinternship"). Results: 94 medical students evaluated a radiology subinternship (54.4 % females). Based on their experiences during the subinternship, 54 students (57.4 %) intended to do a final year clinical elective in radiology, 39 of them (41.5 %) being encouraged by the subinternship. 40 (42.6 %) reported having a negative attitude towards a clinical elective in radiology, 16 of them (17.0 %) having made this decision based on their subinternship experience. Groups did not differ regarding gender (p = 0.396) and age (p = 0.853). Students motivated to do a final year clinical elective in radiology experienced excellent academic teaching (p = 0.001) and practical involvement (p = 0.003), achieved their learning goals more often (p = 0.001), were better integrated into the team (p = 0.001), and acquired more practical skills (p = 0.003). Overall satisfaction was higher in these groups (p = 0.001). Conclusion: Satisfaction with a radiology subinternship is crucial for motivating medical students to do a final year clinical elective in radiology. A structured subinternship and continuous mentoring should be targeted to keep students connected to radiology. Key Points: • Radiology subinternships influence further interest in the specialization.• The quality and structure of teaching critically influence student satisfaction.• Team integration and practical involvement positively affect the attitude towards a specialization. Citation Format: • Kasch R, Wirkner J, Hosten N et al. Subinternship in Radiology - A Practical Start to the Specialization? Fortschr Röntgenstr 2016; 188: 1024 - 1030. © Georg Thieme Verlag KG Stuttgart · New York.

Teaching medical management and operations engineering for systems-based practice to radiology residents.

PubMed

Brandon, Catherine J; Mullan, Patricia B

2013-03-01

To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice. A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions. Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology. Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

Historical influence on the practice of chiropractic radiology: part II - thematic analysis on the opinions of diplomates of the American Chiropractic College of Radiology about the future.

PubMed

Young, Kenneth J

2017-01-01

Over the past 20 years, various authors have addressed the question of the future of chiropractic. Most were positive about the future, with some advocating evidence-based practice and integration with mainstream healthcare, some advocating continued separation with an emphasis on subluxation-based care or the traditional/historical paradigm of chiropractic, and some calling for tolerance and unity. No papers were found specifically inquiring about the future of chiropractic radiology. The study population consisted of all current members of the American Chiropractic College of Radiology (ACCR), estimated at 190 people, known as chiropractic radiologists or Diplomates of the American Chiropractic Board of Radiology (DACBRs). An internet-based, anonymous survey using SurveyMonkey was implemented, supplemented by hard copies distributed at a conference. The main point of interest for this paper is the final item of the overall questionnaire. This item inquired about the future of chiropractic radiology. Thematic analysis was used on the responses, coded in both constructionist and inductive ways to extract both a general outlook and more specific themes. The inductive themes were also assigned secondarily to a SWOT (strengths, weaknesses, opportunities, and threats) analysis. The overall response rate to the survey was 38% (73/190); within the group of respondents, 71 of 73 (98%) answered the item that is the subject of this paper. Opinions on the outlook for chiropractic radiology in the future were more negative than positive, with 14 respondents giving a positive outlook, 26 negative, and 14 non-committal. 28 respondents advocated integration with the wider healthcare community, 11 recommended emphasising separateness or a focus on working within chiropractic, and 15 did not express an opinion on this issue. Ten strengths were noted, 11 weaknesses, 57 opportunities, and 30 threats. The increasing necessity of demonstrating evidence for diagnostic and therapeutic procedures in healthcare makes it likely that chiropractic radiologists and the wider chiropractic profession will need to take a more active position on evidence-based practice. Re-evaluation of guidelines and legislation as well as enforcement policies and practices will be necessary. The consequences of failing to do so may include increased marginalisation and reduced viability as a profession.

Efficient radiologic reading environment by using an open-source macro program as connection software.

PubMed

Lee, Young Han

2012-01-01

The objectives are (1) to introduce an easy open-source macro program as connection software and (2) to illustrate the practical usages in radiologic reading environment by simulating the radiologic reading process. The simulation is a set of radiologic reading process to do a practical task in the radiologic reading room. The principal processes are: (1) to view radiologic images on the Picture Archiving and Communicating System (PACS), (2) to connect the HIS/EMR (Hospital Information System/Electronic Medical Record) system, (3) to make an automatic radiologic reporting system, and (4) to record and recall information of interesting cases. This simulation environment was designed by using open-source macro program as connection software. The simulation performed well on the Window-based PACS workstation. Radiologists practiced the steps of the simulation comfortably by utilizing the macro-powered radiologic environment. This macro program could automate several manual cumbersome steps in the radiologic reading process. This program successfully acts as connection software for the PACS software, EMR/HIS, spreadsheet, and other various input devices in the radiologic reading environment. A user-friendly efficient radiologic reading environment could be established by utilizing open-source macro program as connection software. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Real-Time Electronic Dashboard Technology and Its Use to Improve Pediatric Radiology Workflow.

PubMed

Shailam, Randheer; Botwin, Ariel; Stout, Markus; Gee, Michael S

The purpose of our study was to create a real-time electronic dashboard in the pediatric radiology reading room providing a visual display of updated information regarding scheduled and in-progress radiology examinations that could help radiologists to improve clinical workflow and efficiency. To accomplish this, a script was set up to automatically send real-time HL7 messages from the radiology information system (Epic Systems, Verona, WI) to an Iguana Interface engine, with relevant data regarding examinations stored in an SQL Server database for visual display on the dashboard. Implementation of an electronic dashboard in the reading room of a pediatric radiology academic practice has led to several improvements in clinical workflow, including decreasing the time interval for radiologist protocol entry for computed tomography or magnetic resonance imaging examinations as well as fewer telephone calls related to unprotocoled examinations. Other advantages include enhanced ability of radiologists to anticipate and attend to examinations requiring radiologist monitoring or scanning, as well as to work with technologists and operations managers to optimize scheduling in radiology resources. We foresee increased utilization of electronic dashboard technology in the future as a method to improve radiology workflow and quality of patient care. Copyright © 2017 Elsevier Inc. All rights reserved.

Towards Social Radiology as an Information Infrastructure: Reconciling the Local With the Global

PubMed Central

2014-01-01

The current widespread use of medical images and imaging procedures in clinical practice and patient diagnosis has brought about an increase in the demand for sharing medical imaging studies among health professionals in an easy and effective manner. This article reveals the existence of a polarization between the local and global demands for radiology practice. While there are no major barriers for sharing such studies, when access is made from a (local) picture archive and communication system (PACS) within the domain of a healthcare organization, there are a number of impediments for sharing studies among health professionals on a global scale. Social radiology as an information infrastructure involves the notion of a shared infrastructure as a public good, affording a social space where people, organizations and technical components may spontaneously form associations in order to share clinical information linked to patient care and radiology practice. This article shows however, that such polarization establishes a tension between local and global demands, which hinders the emergence of social radiology as an information infrastructure. Based on an analysis of the social space for radiology practice, the present article has observed that this tension persists due to the inertia of a locally installed base in radiology departments, for which common teleradiology models are not truly capable of reorganizing as a global social space for radiology practice. Reconciling the local with the global signifies integrating PACS and teleradiology into an evolving, secure, heterogeneous, shared, open information infrastructure where the conceptual boundaries between (local) PACS and (global) teleradiology are transparent, signaling the emergence of social radiology as an information infrastructure. PMID:25600710

Time Is Not on Our Side: How Radiology Practices Should Manage Customer Queues.

PubMed

Loving, Vilert A; Ellis, Richard L; Rippee, Robert; Steele, Joseph R; Schomer, Donald F; Shoemaker, Stowe

2017-11-01

As health care shifts toward patient-centered care, wait times have received increasing scrutiny as an important metric for patient satisfaction. Long queues form when radiology practices inefficiently service their customers, leading to customer dissatisfaction and a lower perception of value. This article describes a four-step framework for radiology practices to resolve problematic queues: (1) analyze factors contributing to queue formation; (2) improve processes to reduce service times; (3) reduce variability; (4) address the psychology of queues. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Marketing a Radiology Practice.

PubMed

Levin, David C; Rao, Vijay M; Flanders, Adam E; Sundaram, Baskaran; Colarossi, Margaret

2016-10-01

In addition to being a profession, the practice of radiology is a business, and marketing is an important part of that business. There are many facets to marketing a radiology practice. The authors present a number of ideas on how to go about doing this. Some marketing methods can be directed to both patients and referring physicians. Others should be directed just to patients, while still others should be directed just to referring physicians. Aside from marketing, many of them provide value to both target audiences. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Musculoskeletal symptoms amongst clinical radiologists and the implications of reporting environment ergonomics--a multicentre questionnaire study.

PubMed

Rodrigues, Jonathan C L; Morgan, Steven; Augustine, Katharine; Clague, Gavin; Pearce, Tim; Pollentine, Adrian; Wallis, Adam; Wilson, David; McCoubrie, Paul

2014-04-01

This multicentre study aimed to assess compliance of the reporting environment with best ergonomic practice and to determine the prevalence of musculoskeletal symptoms related to working as a radiologist. All 148 radiology trainees and consultants in 10 hospitals across the region were invited to complete a musculoskeletal symptoms and reporting ergonomics questionnaire. Best ergonomic reporting practice was defined, following literature review, as being able to alter the following: monitor, desk, chair and armrest height, chair back support, ambient light, and temperature. The frequency that these facilities were available and how often they were used was determined. One hundred and twenty-three out of 148 (83%) radiologists responded, and 38% reported radiology-associated occupational injury. Lower back discomfort was the commonest radiology associated musculoskeletal symptom (41%). Only 13% of those with occupational injury sought the advice of occupational health. No reporting environments conformed completely to best ergonomic practice. Where certain facilities were available, less than a third of radiologists made personal ergonomic adjustments prior to starting a reporting session. Radiologists who had good self-assessed knowledge of best ergonomic practice had significantly less back discomfort than those with poor self-assessed knowledge (P < 0.005). We demonstrated high prevalence of musculoskeletal symptoms amongst radiologists. Poor compliance of the reporting environment with best ergonomic practice, in combination with our other findings of a low level of ergonomic awareness, low rates of making ergonomic adjustments and seeking appropriate help, may be implicated. We hope this study raises awareness of this issue and helps prevent long-term occupational injury amongst radiologists from poor ergonomic practice.

Strategy development for anticipating and handling a disruptive technology.

PubMed

Chan, Stephen

2006-10-01

The profession of radiology has greatly benefited from the introduction of new imaging technologies throughout its history. Therefore, it would seem reasonable for radiologists to believe that the emergence of a new imaging technology can generally be foreseen with sufficient advance notice to allow the appropriate levels of time, effort, and money to be devoted toward incorporating it into radiology practice. However, in his seminal work, Christiansen characterized a new form of technologic innovation, known as "disruptive technology," whose emergence often heralds the replacement of market leaders in an industry by competitors who are quicker in adopting and deploying the new technology. This article briefly describes the phenomenon of disruptive technology and addresses the challenges that organizations face in dealing with disruptive technology. The article raises 4 questions about the future of radiology: (1) Are health care and radiology vulnerable to disruptive technology? (2) What kinds of change may be in store for the radiology profession? (3) Can the radiology profession prepare itself to recognize and respond to a disruptive innovation among a group of new imaging technologies? and (4) How should a radiology organization decide whether to invest significant resources in a potentially disruptive technology? This article addresses these questions by reviewing key insights from leading "gurus" in the fields of competitive strategy and technology management and applying them to radiology. This illustrates how and why (despite past successes) the radiology profession may still have a blind spot in recognizing and handling disruptive technologies.

Strengths and Deficiencies in the Content of US Radiology Private Practices' Websites.

PubMed

Johnson, Evan J; Doshi, Ankur M; Rosenkrantz, Andrew B

2017-03-01

The Internet provides a potentially valuable mechanism for radiology practices to communicate with patients and enhance the patient experience. The aim of this study was to assess the websites of US radiology private practices, with attention to the frequency of content of potential patient interest. The 50 largest private practice radiology facilities in the United States were identified from RadiologyBusiness.com. Websites were reviewed for information content and functionality. Content regarding radiologists' names, medical schools, residencies, fellowships, photographs, and board certification status; contact for billing questions; and ability to make online payments was present on 80% to 98% of sites. Content regarding examination preparation, contrast use, examination duration, description of examination experience, scheduling information, directions, privacy policy, radiologists' role in interpretation, and ACR accreditation was present on 60% to 78%. Content regarding accepted insurers, delivery of results to referrers, report turnaround times, radiologists' years of experience, radiation safety, and facility hours was present on 40% to 58%. Content regarding technologist certification, registration forms, instructions for requesting a study on disc, educational videos, and patient testimonials was present on 20% to 38%. Content regarding examination prices, patient satisfaction scores, peer review, online scheduling, online report and image access, and parking was present on <20%. Radiology practices' websites most frequently provided information regarding their radiologists' credentials, as well as billing and payment options. Information regarding quality, safety, and the examination experience, as well as non-payment-related online functionality, was less common. These findings regarding the most common deficiencies may be useful for radiology practices in expanding their websites' content, thereby improving communication and potentially the patient experience. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Teaching surgery, radiology and anatomy together: the mix enhances motivation and comprehension.

PubMed

Dettmer, Sabine; Tschernig, Thomas; Galanski, Michael; Pabst, Reinhard; Rieck, Bernd

2010-10-01

Preclinical and clinical topics are often separated in medical education. For example, surgery and radiology are often taught much later than anatomy. The aim of this study was to establish and to evaluate an interdisciplinary course combining these closely related subjects to enhance medical comprehension. Two tutorials each lasting one term were offered to second year medical students, in which clinical topics were implemented linking anatomy to surgical and radiological knowledge. A questionnaire was used to evaluate the success of this approach. The motivation of the students was above average and the practical work was done accurately. The students confirmed that the course improved anatomical comprehension (>95%) and that the learned matters were relevant for their future (90%). Furthermore, interest in the subjects was higher after the course (>85%). Critical suggestions were to extend the course and to include more topics. A mix of surgery, radiology and anatomy is a teaching concept, which leads to high acceptance and interest in medical students.

Informatics in radiology: evaluation of an e-learning platform for teaching medical students competency in ordering radiologic examinations.

PubMed

Marshall, Nina L; Spooner, Muirne; Galvin, P Leo; Ti, Joanna P; McElvaney, N Gerald; Lee, Michael J

2011-01-01

A preliminary audit of orders for computed tomography was performed to evaluate the typical performance of interns ordering radiologic examinations. According to the audit, the interns showed only minimal improvement after 8 months of work experience. The online radiology ordering module (ROM) program included baseline assessment of student performance (part I), online learning with the ROM (part II), and follow-up assessment of performance with simulated ordering with the ROM (part III). A curriculum blueprint determined the content of the ROM program, with an emphasis on practical issues, including provision of logistic information, clinical details, and safety-related information. Appropriate standards were developed by a committee of experts, and detailed scoring systems were devised for assessment. The ROM program was successful in addressing practical issues in a simulated setting. In the part I assessment, the mean score for noting contraindications for contrast media was 24%; this score increased to 59% in the part III assessment (P = .004). Similarly, notification of methicillin-resistant Staphylococcus aureus status and pregnancy status and provision of referring physician contact information improved significantly. The quality of the clinical notes was stable, with good initial scores. Part III testing showed overall improvement, with the mean score increasing from 61% to 76% (P < .0001). In general, medical students lack the core knowledge that is needed for good-quality ordering of radiology services, and the experience typically afforded to interns does not address this lack of knowledge. The ROM program was a successful intervention that resulted in statistically significant improvements in the quality of radiologic examination orders, particularly with regard to logistic and radiation safety issues.

Machine Learning in Radiology: Applications Beyond Image Interpretation.

PubMed

Lakhani, Paras; Prater, Adam B; Hutson, R Kent; Andriole, Kathy P; Dreyer, Keith J; Morey, Jose; Prevedello, Luciano M; Clark, Toshi J; Geis, J Raymond; Itri, Jason N; Hawkins, C Matthew

2018-02-01

Much attention has been given to machine learning and its perceived impact in radiology, particularly in light of recent success with image classification in international competitions. However, machine learning is likely to impact radiology outside of image interpretation long before a fully functional "machine radiologist" is implemented in practice. Here, we describe an overview of machine learning, its application to radiology and other domains, and many cases of use that do not involve image interpretation. We hope that better understanding of these potential applications will help radiology practices prepare for the future and realize performance improvement and efficiency gains. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Paradigms of perception in clinical practice.

PubMed

Jacobson, Francine L; Berlanstein, Bruce P; Andriole, Katherine P

2006-06-01

Display strategies for medical images in radiology have evolved in tandem with the technology by which images are made. The close of the 20th century, nearly coincident with the 100th anniversary of the discovery of x-rays, brought radiologists to a new crossroad in the evolution of image display. The increasing availability, speed, and flexibility of computer technology can now revolutionize how images are viewed and interpreted. Radiologists are not yet in agreement regarding the next paradigm for image display. The possibilities are being explored systematically through the Society for Computer Applications in Radiology's Transforming the Radiological Interpretation Process initiative. The varied input of radiologists who work in a large variety of settings will enable new display strategies to best serve radiologists in the detection and quantification of disease. Considerations and possibilities for the future are presented in this paper.

Capacity for Cancer Care Delivery Research in National Cancer Institute Community Oncology Research Program Community Practices: Availability of Radiology and Primary Care Research Partners.

PubMed

Carlos, Ruth C; Sicks, JoRean D; Chang, George J; Lyss, Alan P; Stewart, Teresa L; Sung, Lillian; Weaver, Kathryn E

2017-12-01

Cancer care spans the spectrum from screening and diagnosis through therapy and into survivorship. Delivering appropriate care requires patient transitions across multiple specialties, such as primary care, radiology, and oncology. From the program's inception, the National Cancer Institute Community Oncology Research Program (NCORP) sites were tasked with conducting cancer care delivery research (CCDR) that evaluates structural, organizational, and social factors, including care transitions that determine patient outcomes. The aim of this study is to describe the capacity of the NCORP to conduct multidisciplinary CCDR that includes radiology and primary care practices. The NCORP includes 34 community and 12 minority and underserved community sites. The Landscape Capacity Assessment was conducted in 2015 across these 46 sites, composed of the 401 components and subcomponents designated to conduct CCDR. Each respondent had the opportunity to designate an operational practice group, defined as a group of components and subcomponents with common care practices and resources. The primary outcomes were the proportion of adult oncology practice groups with affiliated radiology and primary care practices. The secondary outcomes were the proportion of those affiliated radiology and primary care groups that participate in research. Eighty-seven percent of components and subcomponents responded to at least some portion of the assessment, representing 230 practice groups. Analyzing the 201 adult oncology practice groups, 85% had affiliated radiologists, 69% of whom participate in research. Seventy-nine percent had affiliated primary care practitioners, 31% of whom participate in research. Institutional size, multidisciplinary group practice, and ownership by large regional or multistate health systems was associated with research participation by affiliated radiology and primary care groups. Research participation by these affiliated specialists was not significantly different between the community and the minority and underserved community sites. Research relationships exist between the majority of community oncology sites and affiliated radiology practices. Research relationships with affiliated primary care practices lagged. NCORP as a whole has the opportunity to encourage continued and expanded engagement where relationships exist. Where no relationship exists, the NCORP can encourage recruitment, particularly of primary care practices as partners. Copyright © 2017. Published by Elsevier Inc.

Preparedness for physiotherapy in private practice: Novices identify key factors in an interpretive description study.

PubMed

Atkinson, Robyn; McElroy, Theresa

2016-04-01

Physiotherapists in Australia deliver services to a diverse range of clients, across many settings, however little research exists examining graduate preparedness for practice, even in the populous field of private practice. To explore novice physiotherapist perspectives on preparedness for work in private practice. The qualitative approach of interpretive description was used to guide in-depth interviews with 8 novice physiotherapists from 3 universities working in 5 private practices in Melbourne. All interviews were digitally recorded, transcribed verbatim and analyzed thematically. Four main themes influencing graduate preparedness for work in private practice were identified: 1) non-curricular experiences (e.g. sports training) 2) elective curricular: practicum experiences; 3) curricular: attainment of skills specific to private practice; and 4) the private practice setting: supportive colleagues. This combination of non-curricular, curricular, and practice setting factors offered the necessary scaffolding for the graduates to report feeling prepared for work in private practice. Non-curricular activities, radiological instruction, clinical placements, building supportive colleague relations and professional development in private practice are recommended as potential means of building preparedness in novice therapists. Findings have implications for physiotherapy students, educators and private practice clinics looking to recruit new graduates. Copyright © 2015 Elsevier Ltd. All rights reserved.

Spanish Radiology in the second half of the XX Century: a view from inside.

PubMed

Bonmatí, José

2008-09-01

Radiology was born in 1896 with the immediate recognition of the diagnostic value of X-rays in medicine and progressed throughout the XX Century with the increasing knowledge of its properties and clinical applications. By mid-century Radiology was a respected clinical specialty in advanced countries, the radiological report was a requirement in hospital practice and radiologists' opinions requested in scientific meetings. In the last decades of the century has had a spectacular expansion with the emergence of new imaging modalities and revolutionary technologies that have transformed the specialty worldwide. In Spain Radiology lagged behind needs and demand in 1950. Radiological practice was unregulated and performance of X-ray exams by non-radiologists was common. Teaching of Radiology was non-existent in Medical Schools or postgraduation. The diagnostic value of the specialty was unrecognized by physicians and the role of radiologists ignored. Most hospital radiology services were poorly equipped and functionally inadequate. The shadow of the Civil War (1936-39) was conditioning Radiology in the country. The point of inflexion in the development of Radiology in Spain was the inclusion of film reading sessions in the 1965 academic program of the Society of Radiology. It was in the presentation of cases at these conferences that Clinical Radiology found the finest demonstration ground and as a result was immediately adopted by radiologists and progressively applied in scientific meetings, clinical practices and training programs. Its influence was important in reforming hospital practice, legislation on specialization and education, as well as in national health care plans. At the end of the century radiology in Spain was at a par with the standards of other western nations. The author was a witness of the evolution of Radiology during his 50 years of professional life. This article does not pretend to be exhaustive in names or contributions. It is an overview of the period from the perspective of his past experience and seen from the distance of events that influenced the course of developments. I hope that those interested in the subject find that the effort has been worthwhile and helpful.

ICRP Publication 139: Occupational Radiological Protection in Interventional Procedures.

PubMed

López, P Ortiz; Dauer, L T; Loose, R; Martin, C J; Miller, D L; Vañó, E; Doruff, M; Padovani, R; Massera, G; Yoder, C

2018-03-01

In recent publications, such as Publications 117 and 120, the Commission provided practical advice for physicians and other healthcare personnel on measures to protect their patients and themselves during interventional procedures. These measures can only be effective if they are encompassed by a framework of radiological protection elements, and by the availability of professionals with responsibilities in radiological protection. This framework includes a radiological protection programme with a strategy for exposure monitoring, protective garments, education and training, and quality assurance of the programme implementation. Professionals with responsibilities in occupational radiological protection for interventional procedures include: medical physicists; radiological protection specialists; personnel working in dosimetry services; clinical applications support personnel from the suppliers and maintenance companies; staff engaged in training, standardisation of equipment, and procedures; staff responsible for occupational health; hospital administrators responsible for providing financial support; and professional bodies and regulators. This publication addresses these elements and these audiences, and provides advice on specific issues, such as assessment of effective dose from dosimeter readings when an apron is worn, estimation of exposure of the lens of the eye (with and without protective eyewear), extremity monitoring, selection and testing of protective garments, and auditing the interventional procedures when occupational doses are unusually high or low (the latter meaning that the dosimeter may not have been worn).

Does gender impact upon application rejection rate among Canadian radiology residency applicants?

PubMed

Baerlocher, Mark O; Walker, Michelle

2005-10-01

To determine if and how gender ratios have changed within Canadian radiology, and to determine if gender discrimination occurs at the level of the radiology resident selection committee. The Canadian Medical Association, Canadian Association of Radiologists, Canadian Institute for Health Information, Royal College of Physicians and Surgeons of Canada, and Canadian Residency Matching Service provided gender-specific data. We compared the proportion of female applicants who ranked a radiology program as their top choice and were rejected from any radiology program with the corresponding proportion for male applicants. The numbers of women and men being awarded an MD from a Canadian university equalized nearly a decade ago. Women continue to be numerically underrepresented among practicing radiologists; however, the proportion of women continues to increase so that there is 1 female radiologist in practice to every 3 male radiologists in practice in 2005. More male medical students ranked a radiology residency training program as their top choice in the residency match; however, of those who did, they were as likely as women to be rejected from a radiology residency training program. Grouping all female and male graduating medical students participating in the residency match and ranking a radiology residency as their top choice between 1993 and 2004, the odds of men being rejected were 1.4 times (95% CI 0.99-1.9, p = 0.07) greater than for women. There continues to be more men than women radiologists in practice; however, the female-to-male ratio continues to increase. Our data suggest that discrimination against female applicants at the level of radiology residency selection does not occur.

Artificial Intelligence: Threat or Boon to Radiologists?

PubMed

Recht, Michael; Bryan, R Nick

2017-11-01

The development and integration of machine learning/artificial intelligence into routine clinical practice will significantly alter the current practice of radiology. Changes in reimbursement and practice patterns will also continue to affect radiology. But rather than being a significant threat to radiologists, we believe these changes, particularly machine learning/artificial intelligence, will be a boon to radiologists by increasing their value, efficiency, accuracy, and personal satisfaction. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Analysis of radiology business models.

PubMed

Enzmann, Dieter R; Schomer, Donald F

2013-03-01

As health care moves to value orientation, radiology's traditional business model faces challenges to adapt. The authors describe a strategic value framework that radiology practices can use to best position themselves in their environments. This simplified construct encourages practices to define their dominant value propositions. There are 3 main value propositions that form a conceptual triangle, whose vertices represent the low-cost provider, the product leader, and the customer intimacy models. Each vertex has been a valid market position, but each demands specific capabilities and trade-offs. The underlying concepts help practices select value propositions they can successfully deliver in their competitive environments. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology liability update: review of claims, trends, high-risk conditions and practices, and tort reform alternatives.

PubMed

Thomson, Norman B; Patel, Mohini

2012-10-01

Radiology liability claims data are reviewed to explore the risk for suit and adverse judgments or settlements among radiologists, assess high-risk imaging conditions, and identify high-risk practice issues. Possible medical malpractice tort reform options are reviewed. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Gender Diversity in Academic Radiology Departments: Barriers and Best Practices to Optimizing Inclusion and Developing Women Leaders.

PubMed

Sepulveda, Karla A; Paladin, Angelisa M; Rawson, James V

2018-05-01

Gender diversity remains a challenge for radiology. As we aspire to embrace Diversity 3.0 and the goal of making diversity core to our organizations' mission, there must be increasing awareness of the barriers to achieving inclusion and to best practices for making diversity integral to achieving excellence. This article reviews the literature on gender diversity in radiology and in academic radiology leadership and discusses lessons learned from non-health-care industry and from academic radiology departments that have been successful in developing and supporting female employees. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Practical solutions for staff recruitment & retention.

PubMed

Vander Hoek, N

2001-01-01

There are three essential topics for radiology managers to consider in light of persistent staffing shortages: support of the profession and educational programs, perks as recruitment tools and incentives as retention tools. Some activities that can help support departments and educational programs for radiologic technologists are job shadowing, training for volunteer services, advanced placement for school applicants, sponsoring an educational program or clinical training site, creating a positive work environment and supporting outreach projects geared to local high schools. Traditional perks used in recruitment efforts have included relocation assistance, travel and lodging expenses during the interview process, loan repayment, scholarships and sign-on bonuses. Some common incentives for retaining employees are tuition reimbursement, cross training, availability of educational resources, continuing education opportunities, professional development and incremental increases in salary. There are many other tools that can be used, such as career ladders, creating an environment conducive to teamwork or a more personal atmosphere and showcasing talents of various staff members. There is much overlap among these suggestions in support of the profession and educational programs, recruitment and retention of qualified staff radiologic technologists. Radiology managers can and should be creative in developing different programs to build loyalty and commitment to a radiology department.

Analyzing the glass ceiling effect among radiologic technologists.

PubMed

Belinsky, Susan B; Blagg, James D

2011-01-01

The literature has suggested that advancement within politics, academia and the health professions is influenced by gender. Purpose The authors conducted a survey to determine whether advancement was equal by gender in the radiologic science disciplines of nuclear medicine technology, radiation therapy and radiography. The survey was mailed to 900 subjects, 300 from each discipline. The discipline groups were further stratified by initial year of American Registry of Radiologic Technology certification; the authors selected 100 subjects from each discipline who initially were certified in 1978, 100 in 1988 and 100 in 1998. Approximately 33% of those selected responded. The findings of the study provided no evidence that men are promoted differentially than women. Women perceived that men were paid more for the same work. It appears that gender bias is pervasive outside of promotion decisions and, indeed, that some illegal actions (eg, sexual harassment, inappropriate gender-related interview questions) take place in radiologic science clinical settings. It is hoped that this study will set a baseline for future research on whether there is a glass ceiling effect in radiologic clinical practice and stimulate discussion of the importance of equal opportunity regardless of gender.

Rewards.

PubMed

Gunderman, Richard B; Kamer, Aaron P

2011-05-01

For much of the 20th century, psychologists and economists operated on the assumption that work is devoid of intrinsic rewards, and the only way to get people to work harder is through the use of rewards and punishments. This so-called carrot-and-stick model of workplace motivation, when applied to medical practice, emphasizes the use of financial incentives and disincentives to manipulate behavior. More recently, however, it has become apparent that, particularly when applied to certain kinds of work, such approaches can be ineffective or even frankly counterproductive. Instead of focusing on extrinsic rewards such as compensation, organizations and their leaders need to devote more attention to the intrinsic rewards of work itself. This article reviews this new understanding of rewards and traces out its practical implications for radiology today. Copyright © 2011. Published by Elsevier Inc.

Business intelligence for the radiologist: making your data work for you.

PubMed

Cook, Tessa S; Nagy, Paul

2014-12-01

Although it remains absent from most programs today, business intelligence (BI) has become an integral part of modern radiology practice management. BI facilitates the transition away from lack of understanding about a system and the data it produces toward incrementally more sophisticated comprehension of what has happened, could happen, and should happen. The individual components that make up BI are common across industries and include data extraction and transformation, process analysis and improvement, outcomes measures, performance assessment, graphical dashboarding, alerting, workflow analysis, and scenario modeling. As in other fields, these components can be directly applied in radiology to improve workflow, throughput, safety, efficacy, outcomes, and patient satisfaction. When approaching the subject of BI in radiology, it is important to know what data are available in your various electronic medical records, as well as where and how they are stored. In addition, it is critical to verify that the data actually represent what you think they do. Finally, it is critical for success to identify the features and limitations of the BI tools you choose to use and to plan your practice modifications on the basis of collected data. It is equally important to remember that BI plays a critical role in continuous process improvement; whichever BI tools you choose should be flexible to grow and evolve with your practice. Published by Elsevier Inc.

RCT: Module 2.11, Radiological Work Coverage, Course 8777

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

2017-07-20

Radiological work is usually approved and controlled by radiation protection personnel by using administrative and procedural controls, such as radiological work permits (RWPs). In addition, some jobs will require working in, or will have the potential for creating, very high radiation, contamination, or airborne radioactivity areas. Radiological control technicians (RCTs) providing job coverage have an integral role in controlling radiological hazards. This course will prepare the student with the skills necessary for RCT qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and will provide in-the-field skills.

Interactive anatomical teaching: Integrating radiological anatomy within topographic anatomy.

PubMed

Abed Rabbo, F; Garrigues, F; Lefèvre, C; Seizeur, R

2016-03-01

Hours attributed to teaching anatomy have been reduced in medical curricula through out the world. In consequence, changes in anatomical curriculum as well as in teaching methods are becoming necessary. New methods of teaching are being evaluated. We present in the following paper an example of interactive anatomical teaching associating topographic anatomy with ultrasonographic radiological anatomy. The aim was to explicitly show anatomical structures of the knee and the ankle through dissection and ultrasonography. One cadaver was used as an ultrasonographic model and the other was dissected. Anatomy of the knee and ankle articulations was studied through dissection and ultrasonography. The students were able to simultaneously assimilate both anatomical aspects of radiological and topographic anatomy. They found the teaching very helpful and practical. This body of work provides example of a teaching method combining two important aspects of anatomy to help the students understand both aspects simultaneously. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Controlling instruments in radiology].

PubMed

Maurer, M

2013-10-01

Due to the rising costs and competitive pressures radiological clinics and practices are now facing, controlling instruments are gaining importance in the optimization of structures and processes of the various diagnostic examinations and interventional procedures. It will be shown how the use of selected controlling instruments can secure and improve the performance of radiological facilities. A definition of the concept of controlling will be provided. It will be shown which controlling instruments can be applied in radiological departments and practices. As an example, two of the controlling instruments, material cost analysis and benchmarking, will be illustrated.

A portrait of pediatric radiologists in the United States.

PubMed

Merewitz, Leonard; Sunshine, Jonathan H

2006-01-01

In recognition of the importance of pediatric radiology and the apparent shortage of radiologists in the field, the purpose of this study was to provide an extensive and detailed portrait of pediatric radiologists, their professional activities, and the practices in which they work. We tabulated data from the American College of Radiology's 2003 Survey of Radiologists, a stratified random sample survey that achieved a 63% response rate with a total of 1,924 responses. Responses were weighted to make them representative of all radiologists in the United States. We compare information about pediatric radiologists with that for other radiologists. Approximately 3% of radiologists, some 800-900 physicians, are pediatric radiologists. Depending on how pediatric radiologist is defined, two thirds to three quarters of them spend 70% or more of their clinical work time doing pediatric radiology. Unlike other radiologists, a greater percentage of pediatric radiologists desire a reduction in workload (with a corresponding reduction in income) than desire an increase in workload. Pediatric radiologists who spend 70% or more of their clinical work time in their field are older than radiologists in general (average age, 55 vs 51 years), and the fraction of pediatric radiologists younger than 45 years is lower than for other subspecialists ( approximately 20% vs 37%). Pediatric radiologists are disproportionately women (one third or more, depending on definition, are women, vs 19% for other subspecialists and 15% for nonsubspecialists), hospital-based, in academic practices (approximately half vs one fifth for other subspecialists), and in the main cities of large metropolitan areas. A shortage of pediatric radiologists exists and is likely to intensify. Access to pediatric radiologists is probably a problem except for children in large metropolitan areas who connect readily to academic hospitals. Means to overcome these problems need to be actively sought.

Radiology practices and their contracts with hospitals, 1989-1990: a representative sample survey.

PubMed

Sunshine, J; Chan, W C; Kassing, P J

1991-12-01

Because of concern about pressures from hospitals for changes in their contracts with radiology practices, the American College of Radiology undertook a stratified sample survey of radiology practices and their contracts with hospitals in late 1989 and early 1990. After three remailings, the survey obtained 904 valid responses for a 64% response rate. It found (weighting data to represent all radiology practices in the nation) that 91% of radiology practices provide services in hospitals. There are contracts at 57% of these hospital sites, and hospitals use tax-exempt bond financing in 54% of the sites with contracts. One year is the most common duration of contracts, and 90 days is the most common cancellation period (89% of contracts can be canceled during the contract's term). Eighty-six percent of contracts are exclusive; 73% are automatically renewable ("evergreen"). Separate billing exists in well over 90% of hospitals with contracts. Two percent of contracts require radiologists to provide equipment; 4% require them to provide support staff. There are fixed-fee arrangements in 9% of contracts and percent compensation arrangements in 3%. Hospitals share in radiologists' fees as a charge for contractual privileges in 5% of contracts. Twenty-seven percent of contracts require hospital approval for radiologists' fee increases; 19% require radiologists to participate with Blue Shield or Medicare. If a contract characteristic is predominant nationally, it is predominant in every region, for solo, small, medium, and large practices, and whether or not hospitals use tax-exempt bond financing. There is, however, some modest variation in frequency of contract provisions. Multivariate analysis shows that most such variation reflects true effects of region and other variables, not statistical artifacts. Region was a statistically significant determinant of 11 of 17 contract characteristics studied. Practice size was a statistically significant determinant of only about half as many characteristics. The survey found some interference in the independence of radiology practices (e.g., required hospital approval of fee increases), questionable clauses (e.g., mandated provision of equipment), and even illegal ones (hospitals charging a fee for contract privileges). Knowledge of the survey findings can make individual radiology practices more effective in negotiations with hospitals and assist the profession in forming a strategy to oppose disadvantageous and illegal provisions.

Women in the radiology profession: data from a 1995 national survey.

PubMed

Deitch, C H; Sunshine, J H; Chan, W C; Shaffer, K A

1998-02-01

This report provides an in-depth picture of similarities and differences in the professional and practice characteristics of women and men who are radiologists in the United States, with specific attention to whether gender differences are less pronounced among younger radiologists. Data were taken from a national stratified random sample survey of radiologists. The response rate was 75%. The 1731 men and 294 women responding included diagnostic radiologists, radiation oncologists, and radiology-related nuclear medicine specialists. Seven percent of respondents who completed their radiology residency before 1970 were women, compared with 9% in 1970-1979, 19% in 1980-1989, and 27% in 1990-1995. Gender differences were smaller among posttraining radiologists younger than 40 years old than among those 40 years old or older for the following questions: when the respondent decided to specialize in radiology, whether the respondent is a subspecialist within diagnostic radiology, whether the respondent's practice is primarily academic, whether the practice is privately owned, and whether the respondent is a practice owner (partner, shareholder). Women who were residents and fellows more frequently indicated problems with unwanted sexual attention occurring in the past 2 years than did women who were not in training positions. However, posttraining women were more likely to have encountered discrimination in salary, hiring, or promotion at some time in their careers. Women's professional roles in radiology are changing slowly. A narrowing gender gap among younger radiologists on some professional and practice characteristics may indicate a further diminishing of gender differences in radiology in the future. It may also reflect greater gender equality at earlier rather than later stages of one's career.

Defining the abdominal radiologist based on the current U.S. job market.

PubMed

Hoffman, David H; Rosenkrantz, Andrew B

2018-03-24

The purpose of the study is to characterize current practice patterns of abdominal radiologists based on work descriptions within job postings on numerous national radiology specialty websites. Job postings for either "abdominal" or "body" radiologists were searched weekly on five society websites (SAR, SCBT-MR, ARRS, ACR, RSNA) over a 1-year period. Postings were reviewed for various characteristics. Nine hundred and sixteen total ads for 341 unique abdominal radiologist positions were reviewed (34.6% academic, 64.2% private practice, 1.2% other). Postings occurred most commonly in March (12.3%) and least commonly in November (4.8%). States with most positions were Florida (27), California (26), and New York (24). Of postings delineating expectations of specific abdominal modalities, 67.4% mentioned MRI, 58.5% ultrasound, 41.1% fluoroscopy, 14.3% PET, and 54.0% interventions. Additional non-abdominal expectations included general radiology (28.7%), breast imaging (21.1%), and general nuclear medicine (9.7%). Additional skills included prostate MRI (7.0%), OBGYN ultrasound (5.0%), and CT colonoscopy (2.6%). 79.2% required an abdominal imaging fellowship (specifically a body MRI fellowship in 4.1%). By using job postings for abdominal radiologists, we have taken a practical approach to characterizing the current status of this subspecialty, reflecting recent job expectations and requirements. The large majority of positions required a body fellowship, and the positions commonly entailed a variety of skills beyond non-invasive diagnostic abdominal imaging. Of note, expectations of considerable minorities of positions included abdominal interventions, general radiology, and breast imaging. These insights may guide the development of abdominal radiology fellowships and mini-fellowships, as well as assist radiologists entering or returning to the job market.

Quality assurance and ergonomics in the mammography department.

PubMed

Reynolds, April

2014-01-01

Quality assurance (QA) in mammography is a system of checks that helps ensure the proper functioning of imaging equipment and processes. Ergonomics is a scientific approach to arranging the work environment to reduce the risk of work-related injuries while increasing staff productivity and job satisfaction. This article reviews both QA and ergonomics in mammography and explains how they work together to create a safe and healthy environment for radiologic technologists and their patients. QA and quality control requirements in mammography are discussed, along with ergonomic best practices in the mammography setting.

MO-AB-204-01: IHE RO Overview [Health Care

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hadley, S.

You’ve experienced the frustration: vendor A’s device claims to work with vendor B’s device, but the practice doesn’t match the promise. Getting devices working together is the hidden art that Radiology and Radiation Oncology staff have to master. To assist with that difficult process, the Integrating the Healthcare Enterprise (IHE) effort was established in 1998, with the coordination of the Radiological Society of North America. Integrating the Healthcare Enterprise (IHE) is a consortium of healthcare professionals and industry partners focused on improving the way computer systems interconnect and exchange information. This is done by coordinating the use of published standardsmore » like DICOM and HL7. Several clinical and operational IHE domains exist in the healthcare arena, including Radiology and Radiation Oncology. The ASTRO-sponsored IHE Radiation Oncology (IHE-RO) domain focuses on radiation oncology specific information exchange. This session will explore the IHE Radiology and IHE RO process for; IHE solicitation process for new profiles. Improving the way computer systems interconnect and exchange information in the healthcare enterprise Supporting interconnectivity descriptions and proof of adherence by vendors Testing and assuring the vendor solutions to connectivity problems. Including IHE profiles in RFPs for future software and hardware purchases. Learning Objectives: Understand IHE role in improving interoperability in health care. Understand process of profile development and implantation. Understand how vendors prove adherence to IHE RO profiles. S. Hadley, ASTRO Supported Activity.« less

MO-AB-204-02: IHE RAD [Health care

DOE Office of Scientific and Technical Information (OSTI.GOV)

Seibert, J.

You’ve experienced the frustration: vendor A’s device claims to work with vendor B’s device, but the practice doesn’t match the promise. Getting devices working together is the hidden art that Radiology and Radiation Oncology staff have to master. To assist with that difficult process, the Integrating the Healthcare Enterprise (IHE) effort was established in 1998, with the coordination of the Radiological Society of North America. Integrating the Healthcare Enterprise (IHE) is a consortium of healthcare professionals and industry partners focused on improving the way computer systems interconnect and exchange information. This is done by coordinating the use of published standardsmore » like DICOM and HL7. Several clinical and operational IHE domains exist in the healthcare arena, including Radiology and Radiation Oncology. The ASTRO-sponsored IHE Radiation Oncology (IHE-RO) domain focuses on radiation oncology specific information exchange. This session will explore the IHE Radiology and IHE RO process for; IHE solicitation process for new profiles. Improving the way computer systems interconnect and exchange information in the healthcare enterprise Supporting interconnectivity descriptions and proof of adherence by vendors Testing and assuring the vendor solutions to connectivity problems. Including IHE profiles in RFPs for future software and hardware purchases. Learning Objectives: Understand IHE role in improving interoperability in health care. Understand process of profile development and implantation. Understand how vendors prove adherence to IHE RO profiles. S. Hadley, ASTRO Supported Activity.« less

MO-AB-204-04: Connectathons and Testing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bosch, W.

You’ve experienced the frustration: vendor A’s device claims to work with vendor B’s device, but the practice doesn’t match the promise. Getting devices working together is the hidden art that Radiology and Radiation Oncology staff have to master. To assist with that difficult process, the Integrating the Healthcare Enterprise (IHE) effort was established in 1998, with the coordination of the Radiological Society of North America. Integrating the Healthcare Enterprise (IHE) is a consortium of healthcare professionals and industry partners focused on improving the way computer systems interconnect and exchange information. This is done by coordinating the use of published standardsmore » like DICOM and HL7. Several clinical and operational IHE domains exist in the healthcare arena, including Radiology and Radiation Oncology. The ASTRO-sponsored IHE Radiation Oncology (IHE-RO) domain focuses on radiation oncology specific information exchange. This session will explore the IHE Radiology and IHE RO process for; IHE solicitation process for new profiles. Improving the way computer systems interconnect and exchange information in the healthcare enterprise Supporting interconnectivity descriptions and proof of adherence by vendors Testing and assuring the vendor solutions to connectivity problems. Including IHE profiles in RFPs for future software and hardware purchases. Learning Objectives: Understand IHE role in improving interoperability in health care. Understand process of profile development and implantation. Understand how vendors prove adherence to IHE RO profiles. S. Hadley, ASTRO Supported Activity.« less

MO-AB-204-03: Profile Development and IHE Process

DOE Office of Scientific and Technical Information (OSTI.GOV)

Pauer, C.

You’ve experienced the frustration: vendor A’s device claims to work with vendor B’s device, but the practice doesn’t match the promise. Getting devices working together is the hidden art that Radiology and Radiation Oncology staff have to master. To assist with that difficult process, the Integrating the Healthcare Enterprise (IHE) effort was established in 1998, with the coordination of the Radiological Society of North America. Integrating the Healthcare Enterprise (IHE) is a consortium of healthcare professionals and industry partners focused on improving the way computer systems interconnect and exchange information. This is done by coordinating the use of published standardsmore » like DICOM and HL7. Several clinical and operational IHE domains exist in the healthcare arena, including Radiology and Radiation Oncology. The ASTRO-sponsored IHE Radiation Oncology (IHE-RO) domain focuses on radiation oncology specific information exchange. This session will explore the IHE Radiology and IHE RO process for; IHE solicitation process for new profiles. Improving the way computer systems interconnect and exchange information in the healthcare enterprise Supporting interconnectivity descriptions and proof of adherence by vendors Testing and assuring the vendor solutions to connectivity problems. Including IHE profiles in RFPs for future software and hardware purchases. Learning Objectives: Understand IHE role in improving interoperability in health care. Understand process of profile development and implantation. Understand how vendors prove adherence to IHE RO profiles. S. Hadley, ASTRO Supported Activity.« less

NIKOLA TESLA AND MEDICINE: 160TH ANNIVERSARY OF THE BIRTH OF THE GENIUS WHO GAVE LIGHT TO THE WORLD - PART I.

PubMed

Vucevic, Danijela; Dordevic, Drago; Radosavljevic, Tatjana

2016-09-01

The interest in Nikola Tesla, a scientist, physicist, engineer and inventor, is constantly growing. In the millennialong history of human civilization, it is almost impossible to find another person whose life and work has been under so much scrutiny of such a wide range of researchers, medical professionals included. Although Tesla was not primarily dedicated to biomedical research, his work significantly contributed to the development of radiology, and high frequency electrotherapy. This paper deals with the impact of Tesla's work on the development of a new medical branch - radiology. Nikola Tesla and the Discovery of X-ray radiation. Tesla pioneered the use of X-rays for medical purposes, practically laying the foundations of radiology. Namely, since 1887, Tesla periodically experimented with X-rays, at that time still unknown and unnamed, which he called "shadowgraphs". Moreover, at the end of 1894, lie conducted extensive research focusing on X-rays, but unfortunately it was inlerrupted after the fire burning down his laboratory in 1895. In 1896 and 1897, Tesla published ten papers on the biologic effects of X-ray radiation. All his studies on X-rays were experimental. During 1896 and 1897, Tesla continued improving X-ray devices. Apart from this, Tesla was the first to point out the harmful effects of exposure to X-ray radiation on human body. Nikola Tesla was a visionary genius of the future. Tesla's pioneer steps, made more than a century ago in the domain of radiology, are still being used today.

Teaching and Assessing Professionalism in Radiology Resident Education.

PubMed

Kelly, Aine Marie; Gruppen, Larry D; Mullan, Patricia B

2017-05-01

Radiologists in teaching hospitals and in practices with residents rotating through are involved in the education of their residents. The Accreditation Council for Graduate Medical Education requires evidence that trainees are taught and demonstrate competency not only in medical knowledge and in patient care-the historic focus of radiology education-but also in the so-called non-interpretative core competencies, which include professionalism and interpersonal skills. In addition to accreditation agencies, the prominent assessment practices represented by the American Board of Radiology core and certifying examinations for trainees, as well as Maintenance of Certification for practitioners, are planning to feature more non-interpretative competency assessment, including professionalism to a greater extent. Because professionalism was incorporated as a required competency in medical education as a whole, more clarity about the justification and expected content for teaching about competence in professionalism, as well as greater understanding and evidence about appropriate and effective teaching and assessment methods, have emerged. This article summarizes justifications and expectations for teaching and assessing professionalism in radiology residents and best practices on how to teach and evaluate professionalism that can be used by busy radiology faculty in their everyday practice supervising radiology residents. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Toward Augmented Radiologists: Changes in Radiology Education in the Era of Machine Learning and Artificial Intelligence.

PubMed

Tajmir, Shahein H; Alkasab, Tarik K

2018-06-01

Radiology practice will be altered by the coming of artificial intelligence, and the process of learning in radiology will be similarly affected. In the short term, radiologists will need to understand the first wave of artificially intelligent tools, how they can help them improve their practice, and be able to effectively supervise their use. Radiology training programs will need to develop curricula to help trainees acquire the knowledge to carry out this new supervisory duty of radiologists. In the longer term, artificially intelligent software assistants could have a transformative effect on the training of residents and fellows, and offer new opportunities to bring learning into the ongoing practice of attending radiologists. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Learning, technology and intellectual property: a survey of the philosophies and preferences of our trainees and peers.

PubMed

Bedoya, Maria A; Back, Susan J; Scanlon, Mary H; Delgado, Jorge; Darge, Kassa; Reid, Janet R

2016-12-01

Increasing workloads threaten the quality of teaching in academic radiology practices. There is a wealth of unfiltered educational resources for radiology on the internet. As a digital native, today's radiology trainee may have differing opinions from teachers about learning and intellectual property. To identify the preferences and philosophies regarding learning, technology and intellectual property toward the future development of an innovative radiology curriculum. An electronic survey with 22 questions was sent to 2,010 members of the Society for Pediatric Radiology and 100 radiology trainees. Three hundred sixty-one of the 2,110 surveys were returned. All questions were completed in 342 surveys. Fifty-three respondents were trainees (residents and fellows) and 289 respondents were radiologists (teachers). Time needed for a single learning activity in both groups is <30 min, but teachers spend less time (P=0.007). The preferred learning environments were point-of-care and outside work hours for both groups. Ideal lecture durations were 31-45 min for trainees and 21-30 min for teachers (P=0.001). Adoption of new technology showed late majority and laggard trends for both groups (P=0.296). Interest in gadgets was greater in trainees (17%) than teachers (2%) (P<0.001). Interest in lecture recording was greater in trainees (84%) than teachers (61%) (P=0.008). More trainees (61%) than teachers (42%) would not charge money for educational materials (P=0.028); 27% versus 13%, respectively, disagreed with dissemination of those materials beyond the institution (P=0.013). While millennial trainees are adult learners with a stronger comfort with technology, learning styles of trainees and teachers are more similar than was previously believed. Trainees and teachers hold conflicting philosophies about intellectual property. Results herein speak favorably for revising our teaching portfolio to include practical learning materials of short duration available at point-of-care.

Primary care guidelines on consultation practices: the effectiveness of computerized versus paper-based versions. A cluster randomized controlled trial among newly qualified primary care physicians.

PubMed

Jousimaa, Jukkapekka; Mäkelä, Marjukka; Kunnamo, Ilkka; MacLennan, Graeme; Grimshaw, Jeremy M

2002-01-01

To compare the effects of computerized and paper-based versions of guidelines on recently qualified physicians' consultation practices. Two arm cluster randomized controlled trial. Physicians were randomized to receive computerized or textbook-based versions of the same guidelines for a 4-week study period. Physicians' compliance with guideline recommendations about laboratory, radiological, physical and other examinations, procedures, nonpharmacologic and pharmacologic treatments, physiotherapy, and referrals were measured by case note review. There were 139 recently qualified physicians working in 96 primary healthcare centers in Finland who participated in the study. Data on 4,633 patient encounters were abstracted, of which 3,484 were suitable for further analysis. Physicians' compliance with guidelines was high (over 80% for use of laboratory, radiology, physical examinations, and referrals). There were no significant differences in physicians' consultation practices in any of the measured outcomes between the computerized and textbook group. Guidelines are a useful source of information for recently qualified physicians working in primary care. However, the method of presentation of the guidelines (electronic or paper) does not have an effect on guideline use or their impact on decisions. Other factors should be considered when choosing the method of presentation of guidelines, such as information-seeking time, ease of use during the consultation, ability to update, production costs, and the physician's own preferences.

Familiarity with current practices of granting and maintaining privileges in pediatric interventional radiology--a worldwide survey of the members of the Society for Pediatric Interventional Radiology (SPIR).

PubMed

Harned, Roger K

2012-11-01

Physician credentialing is a complex process driven by the demand for quality improvement in health care. In the U.S., the Joint Commission Standard of 2007 has tied hospital accreditation to credentialing through mandated use of the Focused Professional Practice Evaluation (FPPE) and Ongoing Professional Practice Evaluation (OPPE). To assess pediatric interventional radiologists' knowledge of how institutions grant them privileges. Members of the Society for Pediatric Interventional Radiology (SPIR) were sent a web-based survey regarding credentialing. Of 122 members from 19 countries, 81 (66%) responded, and of these 81, 59 (73%) were familiar with their hospital's privileging process. Of 49 U.S. respondents and 32 non-U.S. respondents, 37 (76%) and 17 (53%), respectively, stated that interventional radiology credentialing was different from diagnostic radiology credentialing. Of the 49 U.S. respondents, 24 (49%) reported an OPPE, and of the 32 non-U.S. respondents, 8 (25%) reported an ongoing evaluation. The U.S. OPPE is performed at shorter intervals than its international equivalent. Four years after the Joint Commission defined the FPPE and OPPE, separate credentialing of pediatric interventional radiology from pediatric diagnostic radiology is more likely in the U.S. than internationally, and U.S. pediatric interventional radiologists are more likely to have a defined ongoing professional evaluation and to be evaluated every 6 months or more frequently. There are many SPIR members who do not know how they obtain privileges and/or are not knowingly subject to an OPPE. This lack of knowledge may affect future education of interventional radiologists as well as the definition of pediatric interventional radiology practices within individual institutions.

Financial ratios in diagnostic radiology practices: variability and trends.

PubMed

Hogan, Christopher; Sunshine, Jonathan H

2004-03-01

To evaluate variation in financial ratios for radiology practices nationwide and trends in these ratios and in payments. In 1999, the American College of Radiology surveyed radiology practices by mail. The final response rate was 66%. Weighting was used to make responses representative of all radiology practices in the United States. Self-reported financial ratios (payments, charges, accounts receivable turnover) were analyzed; 449 responses had usable data on these ratios. Comparison with results of a similar 1992 survey and combined analysis with Medicare data on billed charges provided information on trends. All measures of payment collections declined sharply from 1992 to 1999, with the gross collections rate (revenues as percentage of billed charges) decreasing from 71% to 55%. Average payment for a typical radiology service decreased approximately 4% in dollar terms or approximately 19% in inflation-adjusted terms. In 1999, nonmetropolitan practices appeared to fare better than others. Among insurers, Medicaid stood out as a low and slow payer, but neither managed care nor Medicare had a consistent effect on financial ratios. The gross collections rate varied substantially across geographic areas, as did, in an inverse pattern, the level of billed charges. One-quarter of practices had accounts receivable equal to 90 or more days of billings. The opposing geographic pattern of billed charges and gross collection rate suggests that geographic variation in the latter is driven more by variation in billed charges than by variation in payment levels. Radiologists saw a substantial decrease in the real (inflation-adjusted) value of payment per service during the 1990s. The large fraction of practices with accounts receivable of 90 or more days of billings-a level considered potentially imprudent by financial management advisors-suggests that many practices should improve financial management and that state prompt-payment laws have not had a substantial positive effect. Copyright RSNA, 2004

Guide to thoracic imaging.

PubMed

Skinner, Sarah

2015-08-01

Thoracic imaging is commonly ordered in general practice. Guidelines exist for ordering thoracic imaging but few are specific for general practice. This article summarises current indications for imaging the thorax with chest X-ray and computed tomography. A simple frame-work for interpretation of the chest X-ray, suitable for trainees and practitioners providing primary care imaging in rural and remote locations, is presented. Interpretation of thoracic imaging is best done using a systematic approach. Radiological investigation is not warranted in un-complicated upper respiratory tract infections or asthma, minor trauma or acute-on-chronic chest pain.

Is Your Interventional Radiology Service Ready for SARS?: The Singapore Experience

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lau, Te-Neng; Teo, Ngee; Tay, Kiang-Hiong

2003-09-15

The recent epidemic of severe acute respiratory syndrome caught many by surprise. Hitherto, infection control has not been in the forefront of radiological practice. Many interventional radiology (IR) services are therefore not equipped to deal with such a disease. In this review, we share our experience from the interventional radiologist's perspective, report on the acute measures instituted within our departments and explore the long-term effects of such a disease on the practice of IR.

Effectiveness of Current Practices for Disinfecting Medical Equipment in a Radiology Department.

PubMed

Hubble, William L; Turner, James Austin; Heuertz, Rita

2016-01-01

To evaluate the effectiveness of routine, daily disinfection practices on the control of microorganisms on nuclear medicine equipment in a radiology department. During phase 1, surface samples were collected from various sites in the nuclear medicine division of a radiology department at a single institution. These samples were transferred onto growth plates for evaluation and speciation by a clinical microbiologist. Collection sites that yielded potentially pathogenic bacteria or high numbers (> 100) of colonies of likely nonpathogenic bacteria were identified for resampling. During phase 2, secondary samples were taken at the resampling sites after disinfection. These secondary samples also were evaluated to determine the efficacy of the departmental disinfection practices on surface cleanliness. Phase 1 sampling identified 10 sites that harbored either potentially pathogenic bacteria or high numbers of likely nonpathogenic bacteria. Evaluation of postdisinfection samples indicated elimination of potentially pathogenic bacteria and reduction of likely nonpathogenic colonies. The variety of surfaces and equipment found in radiology departments can present unique challenges for effective disinfection. Porous materials and intricate imaging and peripheral devices require special consideration when designing and maintaining department cleaning policies. The disinfection practices in place at the institution were effective in reducing or eliminating bacteria; however, recolonization after cleaning was recognized as a possibility. Educating staff about the value of disinfecting contact surfaces between patients is necessary to achieve optimum sanitization in the radiology department. © 2016 American Society of Radiologic Technologists.

The American Board of Radiology Perspective on Maintenance of Certification: Part IV: Practice quality improvement in radiologic physics.

PubMed

Frey, G Donald; Ibbott, Geoffrey S; Morin, Richard L; Paliwal, Bhudatt R; Thomas, Stephen R; Bosma, Jennifer

2007-11-01

Recent initiatives of the American Board of Medical Specialties (ABMS) in the area of maintenance of certification (MOC) have been reflective of the response of the medical community to address public concerns regarding quality of care, medical error reduction, and patient safety. In March 2000, the 24 member boards of the ABMS representing all medical subspecialties in the USA agreed to initiate specialty-specific maintenance of certification (MOC) programs. The American Board of Radiology (ABR) MOC program for diagnostic radiology, radiation oncology, and radiologic physics has been developed, approved by the ABMS, and initiated with full implementation for all three disciplines beginning in 2007. The overriding objective of MOC is to improve the quality of health care through diplomate-initiated learning and quality improvement. The four component parts to the MOC process are: Part I: Professional standing, Part II: Evidence of life long learning and periodic self-assessment, Part III: Cognitive expertise, and Part IV: Evaluation of performance in practice (with the latter being the focus of this paper). The key components of Part IV require a physicist-based response to demonstrate commitment to practice quality improvement (PQI) and progress in continuing individual competence in practice. Diplomates of radiologic physics must select a project to be completed over the ten-year cycle that potentially can improve the quality of the diplomate's individual or systems practice and enhance the quality of care. Five categories have been created from which an individual radiologic physics diplomate can select one required PQI project: (1) Safety for patients, employees, and the public, (2) accuracy of analyses and calculations, (3) report turnaround time and communication issues, (4) practice guidelines and technical standards, and (5) surveys (including peer review of self-assessment reports). Each diplomate may select a project appropriate for an individual, participate in a project within a clinical department, participate in a peer review of a self-assessment report, or choose a qualified national project sponsored by a society. Once a project has been selected, the steps are: (1) Collect baseline data relevant to the chosen project, (2) review and analyze the data, (3) create and implement an improvement plan, (4) remeasure and track, and (5) report participation to the ABR, using the template provided by the ABR. These steps begin in Year 2, following training in Year 1. Specific examples of individual PQI projects for each of the three disciplines of radiologic physics are provided. Now, through the MOC programs, the relationship between the radiologic physicist and the ABR will be continuous through the diplomate's professional career. The ABR is committed to providing an effective infrastructure that will promote and assist the process of continuing professional development including the enhancement of practice quality improvement for radiologic physicists.

TH-E-201-00: Teaching Radiology Residents: What, How, and Expectation

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

TH-E-201-01: Diagnostic Radiology Residents Physics Curriculum and Updates

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sensakovic, W.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

Meaningful Peer Review in Radiology: A Review of Current Practices and Potential Future Directions.

PubMed

Moriarity, Andrew K; Hawkins, C Matthew; Geis, J Raymond; Dreyer, Keith J; Kamer, Aaron P; Khandheria, Paras; Morey, Jose; Whitfill, James; Wiggins, Richard H; Itri, Jason N

2016-12-01

The current practice of peer review within radiology is well developed and widely implemented compared with other medical specialties. However, there are many factors that limit current peer review practices from reducing diagnostic errors and improving patient care. The development of "meaningful peer review" requires a transition away from compliance toward quality improvement, whereby the information and insights gained facilitate education and drive systematic improvements that reduce the frequency and impact of diagnostic error. The next generation of peer review requires significant improvements in IT functionality and integration, enabling features such as anonymization, adjudication by multiple specialists, categorization and analysis of errors, tracking, feedback, and easy export into teaching files and other media that require strong partnerships with vendors. In this article, the authors assess various peer review practices, with focused discussion on current limitations and future needs for meaningful peer review in radiology. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A resident's primer of Medicare reimbursement in radiology.

PubMed

Lee, Ryan K

2006-01-01

After having completed medical school, residency, and in many cases specialized fellowships, radiologists are well equipped to practice clinical radiology. However, they receive little if any exposure to the business of radiology, such as coding, billing, and other administrative duties that maintain the financial well-being of any medical practice. Medicare insolvency, managed care, self-referral, and increasing imaging by nonradiology specialists are all issues creating a competitive and ever changing medical environment, and understanding the economic and business aspects of health care is becoming increasingly important for both academic and private practice radiologists. The intent of this paper is to provide new radiologists as well as radiologists in training an introduction to the reimbursement system, as well as to provide a generalized review of the process for practicing radiologists. In particular, this article addresses the fundamentals of the Medicare fee-for-service reimbursement process as well as the factors considered in arriving at the valuation of radiologic services by Medicare.

Approaching the Practice Quality Improvement Project in Interventional Radiology.

PubMed

Reis, Stephen P; White, Benjamin; Sutphin, Patrick D; Pillai, Anil K; Kalva, Sanjeeva P; Toomay, Seth M

2015-12-01

An important component of maintenance of certification and quality improvement in radiology is the practice quality improvement (PQI) project. In this article, the authors describe several methodologies for initiating and completing PQI projects. Furthermore, the authors illustrate several tools that are vital in compiling, analyzing, and presenting data in an easily understandable and reproducible manner. Last, they describe two PQI projects performed in an interventional radiology division that have successfully improved the quality of care for patients. Using the DMAIC (define, measure, analyze, improve, control) quality improvement framework, interventional radiology throughput has been increased, to lessen mediport wait times from 43 to 8 days, and mediport infection rates have decreased from more than 2% to less than 0.4%. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Succession Planning and Management: The Backbone of the Radiology Group's Future.

PubMed

Donner, E Michael; Gridley, Daniel; Ulreich, Sidney; Bluth, Edward I

2017-01-01

The transition of leadership within radiology practices is often not a planned replacement process with formal development of potential future leaders. To ensure their ongoing success, however, practices need to develop comprehensive succession plans that include a robust developmental program for potential leaders consisting of mentoring, coaching, structured socialization, 360-degree feedback, developmental stretch assignments, job rotation, and formal education. Succession planning and leadership development will be necessary in the future for a practice to be successful in its business relationships and to be financially viable. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Dutch guideline for clinical foetal-neonatal and paediatric post-mortem radiology, including a review of literature.

PubMed

Sonnemans, L J P; Vester, M E M; Kolsteren, E E M; Erwich, J J H M; Nikkels, P G J; Kint, P A M; van Rijn, R R; Klein, W M

2018-06-01

Clinical post-mortem radiology is a relatively new field of expertise and not common practice in most hospitals yet. With the declining numbers of autopsies and increasing demand for quality control of clinical care, post-mortem radiology can offer a solution, or at least be complementary. A working group consisting of radiologists, pathologists and other clinical medical specialists reviewed and evaluated the literature on the diagnostic value of post-mortem conventional radiography (CR), ultrasonography, computed tomography (PMCT), magnetic resonance imaging (PMMRI), and minimally invasive autopsy (MIA). Evidence tables were built and subsequently a Dutch national evidence-based guideline for post-mortem radiology was developed. We present this evaluation of the radiological modalities in a clinical post-mortem setting, including MIA, as well as the recently published Dutch guidelines for post-mortem radiology in foetuses, neonates, and children. In general, for post-mortem radiology modalities, PMMRI is the modality of choice in foetuses, neonates, and infants, whereas PMCT is advised in older children. There is a limited role for post-mortem CR and ultrasonography. In most cases, conventional autopsy will remain the diagnostic method of choice. Based on a literature review and clinical expertise, an evidence-based guideline was developed for post-mortem radiology of foetal, neonatal, and paediatric patients. What is Known: • Post-mortem investigations serve as a quality check for the provided health care and are important for reliable epidemiological registration. • Post-mortem radiology, sometimes combined with minimally invasive techniques, is considered as an adjunct or alternative to autopsy. What is New: • We present the Dutch guidelines for post-mortem radiology in foetuses, neonates and children. • Autopsy remains the reference standard, however minimal invasive autopsy with a skeletal survey, post-mortem computed tomography, or post-mortem magnetic resonance imaging can be complementary thereof.

MO-AB-204-00: Interoperability in Radiation Oncology: IHE-RO Committee Update

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

You’ve experienced the frustration: vendor A’s device claims to work with vendor B’s device, but the practice doesn’t match the promise. Getting devices working together is the hidden art that Radiology and Radiation Oncology staff have to master. To assist with that difficult process, the Integrating the Healthcare Enterprise (IHE) effort was established in 1998, with the coordination of the Radiological Society of North America. Integrating the Healthcare Enterprise (IHE) is a consortium of healthcare professionals and industry partners focused on improving the way computer systems interconnect and exchange information. This is done by coordinating the use of published standardsmore » like DICOM and HL7. Several clinical and operational IHE domains exist in the healthcare arena, including Radiology and Radiation Oncology. The ASTRO-sponsored IHE Radiation Oncology (IHE-RO) domain focuses on radiation oncology specific information exchange. This session will explore the IHE Radiology and IHE RO process for; IHE solicitation process for new profiles. Improving the way computer systems interconnect and exchange information in the healthcare enterprise Supporting interconnectivity descriptions and proof of adherence by vendors Testing and assuring the vendor solutions to connectivity problems. Including IHE profiles in RFPs for future software and hardware purchases. Learning Objectives: Understand IHE role in improving interoperability in health care. Understand process of profile development and implantation. Understand how vendors prove adherence to IHE RO profiles. S. Hadley, ASTRO Supported Activity.« less

Collaborative Branding of Partnered Health Systems in Radiology.

PubMed

Kalambo, Megan; Parikh, Jay R

2018-01-01

In an effort to expand clinical reach and achieve economies of scale, academic radiology practices are strategically expanding into the community by establishing partnerships with existing community health systems. A challenge with this model is to effectively brand the collaboration in a way that underscores the strengths of both partners. In this article, the authors look at the benefits and risks of cobranding and review cobranding strategies for implementation by academic radiology practices considering partnership-based network expansion. Published by Elsevier Inc.

The future of radiology augmented with Artificial Intelligence: A strategy for success.

PubMed

Liew, Charlene

2018-05-01

The rapid development of Artificial Intelligence/deep learning technology and its implementation into routine clinical imaging will cause a major transformation to the practice of radiology. Strategic positioning will ensure the successful transition of radiologists into their new roles as augmented clinicians. This paper describes an overall vision on how to achieve a smooth transition through the practice of augmented radiology where radiologists-in-the-loop ensure the safe implementation of Artificial Intelligence systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Proposal of a skin tests based approach for the prevention of recurrent hypersensitivity reactions to iodinated contrast media.

PubMed

Della-Torre, E; Berti, A; Yacoub, M R; Guglielmi, B; Tombetti, E; Sabbadini, M G; Voltolini, S; Colombo, G

2015-05-01

The purpose of the present work is to evaluate the efficacy of an approach that combines clinical history, skin tests results, and premedication, in preventing recurrent hypersensitivity reactions to iodinated contrast media (ICM). Skin Prick tests, Intradermal tests, and Patch tests were performed in 36 patients with a previous reaction to ICM. All patients underwent a second contrast enhanced radiological procedure with an alternative ICM selected on the basis of the proposed approach. After alternative ICM re-injection, only one patient presented a mild NIR. The proposed algorithm, validated in clinical settings where repeated radiological exams are needed, offers a safe and practical approach for protecting patients from recurrent hypersensitivity reactions to ICM.

National entrepreneurial radiology initiatives: what are they, and what can they do to and for you?

PubMed

Muroff, Lawrence R

2013-04-01

National entrepreneurial radiology companies have evolved over the past 3 decades. In the 1990s, a few initiatives were established to implement business principles and reward shareholders with gains derived from management expertise, practice efficiencies, and economies of scale. The next decade saw the emergence of night call coverage and "specialty read" companies. As the market for these services became saturated, the established corporate entities scrambled to find new revenue streams. Hospital radiology contracts were the obvious source for this needed capital. The pursuit of these contracts led to aggressive, nontraditional competition. If radiologists are to respond appropriately, they must understand the reasons behind the strategies used by these national entrepreneurial radiology companies. The author explores the goals and actions of these entities and describes why hospitals may find these national companies to be an attractive alternative to their incumbent radiology practices. Both the benefits and the problems associated with entrepreneurial companies are covered, and concepts such as disintermediation are discussed. Finally, the author suggests appropriate actions for radiologists seeking to retain their hospital contracts. Nontraditional competition is now a way of life for many radiology practices. Relationships, subspecialization, service, and measurable quality indicators are the foundation for the maintenance of tenure at hospitals. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The American Board of Radiology Maintenance of Certification (MOC) Program in Radiologic Physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Thomas, Stephen R.; Hendee, William R.; Paliwal, Bhudatt R.

2005-01-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document the professional development of each diplomate of The American Board of Radiology (ABR) through its focus on the essential elements of quality care in Diagnostic Radiology and its subspecialties, and in the specialties of Radiation Oncology and Radiologic Physics. The initial elements of the ABR-MOC have been developed in accord with guidelines of The American Board of Medical Specialties. All diplomates with a ten-year,more » time-limited primary certificate in Diagnostic Radiologic Physics, Therapeutic Radiologic Physics, or Medical Nuclear Physics who wish to maintain certification must successfully complete the requirements of the appropriate ABR-MOC program for their specialty. Holders of multiple certificates must meet ABR-MOC requirements specific to the certificates held. Diplomates with lifelong certificates are not required to participate in the MOC, but are strongly encouraged to do so. MOC is based on documentation of individual participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Within these components, MOC addresses six competencies: medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice.« less

Interpreting and Reporting Radiological Water-Quality Data

USGS Publications Warehouse

McCurdy, David E.; Garbarino, John R.; Mullin, Ann H.

2008-01-01

This document provides information to U.S. Geological Survey (USGS) Water Science Centers on interpreting and reporting radiological results for samples of environmental matrices, most notably water. The information provided is intended to be broadly useful throughout the United States, but it is recommended that scientists who work at sites containing radioactive hazardous wastes need to consult additional sources for more detailed information. The document is largely based on recognized national standards and guidance documents for radioanalytical sample processing, most notably the Multi-Agency Radiological Laboratory Analytical Protocols Manual (MARLAP), and on documents published by the U.S. Environmental Protection Agency and the American National Standards Institute. It does not include discussion of standard USGS practices including field quality-control sample analysis, interpretive report policies, and related issues, all of which shall always be included in any effort by the Water Science Centers. The use of 'shall' in this report signifies a policy requirement of the USGS Office of Water Quality.

Antiservice Within the Medical Service Encounter: Lessons for Radiologists Beyond Service Recovery.

PubMed

Hill, Paul Armstrong; Hill, Ronald Paul

2015-12-01

Recent modifications in the metrics for reimbursement have reinforced the importance of radiology service-delivery experiences of patients. Evaluating current radiology practices calls for reflection on the various touch points with patients, as well as their overall satisfaction. If problems occur during encounters, service failure, or lack of satisfactory medical experiences can be transformed through service recovery, whereby patients-as-customers are given chances to voice their concerns, and health care providers across the spectrum can work together to resolve problematic issues. This paper takes a systemic view of the patient experience as embedded in the care continuum, recognizing that different beliefs, attitudes, and behaviors of members of the health care team can negatively affect or sabotage patient satisfaction. Although radiologists are only one of many roles in the care continuum, recommendations are discussed for how they can integrate service satisfaction as a pervasive communal goal among all health care team members. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Postmortem computed tomography (PMCT) and disaster victim identification.

PubMed

Brough, A L; Morgan, B; Rutty, G N

2015-09-01

Radiography has been used for identification since 1927, and established a role in mass fatality investigations in 1949. More recently, postmortem computed tomography (PMCT) has been used for disaster victim identification (DVI). PMCT offers several advantages compared with fluoroscopy, plain film and dental X-rays, including: speed, reducing the number of on-site personnel and imaging modalities required, making it potentially more efficient. However, there are limitations that inhibit the international adoption of PMCT into routine practice. One particular problem is that due to the fact that forensic radiology is a relatively new sub-speciality, there are no internationally established standards for image acquisition, image interpretation and archiving. This is reflected by the current INTERPOL DVI form, which does not contain a PMCT section. The DVI working group of the International Society of Forensic Radiology and Imaging supports the use of imaging in mass fatality response and has published positional statements in this area. This review will discuss forensic radiology, PMCT, and its role in disaster victim identification.

Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

NASA Astrophysics Data System (ADS)

Daly, S.; Rainford, L.; Butler, M. L.

2014-03-01

Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

MO-DE-204-00: International Symposium: Patient Dose Reduction in Diagnostic Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2016-06-15

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented.more » Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.« less

MO-DE-204-03: Radiology Dose Optimisation - An Australian Perspective

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schick, D.

2016-06-15

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented.more » Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.« less

The 2014 ACR Commission on Human Resources workforce survey.

PubMed

Bluth, Edward I; Truong, Hang; Bansal, Swati

2014-10-01

The ACR Commission on Human Resources conducts an annual electronic survey during the first quarter of the year to better understand the present workforce scenario for radiologists and allied health professionals. The Practice of Radiology Environment Database is used to identify group leaders who are asked to complete an electronic survey developed by the Commission on Human Resources. The survey asked 1,936 group leaders or their designates to report the number of radiologists currently employed or supervised, the number hired in 2013, and the number they plan to hire in 2014 and 2017. The leaders were asked to report the subspecialty area that was used as the main reason for hiring each physician. The 22% response rate corresponds to 35% of all practicing radiologists in the United States. The 2014 survey demonstrated that 78% of the workforce is male and 22% is female and that 87% of the workforce works full time. Fifty-three percent of the current workforce is in private practice and 47% in varying forms of employment. The current workforce consists of 18% general radiologists and 82% subspecialists. In 2013, 1,069 radiologists were hired. In 2014, 1,114 job opportunities are projected, and 1,131 estimated jobs are forecast for 2017. Job opportunities for radiologists in 2014 remain similar to those in 2013 and close to the numbers of residents completing training programs in diagnostic radiology. Job opportunities remain available but may not necessarily be in the subspecialty, geographic area, or type of practice an individual most desires. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology coding, reimbursement, and economics: a practical playbook for housestaff.

PubMed

Petrey, W Banks; Allen, Bibb; Thorwarth, William T

2009-09-01

As radiologists-in-training, residents and fellows have little time to devote to understanding the complex and often confusing world of reimbursement and radiology economics. At best, housestaff are afforded only a modicum of exposure to the economics of medicine. Although most training programs try to provide some information on the subject, between learning radiology, taking call, and juggling life outside the hospital, the majority of residents and fellows have little time or energy to learn about the economics of radiology. Furthermore, information on medical economics and radiology has only occasionally been directed specifically to housestaff or widely distributed to residents across the country. This is unfortunate because the reimbursement and economic arena will significantly affect daily practice, relationships with other specialties, and compensation. In this article, the authors briefly describe the current reimbursement and economic climate: how we got here and where we may be headed, with specific attention to coding for radiologic services. In addition, and perhaps more important, the authors highlight aspects of residents' or fellows' daily practice that may have the potential to affect reimbursement in their years of practice ahead, such as proper dictation and coding techniques, the importance of adhering to new reporting guidelines, and the need for increased radiologist involvement in professional and community activities. The authors also emphasize measures that can be taken, specifically by housestaff, to promote and preserve the image of our specialty, which ultimately is intertwined with the reimbursement and economics of our field.

University-Based Teleradiology in the United States.

PubMed

Hunter, Tim B; Krupinski, Elizabeth A

2014-04-15

This article reviews the University of Arizona's more than 15 years of experience with teleradiology and provides an overview of university-based teleradiology practice in the United States (U.S.). In the U.S., teleradiology is a major economic enterprise with many private for-profit companies offering national teleradiology services (i.e., professional interpretation of radiologic studies of all types by American Board of Radiology certified radiologists). The initial thrust for teleradiology was for after-hours coverage of radiologic studies, but teleradiology has expanded its venue to include routine full-time or partial coverage for small hospitals, clinics, specialty medical practices, and urgent care centers. It also provides subspecialty radiologic coverage not available at smaller medical centers and clinics. Many U.S. university-based academic departments of radiology provide teleradiology services usually as an additional for-profit business to supplement departmental income. Since academic-based teleradiology providers have to compete in a very demanding marketplace, their success is not guaranteed. They must provide timely, high-quality professional services for a competitive price. Academic practices have the advantage of house officers and fellows who can help with the coverage, and they have excellent subspecialty expertise. The marketplace is constantly shifting, and university-based teleradiology practices have to be nimble and adjust to ever-changing situations.

Adult learning principles for effective teaching in radiology programmes: a review of the literature.

PubMed

Arogundade, R A

2011-01-01

Adult learning processes of acquisition of new knowledge, behaviours, skills, values or preferences generally occur as part of personal professional development. There is need for radiology residency trainers to understand the basic adult learning principles for effective teaching processes. To review the different adult learning styles, learning theories and educational practice as a guide for radiology residency trainers. Literature materials from journals, web articles and reputable textbooks in the last 20 years on adult learning principles in general and radiology in particular were reviewed. Most medical educators, including radiologists, lack appropriate formal training background in educational practice. The adult residency trainee brings to the learning environment high quantity and quality of experiences and some amount of control. Connection of this rich adult experience base to the learning process requires facilitation and motivation by the radiology educator, who must be familiar with the use of appropriate learning theories and educational practices. there is a general agreement about the content of good practice in adult education but a definite comprehensive list does not seem to exist in the literature. Nonetheless, understanding of the basic adult learning principles would aid the concept of guided training, where the adult residency trainee shoulders the bulk of the training responsibilities of acquisition of knowledge.

TH-E-201-02: Hands-On Physics Teaching of Residents in Diagnostic Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, J.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

TH-E-201-03: A Radiology Resident’s Perspectives of Physics Teaching

DOE Office of Scientific and Technical Information (OSTI.GOV)

Key, A.

The ABR Core Examination stresses integrating physics into real-world clinical practice and, accordingly, has shifted its focus from passive recall of facts to active application of physics principles. Physics education of radiology residents poses a challenge. The traditional method of didactic lectures alone is insufficient, yet it is difficult to incorporate physics teaching consistently into clinical rotations due to time constraints. Faced with this challenge, diagnostic medical physicists who teach radiology residents, have been thinking about how to adapt their teaching to the new paradigm, what to teach and meet expectation of the radiology resident and the radiology residency program.more » The proposed lecture attempts to discuss above questions. Newly developed diagnostic radiology residents physics curriculum by the AAPM Imaging Physics Curricula Subcommittee will be reviewed. Initial experience on hands-on physics teaching will be discussed. Radiology resident who will have taken the BAR Core Examination will share the expectation of physics teaching from a resident perspective. The lecture will help develop robust educational approaches to prepare radiology residents for safer and more effective lifelong practice. Learning Objectives: Learn updated physics requirements for radiology residents Pursue effective approaches to teach physics to radiology residents Learn expectation of physics teaching from resident perspective J. Zhang, This topic is partially supported by RSNA Education Scholar Grant.« less

Volumetric CT-images improve testing of radiological image interpretation skills.

PubMed

Ravesloot, Cécile J; van der Schaaf, Marieke F; van Schaik, Jan P J; ten Cate, Olle Th J; van der Gijp, Anouk; Mol, Christian P; Vincken, Koen L

2015-05-01

Current radiology practice increasingly involves interpretation of volumetric data sets. In contrast, most radiology tests still contain only 2D images. We introduced a new testing tool that allows for stack viewing of volumetric images in our undergraduate radiology program. We hypothesized that tests with volumetric CT-images enhance test quality, in comparison with traditional completely 2D image-based tests, because they might better reflect required skills for clinical practice. Two groups of medical students (n=139; n=143), trained with 2D and volumetric CT-images, took a digital radiology test in two versions (A and B), each containing both 2D and volumetric CT-image questions. In a questionnaire, they were asked to comment on the representativeness for clinical practice, difficulty and user-friendliness of the test questions and testing program. Students' test scores and reliabilities, measured with Cronbach's alpha, of 2D and volumetric CT-image tests were compared. Estimated reliabilities (Cronbach's alphas) were higher for volumetric CT-image scores (version A: .51 and version B: .54), than for 2D CT-image scores (version A: .24 and version B: .37). Participants found volumetric CT-image tests more representative of clinical practice, and considered them to be less difficult than volumetric CT-image questions. However, in one version (A), volumetric CT-image scores (M 80.9, SD 14.8) were significantly lower than 2D CT-image scores (M 88.4, SD 10.4) (p<.001). The volumetric CT-image testing program was considered user-friendly. This study shows that volumetric image questions can be successfully integrated in students' radiology testing. Results suggests that the inclusion of volumetric CT-images might improve the quality of radiology tests by positively impacting perceived representativeness for clinical practice and increasing reliability of the test. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Factors Influencing Radiology Residents' Fellowship Training and Practice Preferences in Canada.

PubMed

Mok, Philip S; Probyn, Linda; Finlay, Karen

2016-05-01

The study aimed to examine the postresidency plans of Canadian radiology residents and factors influencing their fellowship choices and practice preferences, including interest in teaching and research. Institutional ethics approval was obtained at McMaster University. Electronic surveys were sent to second to fifth-year residents at all 16 radiology residency programs across Canada. Each survey assessed factors influencing fellowship choices and practice preferences. A total of 103 (31%) Canadian radiology residents responded to the online survey. Over 89% from English-speaking programs intended to pursue fellowship training compared to 55% of residents from French-speaking programs. The most important factors influencing residents' decision to pursue fellowship training were enhanced employability (46%) and personal interest (47%). Top fellowship choices were musculoskeletal imaging (19%), body imaging (17%), vascular or interventional (14%), neuroradiology (8%), and women's imaging (7%). Respondents received the majority of their fellowship information from peers (68%), staff radiologists (61%), and university websites (58%). Approximately 59% planned on practicing at academic institutions and stated that lifestyle (43%), job prospects (29%), and teaching opportunities (27%) were the most important factors influencing their decisions. A total of 89% were interested in teaching but only 46% were interested in incorporating research into their future practice. The majority of radiology residents plan on pursuing fellowship training and often receive their fellowship information from informal sources such as peers and staff radiologists. Fellowship directors can incorporate recruitment strategies such as mentorship programs and improving program websites. There is a need to increase resident participation in research to advance the future of radiology. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

RadSearch: a RIS/PACS integrated query tool

NASA Astrophysics Data System (ADS)

Tsao, Sinchai; Documet, Jorge; Moin, Paymann; Wang, Kevin; Liu, Brent J.

2008-03-01

Radiology Information Systems (RIS) contain a wealth of information that can be used for research, education, and practice management. However, the sheer amount of information available makes querying specific data difficult and time consuming. Previous work has shown that a clinical RIS database and its RIS text reports can be extracted, duplicated and indexed for searches while complying with HIPAA and IRB requirements. This project's intent is to provide a software tool, the RadSearch Toolkit, to allow intelligent indexing and parsing of RIS reports for easy yet powerful searches. In addition, the project aims to seamlessly query and retrieve associated images from the Picture Archiving and Communication System (PACS) in situations where an integrated RIS/PACS is in place - even subselecting individual series, such as in an MRI study. RadSearch's application of simple text parsing techniques to index text-based radiology reports will allow the search engine to quickly return relevant results. This powerful combination will be useful in both private practice and academic settings; administrators can easily obtain complex practice management information such as referral patterns; researchers can conduct retrospective studies with specific, multiple criteria; teaching institutions can quickly and effectively create thorough teaching files.

Strategic Expansion Models in Academic Radiology.

PubMed

Natesan, Rajni; Yang, Wei T; Tannir, Habib; Parikh, Jay

2016-03-01

In response to economic pressures, academic institutions in the United States and their radiology practices, are expanding into the community to build a larger network, thereby driving growth and achieving economies of scale. These economies of scale are being achieved variously via brick-and-mortar construction, community practice acquisition, and partnership-based network expansion. We describe and compare these three expansion models within a 4-part framework of: (1) upfront investment; (2) profitability impact; (3) brand impact; and (4) risk of execution. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Which is the best way of performing a Micturating Cystourethrogram in children?

PubMed

Al-Imam, Ola Ali; Al-Nsour, Nareeman Moh'd; Al-Khulaifat, Samih

2008-01-01

The Micturating Cystourethrogram (MCU) is a tough and stressful examination for patients and their parents as well as the radiologists and pediatric radiology nurses. Even though, it is one of the most commonly used fluoroscopic procedures in pediatric radiology practice, there is no definite agreement as to the best way to perform it, considering that this examination results in the children receiving a high dose of radiation to the gonadal region. This review was undertaken to determine the best way to perform the MCU in modern pediatric radiology practice.

Radiologic sciences. Faculty needs assessment.

PubMed

Powers, Kevin J

2005-01-01

A total of 326 programs are represented in the data collected. Based on the average number of full- and part-time faculty members reported per program, this survey represents more than 1500 faculty positions. Based on the forecast of retirement and career change for all faculty members, there will be a turnover of 700 to 800 positions over the next 5 to 10 years. Part-time/adjunct faculty vacancies are expected to create the greatest number of opportunities for technologists to make the transition to education, with approximately one third of current part-time/adjunct educators planning on leaving radiologic sciences education within 5 years. To encourage retention of part-time/adjunct educators, annual evaluations should be modified to recognize the important educational role these instructors play. There is a need to create enthusiasm and interest in education as a career pathway for radiologic technologists. Resources are needed that help radiologic technologists make the transition to teaching. Finally, the retention of educators must be emphasized. Program applicant trends indicate radiologic technology students are older, have prior postsecondary education experience or are making a career change. This data emphasizes the need for educators, both full time and part time, to understand the characteristics and needs of the adult learner. Adult learners bring a wealth of education, experience and life skills that create both opportunities and challenges in the classroom and clinical setting. All categories of respondents indicated that their current salaries were greater than those of program graduates in their firstjob. Of interest is that 1 in 5 (20%) of part-time/adjunct educators indicated the opposite--that program graduates earn more in their firstjob than educators earn. When asked about salaries if working full time in clinical practice, the majority of all groups indicated their salary would be about the same or would decrease. Only 20% of program directors, 21% of full-time educators and 26% of part-time/adjunct educators indicated their salary would be higher in clinical practice. Part-time/adjunct educators reported working the most in clinical practice within the past week to month. Program directors exhibited the greatest separation from clinical practice, with more than half indicating a gap of 2 years or more from practicing in the clinical environment. While academic achievement is common among the educator populations sampled, a very low percentage of these educators are seeking an advanced academic degree. Less than a third of those surveyed indicated that they were pursuing an advanced degree. Becoming involved in research is not a requirement for many current educators, although survey participants expressed an interest in information about how to conduct a research project. A primary motivator for conducting the faculty development needs assessment was to use the data in strategic planning to set priorities for the resources available to the ASRT Education Department. The data will help maximize ASRT support for present and future educators. Services created by the ASRT Education Department will deepen the relationship with this key segment of the professional community.

What makes 'big data' different from 'regular data' within radiology? The easiest answer: when it no longer fits into Excel!

NASA Astrophysics Data System (ADS)

Lindsköld, L.; Alvfeldt, G.; Wintell, M.

2015-03-01

One of the challenges of today's healthcare is that data from radiology is heterogeneous, stored and managed in silos created by PACS vendors. Also seen is a lack of coordinated use of harmonized reference information models and established healthcare standards. Radiology in Region Västra Götaland has been entering the world of "Big Data" since 2006, 34 departments split into 4 private image center, 2 small-size hospital, 4 middle-sized hospital groups and one University hospital. Using the same information infrastructure as a means of collaborating and sharing information between. As an organization building for the future we must meet the values and requirements of the stakeholders and count the patient as the major actor. Can "Big Data" analytics be a valuable asset from a regional management perspective? Our initial findings indicates that this is the case, based on three different perspectives - work practice changes, understanding data quality when sharing information and introducing new services in work practice. Going from local to enterprise workflow utilizing the power of "Big Data", not only by volume but also by combining diverse sources and aggregate the information domains, visualize new trends as well as dependencies more effectively. Building trust by the use of Big Data in healthcare involves a long and winding journey, but the persevering infrastructure-oriented organization will give new ways of collaboration for the enterprise it serves. It also involves continuous negotiation with people concerning how and why they should collaborate with new actors within the region to achieve patient centric care. This will nurture a more open-minded, hopeful and life-affirming holistic approach involving all stakeholders, newcomers' specialists and patients.

Evaluation of a radiation survey training video developed from a real-time video radiation detection system.

PubMed

Wang, Wei-Hsung; McGlothlin, James D; Smith, Deborah J; Matthews, Kenneth L

2006-02-01

This project incorporates radiation survey training into a real-time video radiation detection system, thus providing a practical perspective for the radiation worker on efficient performance of radiation surveys. Regular surveys to evaluate radiation levels are necessary not only to recognize potential radiological hazards but also to keep the radiation exposure as low as reasonably achievable. By developing and implementing an instructional learning system using a real-time radiation survey training video showing specific categorization of work elements, radiation workers trained with this system demonstrated better radiation survey practice.

Coordinating patient care within radiology and across the enterprise.

PubMed

McEnery, Kevin W

2014-12-01

For the practice of radiology, the transition to filmless imaging operations has resulted in a fundamental transition to more efficient clinical operations. In addition, the electronic delivery of diagnostic studies to the bedside has had a great impact on the care process throughout the health care enterprise. The radiology information system (RIS) has been at the core of the transition to filmless patient care. In a similar manner, the electronic medical record (EMR) is fundamentally and rapidly transforming the clinical enterprise into paperless/digital coordination of care. The widespread availability of EMR systems can be predicted to continue to increase the level of coordination of clinical care within the EMR framework. For the radiologist, readily available clinical information at the point of interpretation will continue to drive the evolution of the interpretation process, leading to improved patient outcomes. Regardless of practice size, efficient workflow processes are required to best leverage the functionality of IT systems. The radiologist should be aware of the scope of the RIS capabilities that allow for maximizing clinical benefit, and of the EMR system capabilities for improving = clinical imaging practice and care coordination across the enterprise. Radiology departments should be actively involved in forming practice patterns that allow efficient EMR-based clinical practice. This summary article is intended to assist radiologists in becoming active participants in the evolving role of both the RIS and EMR systems in coordinating efficient and effective delivery across the clinical enterprise. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

2017 ACR Annual Meeting Open-Microphone Session: Navigating the Landscape of Changing Practice Models: Private Practice, Corporate Radiology, and Enterprise Systems.

PubMed

Stern, Eric J; Everett, Catherine; Friedberg, Eric B; Kotsenas, Amy L; Glover, McKinley; Lightfoote, Johnson B; Lall, Neil; Swan, Timothy L

2017-11-01

Many practice groups are considering adopting new practice models, primarily to secure their practices by adapting to new payment models, government compliance and regulation, and increasing IT and infrastructure costs. As we move toward value-based care and capitation, the value equation (value = quality/cost) will lead us to also compete on cost to improve value. No matter what payment models ultimately dominate, we need to be prepared to lead in a value-based care environment. Measures of value will either be defined by radiologists or imposed by outside entities. It is critical to our continued success that practices and practice leaders continue to fully and strongly support the ACR to avoid the possibility of a decline in membership that may accompany a lack of practice engagement. Consolidation appears inevitable, but with the help of the ACR, radiologists should have a vibrant future if investments are made now in determining appropriate radiology-specific value measures that are meaningful in consolidated health care environments. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quality Improvement With Discrete Event Simulation: A Primer for Radiologists.

PubMed

Booker, Michael T; O'Connell, Ryan J; Desai, Bhushan; Duddalwar, Vinay A

2016-04-01

The application of simulation software in health care has transformed quality and process improvement. Specifically, software based on discrete-event simulation (DES) has shown the ability to improve radiology workflows and systems. Nevertheless, despite the successful application of DES in the medical literature, the power and value of simulation remains underutilized. For this reason, the basics of DES modeling are introduced, with specific attention to medical imaging. In an effort to provide readers with the tools necessary to begin their own DES analyses, the practical steps of choosing a software package and building a basic radiology model are discussed. In addition, three radiology system examples are presented, with accompanying DES models that assist in analysis and decision making. Through these simulations, we provide readers with an understanding of the theory, requirements, and benefits of implementing DES in their own radiology practices. Copyright © 2016 American College of Radiology. All rights reserved.

[To improve the quality of requisitions for radiologic examinations].

PubMed

Roussel, P; Lelièvre, N

2002-05-01

This article presents the different steps implemented in order to improve the quality of requisitions for radiologic examinations in a hospital. and methods. The radiology requests sent from clinical units are periodically analyzed using criteria about tracking, prescription and security required for a good examination. Results are discussed with the clinical units in order to achieve improvements. The periodical analysis of nonconformities shows a gradual improvement of practices. This action contributes to the realization of a single document for every request of examination or analysis in the hospital. The described action is in the context of French regulations, first about the practice of radiology, second about the obligation of quality improvement that health care facilities now have to implement for their accreditation.

The Correlated Lecture Laboratory Series in Diagnostic Radiological Physics.

ERIC Educational Resources Information Center

Lamel, David A.; And Others

This series in diagnostic radiological physics has been designed to provide the physics background requisite for the proper conduct of medical diagnostic x-ray examinations. The basic goal of the series is to bridge physics theory and radiological practice, achieved by combining pertinent lecture material with laboratory exercises that illustrate…

Overview of ICRP Committee 3: protection in medicine.

PubMed

Vañó, E; Miller, D L; Rehani, M M

2016-06-01

Committee 3 of the International Commission on Radiological Protection (ICRP) develops recommendations and guidance for protection of patients, staff, and the public against radiation exposure when ionising radiation is used for medical diagnosis, therapy, or biomedical research. This paper presents a summary of the work that Committee 3 has accomplished over the past few years, and also describes its current work. The most recent reports published by the Commission that relate to radiological protection in medicine are 'Radiological protection in cone beam computed tomography' (Publication 129), 'Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances' (Publication 128, in cooperation with Committee 2), 'Radiological protection in ion beam radiotherapy' (Publication 127), 'Radiological protection in paediatric diagnostic and interventional radiology' (Publication 121), 'Radiological protection in cardiology' (Publication 120), and 'Radiological protection in fluoroscopically guided procedures outside the imaging department' (Publication 117). A new report on diagnostic reference levels in medical imaging will provide specific advice for interventional radiology, digital imaging, computed tomography, nuclear medicine, paediatrics, and hybrid (multi-modality) imaging procedures, and is expected to be published in 2016. Committee 3 is also working on guidance for occupational radiological protection in brachytherapy, and on guidance on occupational protection issues in interventional procedures, paying particular attention to the 2011 Commission's recommendations on the occupational dose limit for the lens of the eye (Publication 118). Other reports in preparation deal with justification, radiological protection in therapy with radiopharmaceuticals, radiological protection in medicine as related to individual radiosusceptibility, appropriate use of effective dose (in cooperation with other Committees), and guidance for healthcare practitioners on radiological and patient protection. Committee 3 has also suggested specific priorities for research on radiological protection in medicine to the Commission. © The International Society for Prosthetics and Orthotics.

Work plan for the radiological survey for the David Witherspoon, Incorporated, Landfill-1630 site, Knoxville, Tennessee

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1996-07-01

This work plan establishes the methods and requirements for performing a radiological survey at the David Witherspoon, Incorporated, Landfill-1630 Site, Knoxville, Tennessee (DWI 1630 Site) in accordance with requirements under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA). The radiological survey will identify the radiological contamination level of the equipment and debris stored at the DWI 1630 Site. The data generated from the survey activities will support the decisions for characterization of the equipment/debris and aid in subsequent disposition and waste handling. The survey activities to be performed under this work plan include an equipment radiological survey,more » a walkover survey, and an immunoassay testing for polychlorinated biphenyls (PCBs). This work plan includes a quality assurance (QA)/quality control (QC) project plan, a health and safety (H&S) plan, and a waste management plan.« less

Strategic marketing: an introduction for medical specialists.

PubMed

Lexa, Frank James; Berlin, Jonathan

2006-03-01

Marketing and branding are 2 of the most important factors for business success in the United States. They are particularly critical in service industries such as diagnostic imaging. However, in spite of their strategic importance in radiology success, a search of the peer-reviewed radiology literature reveals a paucity of published work that addresses marketing for imaging practices. In particular, there is a dearth of literature addressing the role (both direct and indirect) of radiologists in marketing efforts. In this article, the authors attempt to identify and correct some common misconceptions that physicians and other scientific and technical professionals have about marketing. Basic terms and preliminary concepts are introduced to provide a foundational understanding of the topic, allowing the interested reader to move forward and explore these critical issues in greater depth.

Point-of-care ultrasound education for non-physician clinicians in a resource-limited emergency department.

PubMed

Stolz, Lori A; Muruganandan, Krithika M; Bisanzo, Mark C; Sebikali, Mugisha J; Dreifuss, Bradley A; Hammerstedt, Heather S; Nelson, Sara W; Nayabale, Irene; Adhikari, Srikar; Shah, Sachita P

2015-08-01

To describe the outcomes and curriculum components of an educational programme to train non-physician clinicians working in a rural, Ugandan emergency department in the use of POC ultrasound. The use of point-of-care ultrasound was taught to emergency care providers through lectures, bedsides teaching and hands-on practical sessions. Lectures were tailored to care providers' knowledge base and available therapeutic means. Every ultrasound examination performed by these providers was recorded over 4.5 years. Findings of these examinations were categorised as positive, negative, indeterminate or procedural. Other radiologic studies ordered over this same time period were also recorded. A total of 22,639 patients were evaluated in the emergency department by emergency care providers, and 2185 point-of-care ultrasound examinations were performed on 1886 patients. Most commonly used were the focused assessment with sonography in trauma examination (53.3%) and echocardiography (16.4%). Point-of-care ultrasound studies were performed more frequently than radiology department-performed studies. Positive findings were documented in 46% of all examinations. We describe a novel curriculum for point-of-care ultrasound education of non-physician emergency practitioners in a resource-limited setting. These non-physician clinicians integrated ultrasound into clinical practice and utilised this imaging modality more frequently than traditional radiology department imaging with a large proportion of positive findings. © 2015 John Wiley & Sons Ltd.

Culture shift: an imperative for future survival.

PubMed

Muroff, Lawrence R

2013-02-01

Radiologists have experienced unprecedented prosperity for the past 3 decades. Technology has continually evolved, providing exciting opportunities for earlier diagnoses and improved patient care. The financial rewards enjoyed by radiologists have been impressive, and the quality of life has been difficult to beat. Circumstances change, and in the past few years, radiologists have been confronted with a variety of new challenges. These trends include declining reimbursement, an "image problem" at both the local and the national levels, more demanding hospital administrations, nontraditional competition from national entrepreneurial radiology entities for radiology hospital contracts, and alternative payment systems. The author outlines the genesis of these trends, describes strategies for meeting these challenges, and discusses the roles of both radiology practices and the ACR in preparing radiologists for the threats and the opportunities that lie ahead. Although it will be important for radiologists to "get to the table" to participate fully in the new health care environment, it will be imperative for radiologists to know what to do once they are at the table. This is not "business as usual," and for radiologists, there will be winners and losers in the coming years. It will take work to succeed, and the apathy, denial, and sense of entitlement that have characterized our practitioners must be replaced by service, visibility, health policy data, and "value-added" information for referring physicians and their patients. The future for radiology is bright; the future for radiologists is far less certain. Strategic planning, scenario planning, practice building, and the efficient provision of high-quality patient care are the keys for radiologists to succeed. Radiologists must integrate themselves into the medical, social, and political fabrics of their hospitals and their communities, and they will need to get the in-depth leadership training and the important health policy data that the ACR is structured to provide. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Evaluation of clinicians' knowledge and practices regarding medical radiological exposure: findings from a mixed-methods investigation (survey and qualitative study)

PubMed Central

Lumbreras, B; Vilar, J; González-Álvarez, I; Guilabert, M; Parker, L A; Pastor-Valero, M; Domingo, M L; Fernández-Lorente, M F; Hernández-Aguado, I

2016-01-01

Objectives To assess the impact of initiatives aiming to increase clinician awareness of radiation exposure; to explore the challenges they face when communicating with patients; to study what they think is the most appropriate way of communicating the long-term potential risks of medical radiological exposure to patients. Design A quantitative and qualitative evaluation through a survey and focal groups. Setting San Juan Hospital and Dr Peset Hospital (Southeast Spain) and clinicians from Spanish scientific societies. Participants The surveys were answered (a) in person (216: all the radiologists (30), urologists (14) and surgeons (44) working at both participant hospitals; a sample of general practitioners from the catchment area of one hospital (45), and a consecutive sample of radiologists attending a scientific meeting (60)) or (b) electronically through Spanish scientific societies (299: radiologists (45), pneumologists (123), haematologists (75) and surgeons (40)). Clinicians were not randomly selected and thus the results are limited by the diligence of the individuals filling out the survey. Primary and secondary outcome measures Clinicians' knowledge and practices regarding medical radiological exposure, and what they considered most appropriate for communicating information to patients. Results Nearly 80% of the clinicians surveyed had never heard of the European recommendations. Fewer than 20% of the clinicians surveyed identified correctly the radiation equivalence dose of intravenous urography or barium enema. It was reported by 31.7% that they inform patients about the long-term potential risks of ionising radiation. All participants agreed that the most appropriate way to present information is a table with a list of imaging tests and their corresponding radiation equivalence dose in terms of chest X-rays and background radiation exposure. Conclusions Medical radiological exposure is frequently underestimated and rarely explained to patients. With a clear understanding of medical radiological exposure and proper communication tools, clinicians will be able to accurately inform patients. PMID:27799242

Duty to Inform and Informed Consent in Diagnostic Radiology: How Ethics and Law can Better Guide Practice.

PubMed

Doudenkova, Victoria; Bélisle Pipon, Jean-Christophe

2016-03-01

Although there is consensus on the fact that ionizing radiation used in radiological examinations can affect health, the stochastic (random) nature of risk makes it difficult to anticipate and assess specific health implications for patients. The issue of radiation protection is peculiar as any dosage received in life is cumulative, the sensitivity to radiation is highly variable from one person to another, and between 20 % and 50 % of radiological examinations appear not to be necessary. In this context, one might reasonably assume that information and patient consent would play an important role in regulating radiological practice. However, there is to date no clear consensus regarding the nature and content of-or even need for-consent by patients exposed to ionizing radiation. While law and ethics support the same principles for respecting the dignity of the person (inviolability and integrity), in the context of radiology practice, they do not provide a consistent message to guide clinical decision-making. This article analyzes the issue of healthcare professionals' duty to inform and obtain patient consent for radiological examinations. Considering that both law and ethics have as one of their aims to protect vulnerable populations, it is important that they begin to give greater attention to issues raised by the use of ionizing radiation in medicine. While the situation in Canada serves as a backdrop for a reflective analysis of the problem, the conclusions are pertinent for professional practice in other jurisdictions because the principles underlying health law and jurisprudence are fairly general.

[Survey on medical information education for radiologic technologists working at hospitals].

PubMed

Ikeda, Ryuji; Ogasawara, Katsuhiko; Okuda, Yasuo; Konishi, Yasuhiko; Ohoba, Hisateru; Hoshino, Shuhei; Hosoba, Minoru

2011-01-01

Recently, the importance of medical information for radiologic technologists has increased. The purpose of this questionnaire survey was to clarify the method of acquiring skill in medical information for radiologic technologists from the point of view of the managers of radiology departments. The questionnaire was sent to 260 hospitals that had introduced picture archiving and communication systems (PACSs) for the person responsible for medical information in the radiology department. The response rate was 35.4% (92 hospitals). The results of this survey clarified that few hospital have staff for medical information in the radiology department. Nevertheless, the excellent staff who have the skills to troubleshoot and develop systems are earnestly needed in radiology departments. To solve this problem, many technologists should understand the content, work load, and necessity of medical information. In addition, cooperation between radiologic technologist schools and hospitals is important in the field of medical information education.

Complex Problem Solving in Radiologic Technology: Understanding the Roles of Experience, Reflective Judgment, and Workplace Culture

ERIC Educational Resources Information Center

Yates, Jennifer L.

2011-01-01

The purpose of this research study was to explore the process of learning and development of problem solving skills in radiologic technologists. The researcher sought to understand the nature of difficult problems encountered in clinical practice, to identify specific learning practices leading to the development of professional expertise, and to…

Advanced marketing: how to protect and advance your practice.

PubMed

Lexa, Frank James

2007-02-01

Radiology practices in the United States are facing mounting competitive challenges in many metropolitan areas. This competition is multifaceted and includes other traditional diagnostic imagers. However, the most severe pressures are from new entrants, such as primary and specialty physicians outside of radiology. The business science of marketing provides a set of solutions to help you fight back against this onslaught. In particular, advanced marketing techniques offer compelling strengths for raising awareness of the unique nature of our specialty among both the lay population and primary referrers. Applications of advanced marketing can be used to simultaneously hold and expand your turf. Relying on smarts rather than dollars, they also help overcome the fears that many radiology practices have about the high costs of traditional broadcasting.

PathBot: A Radiology-Pathology Correlation Dashboard.

PubMed

Kelahan, Linda C; Kalaria, Amit D; Filice, Ross W

2017-12-01

Pathology is considered the "gold standard" of diagnostic medicine. The importance of radiology-pathology correlation is seen in interdepartmental patient conferences such as "tumor boards" and by the tradition of radiology resident immersion in a radiologic-pathology course at the American Institute of Radiologic Pathology. In practice, consistent pathology follow-up can be difficult due to time constraints and cumbersome electronic medical records. We present a radiology-pathology correlation dashboard that presents radiologists with pathology reports matched to their dictations, for both diagnostic imaging and image-guided procedures. In creating our dashboard, we utilized the RadLex ontology and National Center for Biomedical Ontology (NCBO) Annotator to identify anatomic concepts in pathology reports that could subsequently be mapped to relevant radiology reports, providing an automated method to match related radiology and pathology reports. Radiology-pathology matches are presented to the radiologist on a web-based dashboard. We found that our algorithm was highly specific in detecting matches. Our sensitivity was slightly lower than expected and could be attributed to missing anatomy concepts in the RadLex ontology, as well as limitations in our parent term hierarchical mapping and synonym recognition algorithms. By automating radiology-pathology correlation and presenting matches in a user-friendly dashboard format, we hope to encourage pathology follow-up in clinical radiology practice for purposes of self-education and to augment peer review. We also hope to provide a tool to facilitate the production of quality teaching files, lectures, and publications. Diagnostic images have a richer educational value when they are backed up by the gold standard of pathology.

The state of radiologic teaching practice in preclinical medical education: survey of American medical, osteopathic, and podiatric schools.

PubMed

Rubin, Zachary; Blackham, Kristine

2015-04-01

This study describes the state of preclinical radiology curricula in North American allopathic, osteopathic, and podiatric medical schools. An online survey of teaching methods, radiology topics, and future plans was developed. The Associations of American Medical Colleges, Colleges of Osteopathic Medicine, and Colleges of Podiatric Medicine listing for all US, Canadian, and Puerto Rican schools was used for contact information for directors of anatomy and/or radiology courses. Letters were sent via e-mail to 198 schools, with a link to the anonymous survey. Of 198 schools, 98 completed the survey (48%). Radiology curricula were integrated with other topics (91%), and taught by anatomists (42%) and radiologists (43%). The majority of time was spent on the topic of anatomy correlation (35%). Time spent teaching general radiology topics in the curriculum, such as physics (3%), modality differences (6%), radiation safety (2%), and contrast use (2%) was limited. Most schools had plans to implement an innovative teaching method in the near future (62%). The major challenges included limits on: time in the curriculum (73%); resources (32%); and radiology faculty participation (30%). A total of 82% reported that their curriculum did not model the suggestions made by the Alliance of Medical Student Educators in Radiology. This survey describes the current state of preclinical radiology teaching: curricula were nonstandard, integrated into other courses, and predominantly used for anatomy correlation. Other important contextual principles of the practice of radiology were seldom taught. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Pediatric interventional radiology workforce survey: 10-year follow-up.

PubMed

Kaufman, Claire S; James, Charles A; Harned, Roger K; Connolly, Bairbre L; Roebuck, Derek J; Cahill, Anne M; Dubois, Josee; Morello, Frank P; Morgan, Robin K; Sidhu, Manrita K

2017-05-01

Pediatric interventional radiology is a distinct subspecialty differing from both pediatric diagnostic radiology and adult interventional radiology. We conducted a workforce survey in 2005 to evaluate the state of pediatric interventional radiology at that time. Since then there have been many advancements to the subspecialty, including the founding of the Society for Pediatric Interventional Radiology (SPIR). To evaluate the current state of the pediatric interventional radiology workforce and compare findings with those of the initial 2005 workforce survey. We sent a two-part survey electronically to members of SPIR, the Society for Pediatric Radiology (SPR), the Society of Chairmen of Radiology in Children's Hospitals (SCORCH) and the Society of Interventional Radiology (SIR). Part 1 focused on individual practitioners (n=177), while part 2 focused on group practices and was answered by a leader from each group (n=88). We examined descriptive statistics and, when possible, compared the results to the study from 2005. A total of 177 individuals replied (a 331% increase over the first study) and 88 pediatric interventional radiology (IR) service sites responded (a 131.6% increase). Pediatric IR has become a more clinically oriented specialty, with a statistically significant increase in services with admitting privileges, clinics and performance of daily rounds. Pediatric IR remains diverse in training and practice. Many challenges still exist, including anesthesia/hospital support, and the unknown impact of the new IR residency on pediatric IR training, although the workforce shortage has been somewhat alleviated, as demonstrated by the decreased mean call from 165 days/year to 67.2 days/year. Pediatric interventional radiology practitioners and services have grown significantly since 2005, although the profile of this small subspecialty has changed and some challenges remain.

Interventional Radiology Clinical Practice Guideline Recommendations for Neurovascular Disorders Are Not Based on High-Quality Systematic Reviews.

PubMed

Chong, A B; Taylor, M; Schubert, G; Vassar, M

2017-04-01

In recent years, clinical practice guidelines have been criticized for biased interpretations of research evidence, and interventional radiology is no exception. Our aim was to evaluate the methodologic quality and transparency of reporting in systematic reviews used as evidence in interventional radiology clinical practice guidelines for neurovascular disorders from the Society of Interventional Radiology. Our sources were 9 neurovascular disorder clinical practice guidelines from the Society of Interventional Radiology. We selected 65 systematic reviews and meta-analyses. A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) tools were used to assess the methodologic quality and reporting transparency of systematic reviews. Radial plots were created on the basis of average scores for PRISMA and AMSTAR items. On the basis of AMSTAR scores, 3 (4.62%) reviews were high-quality, 28 reviews (43.08%) were moderate-quality, and 34 reviews (52.31%) were low-quality, with an average quality score of 3.66 (34.32%; minimum, 0%; maximum, 81.82%). The average PRISMA score was 18.18 (69.41%). We were unable to obtain previous versions for 8 reviews, 7 of which were from the Cochrane Database of Systematic Reviews. The methodologic quality of systematic reviews needs to be improved. Although reporting clarity was much better than the methodologic quality, it still has room for improvement. The methodologic quality and transparency of reporting did not vary much among clinical practice guidelines. This study can also be applied to other medical specialties to examine the quality of studies used as evidence in their own clinical practice guidelines. © 2017 by American Journal of Neuroradiology.

Interventional Radiology service provision and practice for the management of traumatic splenic injury across the Regional Trauma Networks of England.

PubMed

Hughes, Jane; Scrimshire, Ashley; Steinberg, Laura; Yiannoullou, Petros; Newton, Katherine; Hall, Claire; Pearce, Lyndsay; Macdonald, Andrew

2017-05-01

The management of blunt splenic injuries (BSI) has evolved toward strategies that avoid splenectomy. There is growing adoption of interventional radiology (IR) techniques in non-operative management of BSI, with evidence suggesting a corresponding reduction in emergency laparotomy requirements and increased splenic preservation rates. Currently there are no UK national guidelines for the management of blunt splenic injury. This may lead to variations in management, despite the reorganisation of trauma services in England in 2012. A survey was distributed through the British Society of Interventional Radiologists to all UK members aiming to identify availability of IR services in England, radiologists' practice, and attitudes toward management of BSI. 116 responses from respondents working in 23 of the 26 Regional Trauma Networks in England were received. 79% provide a single dedicated IR service but over 50% cover more than one hospital within the network. All offer arterial embolisation for BSI. Only 25% follow guidelines. In haemodynamically stable patients, an increasing trend for embolisation was seen as grade of splenic injury increased from 1 to 4 (12.5%-82.14%, p<0.01). In unstable patients or those with radiological evidence of bleeding, significantly more respondents offer embolisation for grade 1-3 injuries (p<0.01), compared to stable patients. Significantly fewer respondents offer embolisation for grade 5 versus 4 injuries in unstable patients or with evidence of bleeding. Splenic embolisation is offered for a variety of injury grades, providing the patient remains stable. Variation in interventional radiology services remain despite the introduction of regional trauma networks. Copyright © 2017 Elsevier Ltd. All rights reserved.

Anesthesia Practices for Interventional Radiology in Europe.

PubMed

Vari, Alessandra; Gangi, Afshin

2017-06-01

The Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe. Anonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology. Predictable differences between countries and national regulations were confirmed, showing how significantly many "local" factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care. Significant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.

Evaluation of Stress and a Stress-Reduction Program Among Radiologic Technologists.

PubMed

Reingold, Lynn

2015-01-01

To investigate stress levels and causes of stress among radiologic technologists and determine whether an intervention could reduce stress in a selected radiologic technologist population. Demographic characteristics and data on preintervention stress sources and levels were collected through Internet-based questionnaires. A 6-week, self-administered, mindfulness-based stress-reduction program was conducted as a pilot intervention with 42 radiologic technologists from the Veterans Administration Medical Center. Data also were collected postintervention. Identified sources of stress were compared with findings from previous studies. Some radiologic technologists experienced improvement in their perceptions of stress after the intervention. Sources of stress for radiologic technologists were similar to those shown in earlier research, including inconsistent management, poor management communication, conflicting demands, long work hours, excessive workloads, lack of work breaks, and time pressures. The mindfulness-based stress-reduction program is an example of an inexpensive method that could improve personal well-being, reduce work errors, improve relationships in the workplace, and increase job satisfaction. More research is needed to determine the best type of intervention for stress reduction in a larger radiologic technologist population.

Strategic planning in radiology.

PubMed

Gill, Ileana E; Ondategui-Parra, Silvia; Nathanson, Eric; Seiferth, Jeremy; Ros, Pablo R

2005-04-01

As radiology continues to evolve and grow, radiologists must be concerned with preparing radiology for the future. Decisions in capital investments, mergers, outpatient diagnostic clinics, and payment and liability issues will require practicing radiologists to develop and follow up managerial, interpersonal, and learning skills that were not as necessary in the past. To become adept in the new radiology environment and be able to manage change and deal with difficult decisions, radiologists need to acquire a background in strategy.

Integrating Radiology and Anatomy Teaching in Medical Education in the UK--The Evidence, Current Trends, and Future Scope.

PubMed

Heptonstall, N B; Ali, T; Mankad, K

2016-04-01

This review article presents the current evidence of the importance of integrating radiology and anatomy in medical education in the UK, a recommendation by a number of key anatomy, education, and radiology organizations. Current evidence highlights that on average only 5% of total teaching time in medical education is dedicated to radiology. Often, radiology teaching does not adequately fulfill students' learning needs and potentially leaves them underprepared for medical practice. Benefits of integrating radiology and anatomy include improved clinical application of anatomy, an increase in student's interest in anatomy, and ultimately improved radiological interpretation. Various modalities exist for the integration of radiology and anatomy, facilitated by the vast portability of radiological images. It appears that combining radiological resources with traditional anatomy teaching methodology in a blended approach is most beneficial. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Informed Consent for Interventional Radiology Procedures: A Survey Detailing Current European Practice

DOE Office of Scientific and Technical Information (OSTI.GOV)

O'Dwyer, H.M.; Lyon, S.M.; Fotheringham, T.

Purpose: Official recommendations for obtaining informed consent for interventional radiology procedures are that the patient gives their consent to the operator more than 24 hr prior to the procedure. This has significant implications for interventional radiology practice. The purpose of this study was to identify the proportion of European interventional radiologists who conform to these guidelines. Methods: A questionnaire was designed consisting of 12 questions on current working practice and opinions regarding informed consent. These questions related to where, when and by whom consent was obtained from the patient. Questions also related to the use of formal consent forms andmore » written patient information leaflets. Respondents were asked whether they felt patients received adequate explanation regarding indications for intervention,the procedure, alternative treatment options and complications. The questionnaire was distributed to 786 European interventional radiologists who were members of interventional societies. The anonymous replies were then entered into a database and analyzed. Results: Two hundred and fifty-four (32.3%) questionnaires were returned. Institutions were classified as academic (56.7%),non-academic (40.5%) or private (2.8%). Depending on the procedure,in a significant proportion of patients consent was obtained in the outpatient department (22%), on the ward (65%) and in the radiology day case ward (25%), but in over half (56%) of patients consent or re-consent was obtained in the interventional suite. Fifty percent of respondents indicated that they obtain consent more than 24 hr before some procedures, in 42.9% consent is obtained on the morning of the procedure and 48.8% indicated that in some patients consent is obtained immediately before the procedure. We found that junior medical staff obtained consent in 58% of cases. Eighty-two percent of respondents do not use specific consent forms and 61% have patient information leaflets. The majority of respondents were satisfied with their level of explanation regarding indications for treatment (69.3%) and the procedure (78.7%). Fifty-nine percent felt patients understood alternative treatment options. Only 37.8% of radiologists document possible complications in the patient's chart. Comments from respondents indicated that there is insufficient time for radiologists to obtain consent in all patients. Suggestions to improve current local policies included developing the role of radiology nursing staff and the use of radiology outpatient clinics. Conclusions: More than 50% of respondents are unhappy with their policies for obtaining informed consent. Interventional societies have a role to play in advocating formal consent guidelines.« less

Evaluation of two selection tests for recruitment into radiology specialty training.

PubMed

Patterson, Fiona; Knight, Alec; McKnight, Liam; Booth, Thomas C

2016-07-11

This study evaluated whether two selection tests previously validated for primary care General Practice (GP) trainee selection could provide a valid shortlisting selection method for entry into specialty training for the secondary care specialty of radiology. We conducted a retrospective analysis of data from radiology applicants who also applied to UK GP specialty training or Core Medical Training. The psychometric properties of the two selection tests, a clinical problem solving (CPS) test and situational judgement test (SJT), were analysed to evaluate their reliability. Predictive validity of the tests was analysed by comparing them with the current radiology selection assessments, and the licensure examination results taken after the first stage of training (Fellowship of the Royal College of Radiologists (FRCR) Part 1). The internal reliability of the two selection tests in the radiology applicant sample was good (α ≥ 0.80). The average correlation with radiology shortlisting selection scores was r = 0.26 for the CPS (with p < 0.05 in 5 of 11 shortlisting centres), r = 0.15 for the SJT (with p < 0.05 in 2 of 11 shortlisting centres) and r = 0.25 (with p < 0.05 in 5 of 11 shortlisting centres) for the two tests combined. The CPS test scores significantly correlated with performance in both components of the FRCR Part 1 examinations (r = 0.5 anatomy; r = 0.4 physics; p < 0.05 for both). The SJT did not correlate with either component of the examination. The current CPS test may be an appropriate selection method for shortlisting in radiology but would benefit from further refinement for use in radiology to ensure that the test specification is relevant. The evidence on whether the SJT may be appropriate for shortlisting in radiology is limited. However, these results may be expected to some extent since the SJT is designed to measure non-academic attributes. Further validation work (e.g. with non-academic outcome variables) is required to evaluate whether an SJT will add value in recruitment for radiology specialty training and will further inform construct validity of SJTs as a selection methodology.

Public transparency Web sites for radiology practices: prevalence of price, clinical quality, and service quality information.

PubMed

Rosenkrantz, Andrew B; Doshi, Ankur M

2016-01-01

To assess information regarding radiology practices on public transparency Web sites. Eight Web sites comparing radiology centers' price and quality were identified. Web site content was assessed. Six of eight Web sites reported examination prices. Other reported information included hours of operation (4/8), patient satisfaction (2/8), American College of Radiology (ACR) accreditation (3/8), on-site radiologists (2/8), as well as parking, accessibility, waiting area amenities, same/next-day reports, mammography follow-up rates, examination appropriateness, radiation dose, fellowship-trained radiologists, and advanced technologies (1/8 each). Transparency Web sites had a preponderance of price (and to a lesser extent service quality) information, risking fostering price-based competition at the expense of clinical quality. Copyright © 2016 Elsevier Inc. All rights reserved.

Activity in the fusiform face area supports expert perception in radiologists and does not depend upon holistic processing of images

NASA Astrophysics Data System (ADS)

Engel, Stephen A.; Harley, Erin M.; Pope, Whitney B.; Villablanca, J. Pablo; Mazziotta, John C.; Enzmann, Dieter

2009-02-01

Training in radiology dramatically changes observers' ability to process images, but the neural bases of this visual expertise remain unexplored. Prior imaging work has suggested that the fusiform face area (FFA), normally selectively responsive to faces, becomes responsive to images in observers' area of expertise. The FFA has been hypothesized to be important for "holistic" processing that integrates information across the entire image. Here, we report a cross-sectional study of radiologists that used functional magnetic resonance imaging to measure neural activity in first-year radiology residents, fourth-year radiology residents, and practicing radiologists as they detected abnormalities in chest radiographs. Across subjects, activity in the FFA correlated with visual expertise, measured as behavioral performance during scanning. To test whether processing in the FFA was holistic, we measured its responses both to intact radiographs and radiographs that had been divided into 25 square pieces whose locations were scrambled. Activity in the FFA was equal in magnitude for intact and scrambled images, and responses to both kinds of stimuli correlated reliably with expertise. These results suggest that the FFA is one of the cortical regions that provides the basis of expertise in radiology, but that its contribution is not holistic processing of images.

Mass Casualty Decontamination in a Chemical or Radiological/Nuclear Incident with External Contamination: Guiding Principles and Research Needs

PubMed Central

Cibulsky, Susan M; Sokolowski, Danny; Lafontaine, Marc; Gagnon, Christine; Blain, Peter G.; Russell, David; Kreppel, Helmut; Biederbick, Walter; Shimazu, Takeshi; Kondo, Hisayoshi; Saito, Tomoya; Jourdain, Jean- René; Paquet, Francois; Li, Chunsheng; Akashi, Makoto; Tatsuzaki, Hideo; Prosser, Lesley

2015-01-01

Hazardous chemical, radiological, and nuclear materials threaten public health in scenarios of accidental or intentional release which can lead to external contamination of people.  Without intervention, the contamination could cause severe adverse health effects, through systemic absorption by the contaminated casualties as well as spread of contamination to other people, medical equipment, and facilities.  Timely decontamination can prevent or interrupt absorption into the body and minimize opportunities for spread of the contamination, thereby mitigating the health impact of the incident.  Although the specific physicochemical characteristics of the hazardous material(s) will determine the nature of an incident and its risks, some decontamination and medical challenges and recommended response strategies are common among chemical and radioactive material incidents.  Furthermore, the identity of the hazardous material released may not be known early in an incident.  Therefore, it may be beneficial to compare the evidence and harmonize approaches between chemical and radioactive contamination incidents.  Experts from the Global Health Security Initiative’s Chemical and Radiological/Nuclear Working Groups present here a succinct summary of guiding principles for planning and response based on current best practices, as well as research needs, to address the challenges of managing contaminated casualties in a chemical or radiological/nuclear incident. PMID:26635995

Managing a Multisite Academic-Private Radiology Practice Reading Environment: Impact of IT Downtimes on Enterprise Efficiency.

PubMed

Becker, Murray; Goldszal, Alberto; Detal, Julie; Gronlund-Jacob, Judith; Epstein, Robert

2015-06-01

The aim of this study was to assess whether the complex radiology IT infrastructures needed for large, geographically diversified, radiology practices are inherently stable with respect to system downtimes, and to characterize the nature of the downtimes to better understand their impact on radiology department workflow. All radiology IT unplanned downtimes over a 12-month period in a hybrid academic-private practice that performs all interpretations in-house (no commercial "nighthawk" services) for approximately 900,000 studies per year, originating at 6 hospitals, 10 outpatient imaging centers, and multiple low-volume off-hours sites, were logged and characterized using 5 downtime metrics: duration, etiology, failure type, extent, and severity. In 12 consecutive months, 117 unplanned downtimes occurred with the following characteristics: duration: median time = 3.5 hours with 34% <1.5 hours and 30% >12 hours; etiology: 87% were due to software malfunctions, and 13% to hardware malfunctions; failure type: 88% were transient component failures, 12% were complete component failures; extent: all sites experienced downtimes, but downtimes were always localized to a subset of sites, and no system-wide downtimes occurred; severity (impact on radiologist workflow): 47% had minimal impact, 50% moderate impact, and 3% severe impact. In the complex radiology IT system that was studied, downtimes were common; they were usually a result of transient software malfunctions; the geographic extent was always localized rather than system wide; and most often, the impacts on radiologist workflow were modest. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology Jobs: Uncovering Hidden and Not-So-Hidden Opportunities From the ACR Jobs Board.

PubMed

Misono, Alexander S; Saini, Sanjay; Prabhakar, Anand M

2016-04-01

The radiology job market remains daunting. Trainees choosing fellowships benefit from understanding employers' likely future needs. Radiology practices may similarly refine recruiting practices. This study quantitatively analyzes the current radiology job landscape. Job postings on the ACR Career Center online portal between June 2014 and June 2015 were reviewed. As entries are frequently added and removed, posts were manually collected weekly. Postings were recorded in a database and included date, practice, location, specialty/subspecialty, job type, years of experience, salary, and job description. The database was analyzed to characterize employer needs, salary, partnership track availability, and job availability by geography. A total of 1,778 jobs were posted during the study period. Of these, 1,529 (86.0%) were diagnostic; 240 (13.5%) were interventional; and 9 (0.5%) were administrative. Most jobs were in private practice (75.7%), compared with academic (16.3%) and other (7.9%). Although many did not require a specific specialty (46%), the most-frequent needs were breast (17%), neuroradiology (11%), musculoskeletal (8%), and body (7%). Of non-breast-imaging jobs, roughly 30% indicated an interest in breast-imaging skills. A minority (13%) requested prior experience of greater than 1 year, with some seeking 7-10 years of experience. Although most (87%) were full-time positions, part-time, temporary, and contractor roles were described in the remaining 13%. Salary data were rarely reported (7%), with a range of $98,967-$1,000,000. The most jobs were based in California (11%); New York (7%); Pennsylvania (7%); and Illinois (6%). However, when indexed per million population, the highest job rates were in Nevada (14.1); Washington DC (13.7); Hawaii (13.4); Montana (9.8); and Pennsylvania (9.1). Roughly 31% of postings described partnership tracks, with the highest rates in New England (58%), the Pacific Northwest (56%), the Midwest (40%), and Southern (40%) regions; the lowest were in the Mountain (26%), Mid-Atlantic (25%), and Southwest (21%) regions. Most radiology jobs remain in private practice general radiology. Breast, neuroradiology, and musculoskeletal radiology were most frequently desired among areas of subspecialty training. Advertised partnership tracks were less common and varied widely geographically. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Behavioral Interviewing: Integrating ACGME Competency-Based Questions Into the Radiology Resident Selection Process.

PubMed

McArthur, Tatum A; Flug, Jonathan A; Restauri, Nicole

The practice of radiology is continually evolving with external pressures increasing the involvement of the radiologist as an integrated member of the multidisciplinary care delivery team and not just image interpreters working in isolation. Radiologists need to be comfortable interacting directly with patients and practicing "patient and family-centered care" and "value-based medicine." Despite this evolving role of the radiologist, medical training and the residency selection process have not significantly adapted to accommodate these new demands. In order to develop and hire radiologists who can excel in this role, the selection and interview process must be adapted to prospectively identify those candidates who can thrive in this changing role. Behavior-based interviewing is a tool that can help identify those candidates who may excel in the future. 1-3 Though there are reports of it being used in the United States medical schools and residency programs across the nation, it has not become a mainstay for medical residency and professional medical interviewing. Copyright © 2017 Elsevier Inc. All rights reserved.

Artifice, Interpretation and Nature: Key Categories in Radiology Work

NASA Astrophysics Data System (ADS)

Nyce, James M.

This paper extends on some prior work on nature, culture and computation. This paper will look at “image work” in a radiology department, i.e, how radiologists use images and other kinds of knowledge in daily clinical work. In particular, the paper will look at the role tacit knowledge and categories have in the work radiologists carry out. How radiologists make use of and contrast analog and digital representations of nature will be explored here because this is key to how radiologists work and think. In other words, the role that computer derived artifacts, correspondence theory and mimesis play in the clinical work of radiology will be discussed.

Quality measures and pediatric radiology: suggestions for the transition to value-based payment.

PubMed

Heller, Richard E; Coley, Brian D; Simoneaux, Stephen F; Podberesky, Daniel J; Hernanz-Schulman, Marta; Robertson, Richard L; Donnelly, Lane F

2017-06-01

Recent political and economic factors have contributed to a meaningful change in the way that quality in health care, and by extension value, are viewed. While quality is often evaluated on the basis of subjective criteria, pay-for-performance programs that link reimbursement to various measures of quality require use of objective and quantifiable measures. This evolution to value-based payment was accelerated by the 2015 passage of the Medicare Access and CHIP (Children's Health Insurance Program) Reauthorization Act (MACRA). While many of the drivers of these changes are rooted in federal policy and programs such as Medicare and aimed at adult patients, the practice of pediatrics and pediatric radiology will be increasingly impacted. This article addresses issues related to the use of quantitative measures to evaluate the quality of services provided by the pediatric radiology department or sub-specialty section, particularly as seen from the viewpoint of a payer that may be considering ways to link payment to performance. The paper concludes by suggesting a metric categorization strategy to frame future work on the subject.

Development of a user-centered radiology teaching file system

NASA Astrophysics Data System (ADS)

dos Santos, Marcelo; Fujino, Asa

2011-03-01

Learning radiology requires systematic and comprehensive study of a large knowledge base of medical images. In this work is presented the development of a digital radiology teaching file system. The proposed system has been created in order to offer a set of customized services regarding to users' contexts and their informational needs. This has been done by means of an electronic infrastructure that provides easy and integrated access to all relevant patient data at the time of image interpretation, so that radiologists and researchers can examine all available data to reach well-informed conclusions, while protecting patient data privacy and security. The system is presented such as an environment which implements a distributed clinical database, including medical images, authoring tools, repository for multimedia documents, and also a peer-reviewed model which assures dataset quality. The current implementation has shown that creating clinical data repositories on networked computer environments points to be a good solution in terms of providing means to review information management practices in electronic environments and to create customized and contextbased tools for users connected to the system throughout electronic interfaces.

Specialising in radiology in Switzerland: still attractive for medical school graduates?

PubMed

Buddeberg-Fischer, B; Hoffmann, A; Christen, S; Weishaupt, D; Kubik-Huch, R A

2012-07-01

To gain insight into the professional characteristics of radiologists in Switzerland and to determine how to enhance the attractiveness of radiology to medical graduates as a specialty. Data from 262 members of the Swiss Society of Radiology (m:f = 76:24%) obtained in a questionnaire survey were analysed regarding socio-demographic variables, working status, specialty, main fields of interest, career success, mentoring and reasons for the shortage of radiologists. 35 (56.4%) female and 85 (45.5%) male radiologists were aged ≤ 45 years. 228 (87%) were board-certified; 44 (17.9%) had completed a sub-specialisation. Men worked part-time mostly just before retirement, while women worked part-time at a younger age. As reasons for specialty choice, the wide range of clinical work and the combination of technology and medicine were ranked highest. Women reported significantly less career success and support. To improve the attractiveness of radiology to graduates, radiology should be visible on medical school curricula. In Switzerland, more female radiologists work part-time than male ones, and there is less career success and support for women. In order to make radiology more attractive to medical graduates as a specialty, structured residency programmes and reliable gender-respecting career support are needed. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Mayo Clinic Jacksonville electronic radiology practice

NASA Astrophysics Data System (ADS)

Morin, Richard L.; Berquist, Thomas H.; Rueger, Wolfgang

1996-05-01

We have begun a project to implement an Electronic (Filmless) Radiology Practice (ERP) at Mayo Clinic Jacksonville. This project is integrated with the implementation of a project (Automated Clinical Practice--ACP) to eliminate circulation and archival of the current paper Medical Record. The ERP will result in elimination of screen/film radiography and the transmittal of film throughout the institution by the end of 1996. In conjunction with the ACP, paper and film will not circulate within the clinic by the end of this year.

Review of Dangerous Radioisotopes: What is Available in Practice, What Should We be Concerned About?

DTIC Science & Technology

2015-06-01

of the credibility of a radioactive material as a radiological weapon to be applied to specific scenarios. • This does not replace the IAEA "AID...34 ratios, but more precisely applies this concept to assessments of interest. 7Jt#,�$ 2 IDA I Radiological Weapons • This analysis identified the...radiological weapons under seven different routes of exposure (or types of radiological weapons ), including external irradiation from a point source

Computer network security for the radiology enterprise.

PubMed

Eng, J

2001-08-01

As computer networks become an integral part of the radiology practice, it is appropriate to raise concerns regarding their security. The purpose of this article is to present an overview of computer network security risks and preventive strategies as they pertain to the radiology enterprise. A number of technologies are available that provide strong deterrence against attacks on networks and networked computer systems in the radiology enterprise. While effective, these technologies must be supplemented with vigilant user and system management.

Socioeconomic trends in radiology.

PubMed

Barneveld Binkhuysen, F H

1998-01-01

For radiology the socioeconomic environment is a topic of increasing importance. In addition to the well-known important scientific developments in radiology such as interventional MRI, several other major trends can be recognized: (1) changes in the delivery of health care, in which all kinds of managed care are developing and will influence the practice of radiology, and (2) the process of computerization and digitization. The socioeconomic environment of radiology will be transformed by the developments in managed care, teleradiology and the integration of information systems. If radiologists want to manage future radiology departments they must have an understanding of the changes in the fields of economics and politics that are taking place and that will increasingly influence radiology. Some important and recognizable aspects of these changes will be described here.

Cybersecurity in radiology: Access of public hot spots and public Wi-Fi and prevention of cybercrimes and HIPAA violations.

PubMed

Gerard, Perry; Kapadia, Neil; Acharya, Jay; Chang, Patricia T; Lefkovitz, Zvi

2013-12-01

The purpose of this article is to review the steps that can be taken to ensure secure transfer of information over public and home networks, given the increasing utilization of mobile devices in radiology. With the rapid technologic developments in radiology, knowledge of various technical aspects is crucial for any practicing radiologist. Utilization of mobile devices, such as laptops, tablets, and even cellular phones, for reading radiologic studies has become increasingly prevalent. With such usage comes a need to ensure that both the user's and the patient's private information is protected. There are several steps that can be taken to protect sensitive information while using public networks. These steps include being diligent in reviewing the networks to which one connects, ensuring encrypted connections to web-sites, using strong passwords, and using a virtual private network and a firewall. As the role of information technology in modern radiology practice becomes more critical, these safety mechanisms must be addressed when viewing studies on any mobile device.

Assessment of radiological protection systems among diagnostic radiology facilities in North East India.

PubMed

Singh, Thokchom Dewan; Jayaraman, T; Arunkumar Sharma, B

2017-03-01

This study aims to assess the adequacy level of radiological protection systems available in the diagnostic radiology facilities located in three capital cities of North East (NE) India. It further attempts to understand, using a multi-disciplinary approach, how the safety codes/standards in diagnostic radiology framed by the Atomic Energy Regulatory Board (AERB) and the International Atomic Energy Agency (IAEA) to achieve adequate radiological protection in facilities, have been perceived, conceptualized, and applied accordingly in these facilities. About 30 diagnostic radiology facilities were randomly selected from three capitals of states in NE India; namely Imphal (Manipur), Shillong (Meghalaya) and Guwahati (Assam). A semi-structured questionnaire developed based on a multi-disciplinary approach was used for this study. It was observed that radiological practices undertaken in these facilities were not exactly in line with safety codes/standards in diagnostic radiology of the AERB and the IAEA. About 50% of the facilities had registered/licensed x-ray equipment with the AERB. More than 80% of the workers did not use radiation protective devices, although these devices were available in the facilities. About 85% of facilities had no institutional risk management system. About 70% of the facilities did not carry out periodic quality assurance testing of their x-ray equipment or surveys of radiation leakage around the x-ray room, and did not display radiation safety indicators in the x-ray rooms. Workers in these facilities exhibited low risk perception about the risks associated with these practices. The majority of diagnostic radiology facilities in NE India did not comply with the radiological safety codes/standards framed by the AERB and IAEA. The study found inadequate levels of radiological protection systems in the majority of facilities. This study suggests a need to establish firm measures that comply with the radiological safety codes/standards of the AERB and IAEA to protect patients, workers and the public of this region.

Current Trends in Heparin Use During Arterial Vascular Interventional Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Durran, Alexandra C., E-mail: durranjobs@hotmail.com; Watts, Christopher, E-mail: Christopher.watts@salisbury.nhs.uk

2012-12-15

Purpose: This study was designed to assess the current use of heparinized saline and bolus doses of heparin in non-neurological interventional radiology and to determine whether consensus could be reached to produce guidance for heparin use during arterial vascular intervention. Methods: An interactive electronic questionnaire was distributed to members of the British Society of Interventional Radiology regarding their current practice in the use, dosage, and timing of heparin boluses and heparinized flushing solutions.ResultsA total of 108 completed questionnaires were received. More than 80% of respondents used heparinized saline with varying concentrations; the most prevalent was 1,000 IU/l (international units ofmore » heparin per liter) and 5,000 IU/l. Fifty-one percent of interventionalists use 3,000 IU as their standard bolus dose; however, the respondents were split regarding the timing of bolus dose with {approx}60% administering it after arterial access is obtained and 40% after crossing the lesion. There was no consensus on altering dose according to body weight, and only 4% monitored clotting parameters. Conclusions: There seems to be some coherence among practicing interventionalists regarding heparin administration. We hypothesize that heparinized saline should be used at a recognized standard concentration of 1,000 IU/l as a flushing concentration in all arterial vascular interventions and that 3,000 IU bolus is considered the standard dose for straightforward therapeutic procedures and 5000 IU for complex, crural, and endovascular aneurysm repair work. The bolus should be given after arterial access is obtained to allow time for optimal anticoagulation to be achieved by the time of active intervention and stenting. Further research into clotting abnormalities following such interventional procedures would be an interesting quantifiable follow-up to this initial survey of opinions and practice.« less

Work and retirement preferences of practicing radiologists as a predictor of workforce needs.

PubMed

Moriarity, Andrew K; Brown, Manuel L; Schultz, Lonni R

2014-08-01

The radiology job market has been described as highly variable, and recent practice hiring surveys predict that the number of available jobs will remain flat. Radiologists may be working more hours and retiring later than desired, activities that influence overall job availability. A national survey was performed to determine the desired work rate and retirement preferences of practicing radiologists, and the responses are used to estimate current and potential future work output and future workforce needs. Practicing radiologists were surveyed regarding current and preferred work level and desired and expected retirement age. A model incorporating these preferences and stratified by age was developed using survey responses and American Medical Association full-time equivalent (FTE) estimates. Available FTE radiologists are estimated under four scenarios from 2016 to 2031 in 5-year intervals. The model predicts a total of 26,362 FTE radiologists available in 2011, which corresponds to previous estimates. Participants reported working more hours and expecting to retire later than desired, with younger radiologists and women reporting the greatest desired decrease in FTE hours worked. Under each scenario, there is an initial FTE availability in 2016 ranging from 21,156 to 24,537, which increases to between 27,753 and 31,435 FTE by 2031 depending on work rate and retirement patterns. Practicing radiologists report that they currently work more hours than desired and expect to retire later than they would prefer. If radiologists changed current personal work rate and expected retirement age to meet these preferences, there would be an immediate shortage of FTE radiologists continuing until at least 2020 assuming no other workforce needs changes. Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.

Accreditation in radiation protection for cardiologists and interventionalists.

PubMed

Vano, E; Gonzalez, L

2005-01-01

Training in radiation protection is widely recognised as one of the basic components of optimisation programmes for medical exposures. Occupational and patient radiation risks in interventional radiology can be quite high and international bodies have shown concern on this item. Following recommendations of the International Commission on Radiological Protection and in accordance with the European Directive on medical exposures, some initiatives for training in radiation protection took place in Spain and Luxembourg. These provided practitioners of interventional radiology adequate theoretical and practical training in radiation protection. The main outcome of the pilot courses organised to this end is discussed, concluding its suitability to implement the European Directive in practice.

The advantages, disadvantages, and policies for part-time radiologists: report of the ACR Commission on Human Resources.

PubMed

Harolds, Jay A; Coleman, Beverly G; Recht, Michael P; Bluth, Edward I

2014-07-01

The employment of part-time radiologists (PTRs) has both advantages and disadvantages in various practice settings. The authors examine the pros and cons of PTRs and review the literature regarding PTRs both within and outside the specialty of radiology. The complexity of this issue is manifested in our inability to reach consensus on many policy issues for PTRs. Nevertheless, this article should be helpful in offering an objective, nonbiased background to initiating a discussion on employing PTRs in various radiology practices. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Interventional Radiology in Paediatrics.

PubMed

Chippington, Samantha J; Goodwin, Susie J

2015-01-01

As in adult practice, there is a growing role for paediatric interventional radiology expertise in the management of paediatric pathologies. This review is targeted for clinicians who may refer their patients to paediatric interventional radiology services, or who are responsible for patients who are undergoing paediatric interventional radiology procedures. The article includes a brief overview of the indications for intervention, techniques involved and the commonest complications. Although some of the procedures described are most commonly performed in a tertiary paediatric centre, many are performed in most Children's hospitals.

[Interventional radiology: current problems and new directions].

PubMed

Santos Martín, E; Crespo Vallejo, E

2014-01-01

In recent years, vascular and interventional radiology has become one of the fastest growing diagnostic and therapeutic specialties. This growth has been based on a fundamental concept: performing minimally invasive procedures under imaging guidance. This attractive combination has led to the interest of professionals from other clinical specialties outside radiology in performing this type of intervention. The future of vascular and interventional radiology, although uncertain, must be linked to clinical practice and multidisciplinary teamwork. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

Justification and radiology: some ethical considerations.

PubMed

Sia, Santiago

2009-07-01

This paper, which seeks to address the issue of justification in radiology, intends firstly to comment on the current discussion of the ethical foundation of radiological practice that focuses on the move from utilitarianism to the rights-centred criterion. Secondly, and this constitutes the bulk of the paper, it aims to offer a philosophical perspective, which is hoped will lead to a consideration of certain specific areas in ethical decision-making in the attempts here to deal with the main issue of justification in radiology.

Factors influencing career choices in radiology trainees in Queensland, Australia.

PubMed

Ip, S W; Ko, H S; Applegate, K E

2010-04-01

The aim of this study was to investigate factors influencing career choices in radiology trainees. We distributed a 27-question written survey to all radiology registrars in Queensland. The questions investigated whether radiology was their first specialty choice, career satisfaction, ideal working conditions and attitudes regarding having children during the time of training. Forty-four of 51 surveys were returned (86% participation rate, 73% men, P = 0.048055) with 100% reporting a high job satisfaction; 28% of male registrars compared to 8% of female registrars did extra work outside of training to earn extra money (P = 0.000003), and 17% of female registrars took a leave of absence during their training, while no male registrar did (P = 0.087923). Only one female trainee worked part-time (P = 0.272727). In addition, 58% of female registrars planned a pregnancy (P = 0.731789) before completion of training; 83% of women versus 75% of men had no children (P = 0.329263). Only 5% of trainees agreed that it was easy to arrange part-time training, only 14% stated that it was easy to negotiate flexible work schedules and 7% agreed that it was easy to return to work after a period of absence. 'Time spent with immediate family' was rated the most important lifestyle factor, followed by 'work hours' and 'on-call duty'. The least important factors were 'being away from extended family', 'availability of part-time work' and whether 'work was in a rural location'. Overall job satisfaction is high among radiology trainees. Nevertheless, lifestyle factors, particularly those related to work time, are becoming more important for career decisions. This should be taken into account when designing and structuring radiology training to ensure that it is considered an attractive career choice.

ESR concept paper on value-based radiology.

PubMed

2017-10-01

The European Society of Radiology (ESR) established a Working Group on Value-Based Imaging (VBI WG) in August 2016 in response to developments in European healthcare systems in general, and the trend within radiology to move from volume- to value-based practice in particular. The value-based healthcare (VBH) concept defines "value" as health outcomes achieved for patients relative to the costs of achieving them. Within this framework, value measurements start at the beginning of therapy; the whole diagnostic process is disregarded, and is considered only if it is the cause of errors or complications. Making the case for a new, multidisciplinary organisation of healthcare delivery centred on the patient, this paper establishes the diagnosis of disease as a first outcome in the interrelated activities of the healthcare chain. Metrics are proposed for measuring the quality of radiologists' diagnoses and the various ways in which radiologists provide value to patients, other medical specialists and healthcare systems at large. The ESR strongly believes value-based radiology (VBR) is a necessary complement to existing VBH concepts. The Society is determined to establish a holistic VBR programme to help European radiologists deal with changes in the evolution from volume- to value-based evaluation of radiological activities. Main Messages • Value-based healthcare defines value as patient's outcome over costs. • The VBH framework disregards the diagnosis as an outcome. • VBH considers diagnosis only if wrong or a cause of complications. • A correct diagnosis is the first outcome that matters to patients. • Metrics to measure radiologists' impacts on patient outcomes are key. • The value provided by radiology is multifaceted, going beyond exam volumes.

SU-E-E-01: ABR Diagnostic Radiology Core Exam: Was Our Redesigned Physics Course Successful in Teaching Physics to Radiology Residents?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kanal, K; Hoff, M; Dickinson, R

Purpose: Our purpose is to evaluate the effectiveness of our two year physics course in preparing radiology residents for the American Board of Radiology (ABR) diagnostic radiology exam. Methods: We designed a new two-year physics course that integrates radiology clinical content and practice and is primarily based on the AAPM curriculum and RSNA/AAPM physics modules. Biweekly classes focus on relevant concepts from assigned reading and use audience response systems to encourage participation. Teaching efficiency is optimized through lecturer rotations of physicists, radiologists, and guest speakers. An emphasis is placed on clinical relevance by requiring lab work and providing equipment demonstrations.more » Periodic quiz were given during the course. The course website was also redesigned for usability, and physics review lectures were conducted two weeks before the board exam to refresh key concepts. At the completion of our first two-year course, we conducted a confidential evaluation of the faculty and course. The evaluation assessed metrics such as overall organization, clinical relevance of content, and level of difficulty, with a rating scale from poor to excellent. Results: Our evaluation indicated that the redesigned course provided effective board exam preparation, with most responses between good and excellent. There was some criticism on the course length and on chronological discontinuity, but the review lectures were appreciated by the residents. All of our residents passed the physics component of the ABR exam with scores exceeding the minimum passing score by a significant margin. Conclusion: The course evaluation and board exam results indicate that our new two-year course format provides valuable board exam preparation. This is possible thanks to the time and effort taken by the physics faculty on ensuring the residents get quality physics education.« less

Auditor recommendations resulting from three clinical audit rounds in Finnish radiology units.

PubMed

Miettunen, Kirsi; Metsälä, Eija

2017-06-01

Background The purpose of clinical audits performed in radiology units is to reduce the radiation dose of patients and staff and to implement evidence-based best practices. Purpose To describe auditor recommendations in three Finnish clinical audit rounds performed in 2002-2014, and to determine if auditor recommendations have had any impact on improving medical imaging practice. Material and Methods The retrospective observational study was performed in radiology units holding a radiation safety license issued by the Finnish Radiation and Nuclear Safety Authority. The data comprised a systematic sample (n = 120) of auditor reports produced in three auditing rounds in these units during the years 2002-2014. The data were analyzed by descriptive methods and by using the Friedman two-way ANOVA test. Results The number of auditor recommendations given varied between clinical audit rounds and according to the type of imaging unit, as well as according to calculation method. Proportionally, the most recommendations in all three clinical audit rounds were given about defining and using quality assurance functions and about guidelines and practices for carrying out procedures involving radiation exposure. Demanding radiology units improved their practices more than basic imaging units towards the third round. Conclusion Auditor recommendations help to address the deficiencies in imaging practices. There is a need to develop uniform guidelines and to provide tutoring for clinical auditors in order to produce comparable clinical audit results.

Anesthesia Practices for Interventional Radiology in Europe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vari, Alessandra, E-mail: alessandra.vari@uniroma1.it; Gangi, Afshin, E-mail: gangi@unistra.fr

PurposeThe Cardiovascular and Interventional Radiological Society of Europe (CIRSE) prompted an initiative to frame the current European status of anesthetic practices for interventional radiology, in consideration of the current variability of IR suite settings, staffing and anesthetic practices reported in the literature and of the growing debate on sedation administered by non-anesthesiologists, in Europe.MethodsAnonymous online survey available to all European CIRSE members to assess IR setting, demographics, peri-procedural care, anesthetic management, resources and staffing, pain management, data collection, safety, management of emergencies and personal opinions on the role CIRSE should have in promoting anesthetic care for interventional radiology.ResultsPredictable differences betweenmore » countries and national regulations were confirmed, showing how significantly many “local” factors (type and size of centers, the availability of dedicated inpatient bed, availability of anesthesia staff) can affect the routine practice and the expansion of IR as a subspecialty. In addition, the perception of the need for IR to acquire more sedation-related skills is definitely stronger for those who practice with the lowest availability of anesthesia care.ConclusionSignificant country variations and regulations along with a controversial position of the anesthesia community on the issue of sedation administered by non-anesthesiologists substantially represent the biggest drawbacks for the expansion of peri-procedural anesthetic care for IR and for potential initiatives at an European level.« less

Intraoral radiology in general dental practices - a comparison of digital and film-based X-ray systems with regard to radiation protection and dose reduction.

PubMed

Anissi, H D; Geibel, M A

2014-08-01

The purpose of this study was to gain insight into the distribution and application of digital intraoral radiographic techniques within general dental practices and to compare these with film-based systems in terms of patient dose reduction. 1100 questionnaires were handed out to general dental practitioners. Data was analyzed with respect to the type of system by using descriptive statistics and nonparametric tests, i.e. Kruskal-Wallis, Mann-Whitney and chi-square test (SPSS 20). 64% of the questioned dentists still use film-based radiology, 23% utilize storage phosphor plate (SPP) systems and 13% use a charge-coupled device (CCD). A strong correlation between the number of dentists working in a practice and the use of digital dental imaging was observed. Almost 3/4 of the film users work with E- or F-speed film. 45% of them refuse to change to a digital system. The use of lead aprons was popular, while only a minority preferred thyroid shields and rectangular collimators. A fourfold reduction of exposure time from D-speed film to CCD systems was observed. Due to detector size and positioning errors, users of CCD systems take significantly more single-tooth radiographs in total. Considering the number of radiographs per patient, there is only a slight tendency towards more X-rays with CCD systems. Up to image generation, digital systems seem to be as or even more difficult to handle than film-based systems, while their handling was favored after radiographic exposure. Despite a slight increase of radiographs taken with CCD systems, there is a significant dosage reduction. Corresponding to the decrease in exposure time, the patient dose for SPP systems is reduced to one half compared to film. The main issues in CCD technology are positioning errors and the size of the X-ray detectors which are difficult to eliminate. The usage of radiation protection measures still needs to be improved. ► Responsible use of digital intraoral radiology results in a significant dose reduction in everyday practice. ► The ALARA principle is only achieved by strict implementation of dose-reducing methods. ► The efforts to use dose-reducing devices must be increased. © Georg Thieme Verlag KG Stuttgart · New York.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hillmer, Kurt T.

This course presents information on radiological work permits (RWPs), various types of postings used in radiological areas, radiological area setups, access controls, and releases of material from radiological areas. All of these are fundamental duties of RCTs. This course will prepare the student with the skills necessary for radiological control technician (RCT) qualification by passing quizzes, tests, and the RCT Comprehensive Phase 1, Unit 2 Examination (TEST 27566) and providing in-thefield skills.

ICRP Publication 138: Ethical Foundations of the System of Radiological Protection.

PubMed

Cho, K-W; Cantone, M-C; Kurihara-Saio, C; Le Guen, B; Martinez, N; Oughton, D; Schneider, T; Toohey, R; ZöLzer, F

2018-02-01

Despite a longstanding recognition that radiological protection is not only a matter of science, but also ethics, ICRP publications have rarely addressed the ethical foundations of the system of radiological protection explicitly. The purpose of this publication is to describe how the Commission has relied on ethical values, either intentionally or indirectly, in developing the system of radiological protection with the objective of presenting a coherent view of how ethics is part of this system. In so doing, it helps to clarify the inherent value judgements made in achieving the aim of the radiological protection system as underlined by the Commission in Publication 103. Although primarily addressed to the radiological protection community, this publication is also intended to address authorities, operators, workers, medical professionals, patients, the public, and its representatives (e.g. NGOs) acting in the interest of the protection of people and the environment. This publication provides the key steps concerning the scientific, ethical, and practical evolutions of the system of radiological protection since the first ICRP publication in 1928. It then describes the four core ethical values underpinning the present system: beneficence/ non-maleficence, prudence, justice, and dignity. It also discusses how these core ethical values relate to the principles of radiological protection, namely justification, optimisation, and limitation. The publication finally addresses key procedural values that are required for the practical implementation of the system, focusing on accountability, transparency, and inclusiveness. The Commission sees this publication as a founding document to be elaborated further in different situations and circumstances.

Patient communication in radiology: current status of breaking bad news among radiologists and radiology trainees in Pakistan.

PubMed

Ali Khawaja, Ranish Deedar; Akhtar, Waseem; Khawaja, Ali; Irfan, Hira; Naeem, Mohammad; Memon, Mukhtiar

2013-10-01

Breaking bad news can be an intimidating task for any physician. The aim of this study was to record the practices of breaking bad news to the patients by Pakistani radiologists and trainees. The radiologists and trainees attending the 26th National Radiological Conference in October 2010 in Karachi, Pakistan, were surveyed. The response rate was 76%. The respondents included residents (51%), private practicing radiologists (28%), academic radiologists (13%), and other trainees (8%). Most of the academic radiologists communicated with their patients. The daily frequency of breaking bad news by residents was noted, which was highest in the public teaching hospitals (71%). For severe abnormalities such as malignancy, 50% residents, 55% of the academic radiologists and 74% of the private practicing radiologists were very uncomfortable in disclosure of results. Differences in frequency of communication with patients were noticed with both different training levels, and different settings of practice in a developing country.

Radiology online: information, education, and networking--a summary of the 2012 Intersociety Committee Summer Conference.

PubMed

Dodd, Gerald D; Naeger, David M

2013-05-01

The "new online" (Web 2.0) world is evolving rapidly, and the digital information, education, and networking resources available to radiologists have exploded over the past 2 decades. The 2012 Intersociety Committee Summer Conference attendees explored the online resources that have been produced by societies, universities, and commercial entities. Specific attention was given to identifying the best products and packaging them in tablet computers for use by residents and practicing radiologists. The key functions of social networking websites and the possible roles they can play in radiology were explored as well. It was the consensus of the attendees that radiologic digital resources and portable electronic devices have matured to the point that they should become an integral part of our educational programs and clinical practice. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Neuroanesthesia for embolization of a ruptured cerebral aneurysm: clinical practice guidelines].

PubMed

Ingelmo Ingelmo, I; Rubio Romero, R; Fàbregas Julià, N; Rama-Maceiras, P; Hernández-Palazón, J

2010-12-01

When the neuroanesthesia working group of the Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor surveyed Spanish anesthesiologists to learn the degree of their involvement in the diagnosis and treatment of spontaneous subarachnoid hemorrhage, a surprising finding was that anesthetists did not participate in endovascular repair of intracranial aneurysms when the procedure was carried out in an interventional radiology department. These interventions, which are considered minimally invasive and are performed outside the operating room, are not risk-free. Based on the survey results and a systematic review of the literature, the working group has provided practice guidelines for the perioperative management of anesthesia for endovascular repair of ruptured cerebral aneurysms. In our opinion, the diversity of practice in the hospitals surveyed calls for the application of practice guidelines based on consensus if we are to reduce variability in clinical and anesthetic approaches as well as lower the rates of morbidity and mortality and shorten the hospital stay of patients undergoing exclusion of an aneurysm.

ACR white paper on teleradiology practice: a report from the Task Force on Teleradiology Practice.

PubMed

Silva, Ezequiel; Breslau, Jonathan; Barr, Robert M; Liebscher, Lawrence A; Bohl, Michael; Hoffman, Thomas; Boland, Giles W L; Sherry, Cynthia; Kim, Woojin; Shah, Samir S; Tilkin, Mike

2013-08-01

Teleradiology services are now embedded into the workflow of many radiology practices in the United States, driven largely by an expanding corporate model of services. This has brought opportunities and challenges to both providers and recipients of teleradiology services and has heightened the need to create best-practice guidelines for teleradiology to ensure patient primacy. To this end, the ACR Task Force on Teleradiology Practice has created this white paper to update the prior ACR communication on teleradiology and discuss the current and possible future state of teleradiology in the United States. This white paper proposes comprehensive best-practice guidelines for the practice of teleradiology, with recommendations offered regarding future actions. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Westinghouse corporate development of a decision software program for Radiological Evaluation Decision Input (REDI)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bush, T.S.

1995-03-01

In December 1992, the Department of Energy (DOE) implemented the DOE Radiological Control Manual (RCM). Westinghouse Idaho Nuclear Company, Inc. (WINCO) submitted an implementation plan showing how compliance with the manual would be achieved. This implementation plan was approved by DOE in November 1992. Although WINCO had already been working under a similar Westinghouse RCM, the DOE RCM brought some new and challenging requirements. One such requirement was that of having procedure writers and job planners create the radiological input in work control procedures. Until this time, that information was being provided by radiological engineering or a radiation safety representative.more » As a result of this requirement, Westinghouse developed the Radiological Evaluation Decision Input (REDI) program.« less

Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

PubMed

Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

2014-04-01

Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

Transformation and Transformational Leadership: A Review of the Current and Relevant Literature for Academic Radiologists.

PubMed

Thomson, Norman B; Rawson, James V; Slade, Catherine P; Bledsoe, Martin

2016-05-01

With the US healthcare system on an unsustainable course, change is inevitable. Changes in the healthcare landscape impacting radiology include changing payment models, rapid adoption of digital technology, changes in radiology resident certifying exams, and the rise of consumerism in health care. Academic Radiology will be part of that change with none of its missions spared. What matters is not that change is coming but how Academic Radiology responds to change. Do we ignore, adapt, adopt others' practices, or lead change? Change management or transformation is a management skill set that can be learned and developed. Transformational leadership is a leadership style defined by the relationships between the leaders and the followers and the results they are able to achieve together to meet organizational goals. In this paper, we provide a review of key change management theories, as well as practical advice for self-reflection and development of leadership behaviors that promote effective change management and organizational transformation, particularly in a complex industry like Academic Radiology. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Precision Radiology Residency Training: Special Distinction Tracks for Noninterpretative Professional Development.

PubMed

Snyder, Elizabeth; Solnes, Lilja; Horton, Karen M; Johnson, Pamela T

2018-06-01

The role of a radiologist has expanded beyond the tripartite mission of patient care, education, and research to include cross-specialty consultation for patient management, innovative solutions to improve health-care quality and safety, device design, and policy advocacy. As such, radiology residency programs should incorporate formalized training to prepare residents for these various professional roles. Since the 2015-2016 academic year, five training tracks focused on noninterpretative skills have been integrated into our residency training program: Clinician Educator, Quality Improvement, Entrepreneurship/Innovation, Health Policy Advocacy, and High-Value Care. Each track is longitudinal, with a set of requirements throughout the residents' training necessary to achieve certification at graduation. To date nine residents have participated in the programs, including two who received distinction in two separate tracks. Residents in each of the tracks have implemented successful initiatives related to the focus area. As such, these tracks enrich training by ensuring that residents make meaningful contributions to the department and institution during their training and disseminate successful initiatives through presentation at national meetings and publications. The duration of a radiology residency and resources available in an academic center provide opportunities for residency program directors to advance residents' skills in important noninterpretative components of radiology practice. Regardless of whether residents pursue academic medicine or private practice, these skills are necessary for graduates to become valuable members of a radiology practice and serve as national leaders in the field of radiology. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Sedation/anaesthesia in paediatric radiology

PubMed Central

Arlachov, Y; Ganatra, R H

2012-01-01

Objectives In this article we will give a comprehensive literature review on sedation/general anaesthesia (S/GA) and discuss the international variations in practice and options available for S/GA for imaging children. Methods The key articles were obtained primarily from PubMed, MEDLINE, ERIC, NHS Evidence and The Cochrane Library. Results Recently, paediatric radiology has seen a surge of diagnostic and therapeutic procedures, some of which require children to be still and compliant for up to 1 h. It is difficult and sometimes even impossible to obtain quick and high-quality images without employing sedating techniques in certain children. As with any medical procedure, S/GA in radiological practice is not without risks and can have potentially disastrous consequences if mismanaged. In order to reduce any complications and practice safety in radiological units, it is imperative to carry out pre-sedation assessments of children, obtain parental/guardian consent, monitor them closely before, during and after the procedure and have adequate equipment, a safe environment and a well-trained personnel. Conclusion Although the S/GA techniques, sedative drugs and personnel involved vary from country to country, the ultimate goal of S/GA in radiology remains the same; namely, to provide safety and comfort for the patients. Advances in knowledge Imaging children under general anaesthesia is becoming routine and preferred by operators because it ensures patient conformity and provides a more controlled environment. PMID:22898157

Diversity Matters in Academic Radiology: Acknowledging and Addressing Unconscious Bias.

PubMed

Allen, Brenda J; Garg, Kavita

2016-12-01

To meet challenges related to changing demographics, and to optimize the promise of diversity, radiologists must bridge the gap between numbers of women and historically underrepresented minorities in radiology and radiation oncology as contrasted with other medical specialties. Research reveals multiple ways that women and underrepresented minorities can benefit radiology education, research, and practice. To achieve those benefits, promising practices promote developing and implementing strategies that support diversity as an institutional priority and cultivate shared responsibility among all members to create inclusive learning and workplace environments. Strategies also include providing professional development to empower and equip members to accomplish diversity-related goals. Among topics for professional development about diversity, unconscious bias has shown positive results. Unconscious bias refers to ways humans unknowingly draw upon assumptions about individuals and groups to make decisions about them. Researchers have documented unconscious bias in a variety of contexts and professions, including health care, in which they have studied differential treatment, diagnosis, prescribed care, patient well-being and compliance, physician-patient interactions, clinical decision making, and medical school education. These studies demonstrate unfavorable impacts on members of underrepresented groups and women. Learning about and striving to counteract unconscious bias points to promising practices for increasing the numbers of women and underrepresented minorities in the radiology and radiation oncology workforce. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Changes in the market for diagnostic radiologists as measured through a help wanted index.

PubMed

Forman, H P; Kamin, D S; Covey, A M; Sunshine, J H

2000-04-01

We sought to create and validate a help wanted index for tracking changes in the radiology job market. All jobs advertised in Radiology and the American Journal of Roentgenology from January 1991 through December 1998 were tracked according to three separate parameters: academic versus private practice, subspecialty, and region. Statistical comparison was made between the first and second 48-month subperiods to identify changes. Thirteen thousand seven hundred one advertised positions were coded. A dramatic decrease in job advertisements was noted after December 1991, with advertisements falling to one eighth of their late 1991 peak. A recovery has occurred, with advertising now approaching peak levels. Shifts were seen toward more private practice, midwestern location, vascular and interventional, and mammography positions. Declines occurred in the share of positions in California, the Southwest, and several radiology subspecialties. Other trends were noted but were statistically less significant. A strong correlation (R = 0.98) was found between the annual number of positions advertised and radiologists' median incomes relative to those of all physicians. The job market in radiology, much as in other fields, can be tracked in a coincident manner with the use of a help wanted index. Changes in the makeup of radiology practice are important and are identified in a well-constructed index. These findings have validity and can be useful as an adjunct to other information for policy and planning purposes.

Business of radiology: financial fundamentals for radiologists.

PubMed

Medverd, Jonathan R; Prabhu, Somnath J; Lam, Diana L

2013-11-01

The purposes of this article are to provide a primer on financial statements and to review several financial concepts that are at the foundation of the business of medicine. For radiologists to effectively contribute to the leadership and management of their practices, it is imperative that they understand the business aspects of radiology. Radiologists' understanding and participation in practice management may also facilitate job satisfaction and assist the provision of optimal patient care.

An update on dental imaging.

PubMed

Whaites, E; Brown, J

1998-08-22

This paper reviews recent advances and current trends in dental radiology. Developments in the design of dental x-ray equipment which improve both radiation hygiene and image quality are described. Also discussed are new features which broaden the scope of intra-oral and panoramic radiological diagnosis in the general dental practice setting. The article concludes with the main recommendations from the latest guidelines on quality standards for radiography, selection criteria and quality assurance in general practice.

Teaching and Assessing Professionalism in Radiology: Resources and Scholarly Opportunities to Contribute to Required Expectations.

PubMed

Kelly, Aine Marie; Mullan, Patricia B

2018-05-01

Teaching and assessing trainees' professionalism now represents an explicit expectation for Accreditation Council Graduate Medical Education-accredited radiology programs. Challenges to meeting this expectation include variability in defining the construct of professionalism; limits of traditional teaching and assessment methods, used for competencies historically more prominent in medical education, for professionalism; and emerging expectations for credible and feasible professionalism teaching and assessment practices in the current context of health-care training and practice. This article identifies promising teaching resources and methods that can be used strategically to augment traditional teaching of the cognitive basis for professionalism, including role modeling, case-based scenarios, debriefing, simulations, narrative medicine (storytelling), guided discussions, peer-assisted learning, and reflective practice. This article also summarizes assessment practices intended to promote learning, as well as to inform how and when to assess trainees as their professional identities develop over time, settings, and autonomous practice, particularly in terms of measurable behaviors. This includes assessment tools (including mini observations, critical incident reports, and appreciative inquiry) for authentic assessment in the workplace; engaging multiple sources (self-, peer, other health professionals, and patients) in assessment; and intentional practices for trainees to take responsibility for seeking our actionable feedback and reflection. This article examines the emerging evidence of the feasibility and value added of assessment of medical competency milestones, including professionalism, coordinated by the Accreditation Council Graduate Medical Education in radiology and other medical specialties. Radiology has a strategic opportunity to contribute to scholarship and inform policies in professionalism teaching and assessment practices. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Competency-Based Teaching in Radiology - Implementation and Evaluation of Interactive Workstation-Based Learning to Apply NKLM-Based Content.

PubMed

Koestner, Wolfgang; Otten, Wiebke; Kaireit, Till; Wacker, Frank K; Dettmer, Sabine

2017-11-01

Purpose  New teaching formats are required to implement competency-based teaching in radiology teaching. Therefore, we have established and evaluated two practical competency-based radiological courses. Materials and Methods  The courses were held in a multimedia room with 25 computers and a professional DICOM viewer. Students were taught basic image analysis and presented clinical cases with a DICOM viewer under supervision of an instructor using desktop monitoring software. Two courses (elective course and obligatory course) were evaluated by the students (n = 160 and n = 100) and instructors (n = 9) using an anonymized online survey. Results  Courses were evaluated positively by the students and instructors. From the perspective of the students, the courses increased understanding of cross-sectional anatomy (elective/obligatory course: 97 %/95 %) and radiologic findings (97 %/99 %). Furthermore, the course increased the students' interest in radiology (61 %/65 %). The students considered this way of teaching to be relevant to their future occupation (92 % of students in the obligatory course). The higher incidence of teacher-student interaction and the possibility of independent image analysis were rated positively. The majority of instructors did not observe increased distractibility due to the computers (67 %) or notice worse preparation for MC tests (56 %). However, 56 % of instructors reported greater preparation effort. Conclusion  Practical competency-based radiological teaching using a DICOM viewer is a feasible innovative approach with high acceptance among students and instructors. It fosters competency-based learning as proposed by the model curriculum of the German Radiological Society (DRG) and the National Competency-based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). Key Points   · Practical competency-based radiological teaching is highly accepted by students and instructors.. · Students report improved understanding of imaging anatomy and radiological findings.. · Interactive case presentation with a DICOM viewer fosters competency-based learning.. Citation Format · Koestner W, Otten W, Kaireit T et al. Competency-Based Teaching in Radiology - Implementation and Evaluation of Interactive Workstation-Based Learning to Apply NKLM-Based Content. Fortschr Röntgenstr 2017; 189: 1076 - 1085. © Georg Thieme Verlag KG Stuttgart · New York.

Mixed methods study on the use of and attitudes towards safety checklists in interventional radiology.

PubMed

Munn, Zachary; Giles, Kristy; Aromataris, Edoardo; Deakin, Anita; Schultz, Timothy; Mandel, Catherine; Peters, Micah Dj; Maddern, Guy; Pearson, Alan; Runciman, William

2018-02-01

The use of safety checklists in interventional radiology is an intervention aimed at reducing mortality and morbidity. Currently there is little known about their practical use in Australian radiology departments. The primary aim of this mixed methods study was to evaluate how safety checklists (SC) are used and completed in radiology departments within Australian hospitals, and attitudes towards their use as described by Australian radiologists. A mixed methods approach employing both quantitative and qualitative techniques was used for this study. Direct observations of checklist use during radiological procedures were performed to determine compliance. Medical records were also audited to investigate whether there was any discrepancy between practice (actual care measured by direct observation) and documentation (documented care measured by an audit of records). A focus group with Australian radiologists was conducted to determine attitudes towards the use of checklists. Among the four participating radiology departments, overall observed mean completion of the components of the checklist was 38%. The checklist items most commonly observed to be addressed by the operating theatre staff as noted during observations were correct patient (80%) and procedure (60%). Findings from the direct observations conflicted with the medical record audit, where there was a higher percentage of completion (64% completion) in comparison to the 38% observed. The focus group participants spoke of barriers to the use of checklists, including the culture of radiology departments. This is the first study of safety checklist use in radiology within Australia. Overall completion was low across the sites included in this study. Compliance data collected from observations differed markedly from reported compliance in medical records. There remain significant barriers to the proper use of safety checklists in Australian radiology departments. © 2017 The Royal Australian and New Zealand College of Radiologists.

Interventional radiology virtual simulator for liver biopsy.

PubMed

Villard, P F; Vidal, F P; ap Cenydd, L; Holbrey, R; Pisharody, S; Johnson, S; Bulpitt, A; John, N W; Bello, F; Gould, D

2014-03-01

Training in Interventional Radiology currently uses the apprenticeship model, where clinical and technical skills of invasive procedures are learnt during practice in patients. This apprenticeship training method is increasingly limited by regulatory restrictions on working hours, concerns over patient risk through trainees' inexperience and the variable exposure to case mix and emergencies during training. To address this, we have developed a computer-based simulation of visceral needle puncture procedures. A real-time framework has been built that includes: segmentation, physically based modelling, haptics rendering, pseudo-ultrasound generation and the concept of a physical mannequin. It is the result of a close collaboration between different universities, involving computer scientists, clinicians, clinical engineers and occupational psychologists. The technical implementation of the framework is a robust and real-time simulation environment combining a physical platform and an immersive computerized virtual environment. The face, content and construct validation have been previously assessed, showing the reliability and effectiveness of this framework, as well as its potential for teaching visceral needle puncture. A simulator for ultrasound-guided liver biopsy has been developed. It includes functionalities and metrics extracted from cognitive task analysis. This framework can be useful during training, particularly given the known difficulties in gaining significant practice of core skills in patients.

Picture archiving and communication systems (PACS).

PubMed

Gamsu, Gordon; Perez, Enrico

2003-07-01

Over the past 2 decades, groups of computer scientists, electronic design engineers, and physicians, in universities and industry, have worked to achieve an electronic environment for the practice of medicine and radiology. The radiology component of this revolution is often called PACS (picture archiving and communication systems). More recently it has become evident that the efficiencies and cost savings of PACS are realized when they are part of an enterprise-wide electronic medical record. The installation of PACS requires careful planning by all the various stakeholds over many months prior to installation. All of the users must be aware of the initial disruption that will occur as they become familiar with the systems. Modern fourth generation PACS is linked to radiology and hospital information systems. The PACS consist of electronic acquisition sites-a robust network intelligently managed by a server, multiple viewing sites, and an archive. The details of how these are linked and their workflow analysis determines the success of PACS. PACS evolves over time, components are frequently replaced, and so the users must expect continuous learning about new updates and improved functionality. The digital medical revolution is rapidly being adopted in many medical centers, improving patient care and the success of the institution.

Learning on human resources management in the radiology residency program*

PubMed Central

de Oliveira, Aparecido Ferreira; Lederman, Henrique Manoel; Batista, Nildo Alves

2014-01-01

Objective To investigate the process of learning on human resource management in the radiology residency program at Escola Paulista de Medicina - Universidade Federal de São Paulo, aiming at improving radiologists' education. Materials and Methods Exploratory study with a quantitative and qualitative approach developed with the faculty staff, preceptors and residents of the program, utilizing a Likert questionnaire (46), taped interviews (18), and categorization based on thematic analysis. Results According to 71% of the participants, residents have clarity about their role in the development of their activities, and 48% said that residents have no opportunity to learn how to manage their work in a multidisciplinary team. Conclusion Isolation at medical records room, little interactivity between sectors with diversified and fixed activities, absence of a previous culture and lack of a training program on human resources management may interfere in the development of skills for the residents' practice. There is a need to review objectives of the medical residency in the field of radiology, incorporating, whenever possible, the commitment to the training of skills related to human resources management thus widening the scope of abilities of the future radiologists. PMID:25741056

Implementing an effective organization and governance structure for a radiology practice.

PubMed

Muroff, Lawrence R

2004-01-01

Radiology practices that are well organized and effectively governed have a competitive advantage. Decisions are made rapidly, actions are taken decisively and in accordance with established policy, and each group member has a responsibility for practice building. Such groups are perceived by their peers, hospital administration, and community business leaders to be both formidable and effective. This paper details the mechanisms that facilitate planning for and implementing an efficient practice organization and governance structure. The tasks of group leaders are defined, as are the committees necessary for appropriate action. The integral roles of a mission statement and a business plan are discussed. Practices adopting the suggested organizational structure will be best positioned to survive in both good times and bad.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holliday, B.

Information that would allow an assessment of the standard of radiological protection in the United Kingdom is very limited. The Radiological Protection Service (now the National Radiological Protection Board) has provided a monitoring and advisory service to dentists for many years but very limited use has been made of this service. In a recent survey a total of 114 dentists was visited in representative practices in South East England and it was established that only 6.5 per cent of dentists in general practice do not use radiography as an adjunct to their practice (Smith, 1969). In the 88 x-ray setsmore » which were examined, 24 per cent had less than the recommended thickness of aluminium filtration, while 25 per cent had a fixed field size which was larger than necessary for dental radiography, in addition 27 per cent of the timers were found to have an error of greater than 20 per cent in repetition of the pre-set exposure time. These figures are consistent with the results of surveys performed by the National Radiological ProteCtion Board at the request of dentists, but the sample has been small, i.e., a few per cent of dentists in general practice. It is also possible that these results are not typical as the dentist requesting such a survey may have a greater awareness than others of the need for protection.« less

Radiation Protection of the Child from Diagnostic Imaging.

PubMed

Leung, Rebecca S

2015-01-01

In recent years due to the technological advances in imaging techniques, which have undoubtedly improved diagnostic accuracy and resulted in improved patient care, the utilization of ionizing radiation in diagnostic imaging has significantly increased. Computed tomography is the major contributor to the radiation burden, but fluoroscopy continues to be a mainstay in paediatric radiology. The rise in the use of ionizing radiation is of particular concern with regard to the paediatric population, as they are up to 10 times more sensitive to the effects of radiation than adults, due to their increased tissue radiosensitivity, increased cumulative lifetime radiation dose and longer lifetime in which to manifest the effects. This article will review the estimated radiation risk to the child from diagnostic imaging and summarise the various methods through which both the paediatrician and radiologist can practice the ALARA (As Low As Reasonably Achievable) principle, which underpins the safe practice of radiology. Emphasis is on the justification for an examination, i.e. weighing of benefits versus radiation risk, on the appropriate utilization of other, non-ionizing imaging modalities such as ultrasound and magnetic resonance imaging, and on optimisation of a clinically indicated examination. It is essential that the paediatrician and radiologist work together in this decision making process for the mutual benefit of the patient. The appropriate practical application of ALARA in the workplace is crucial to the radiation safety of our paediatric patients.

The quality and impact of computer supported collaborative learning (CSCL) in radiology case-based learning.

PubMed

Kourdioukova, Elena V; Verstraete, Koenraad L; Valcke, Martin

2011-06-01

The aim of this research was to explore (1) clinical years students' perceptions about radiology case-based learning within a computer supported collaborative learning (CSCL) setting, (2) an analysis of the collaborative learning process, and (3) the learning impact of collaborative work on the radiology cases. The first part of this study focuses on a more detailed analysis of a survey study about CSCL based case-based learning, set up in the context of a broader radiology curriculum innovation. The second part centers on a qualitative and quantitative analysis of 52 online collaborative learning discussions from 5th year and nearly graduating medical students. The collaborative work was based on 26 radiology cases regarding musculoskeletal radiology. The analysis of perceptions about collaborative learning on radiology cases reflects a rather neutral attitude that also does not differ significantly in students of different grade levels. Less advanced students are more positive about CSCL as compared to last year students. Outcome evaluation shows a significantly higher level of accuracy in identification of radiology key structures and in radiology diagnosis as well as in linking the radiological signs with available clinical information in nearly graduated students. No significant differences between different grade levels were found in accuracy of using medical terminology. Students appreciate computer supported collaborative learning settings when tackling radiology case-based learning. Scripted computer supported collaborative learning groups proved to be useful for both 5th and 7th year students in view of developing components of their radiology diagnostic approaches. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Financial accounting for radiology executives.

PubMed

Seidmann, Abraham; Mehta, Tushar

2005-03-01

The authors review the role of financial accounting information from the perspective of a radiology executive. They begin by introducing the role of pro forma statements. They discuss the fundamental concepts of accounting, including the matching principle and accrual accounting. The authors then explore the use of financial accounting information in making investment decisions in diagnostic medical imaging. The paper focuses on critically evaluating the benefits and limitations of financial accounting for decision making in a radiology practice.

Use of OsiriX in developing a digital radiology teaching library.

PubMed

Shamshuddin, S; Matthews, H R

2014-10-01

Widespread adoption of digital imaging in clinical practice and for the image-based examinations of the Royal College of Radiologists has created a desire to provide a digital radiology teaching library in many hospital departments around the UK. This article describes our experience of using OsiriX software in developing digital radiology teaching libraries. Copyright © 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

[From the x-ray department to the institute for imaging diagnosis].

PubMed

Voegeli, E; Steck, W

1985-02-01

The increasing sophistication of diagnostic radiology has led to rising emphasis on modality-related training and practice in radiological subspecialties. To accomplish both optimal patient management and a rational, cost-effective analysis of imaging procedures, a comprehensive approach to modern radiology is needed rather than a technology-related attitude. The imaging department, where the various imaging data are synthesized and correlation by a general practitioner of radiology, as opposed to the subspecialty radiologist, is the most suitable solution. The principles of management and the layout of such a center are described by the authors.

Advanced Trauma Life Support®. ABCDE from a radiological point of view

PubMed Central

Blickman, Johan G.

2007-01-01

Accidents are the primary cause of death in patients aged 45 years or younger. In many countries, Advanced Trauma Life Support® (ATLS®) is the foundation on which trauma care is based. We will summarize the principles and the radiological aspects of the ATLS®, and we will discuss discrepancies with day to day practice and the radiological literature. Because the ATLS® is neither thorough nor up-to-date concerning several parts of radiology in trauma, it should not be adopted without serious attention to defining the indications and limitations pertaining to diagnostic imaging. PMID:17564732

Practice analysis of chiropractic radiology: identifying items for part I of the clinical competency examination.

PubMed

Smith, Sara Dawn; Beran, Tanya N

2012-01-01

The purpose of this study was to describe the current scope of practice of chiropractic radiologists by identifying frequent tasks conducted as well as those conditions most often seen and those that present the greatest risk of harm to patients. A mixed-methods approach was used. An online survey was conducted with 91 diplomates listed with the American Chiropractic Board of Radiology. Participants rated the frequency of tasks they perform and conditions they see on a 5-point scale from "never" to "daily." They also rated the level of risk each condition presents to patients on a 5-point scale from "no risk" to "severe risk." Frequency and risk ratings were then presented in rank order to 22 subject matter experts at 3 focus groups. The most frequent task reported was writing radiology reports (mean [SD], 4.29 [1.58]). Ratings of the frequency of conditions seen in practice and the risk they present to patients were ranked from the highest to lowest for frequency and risk separately. The most frequent conditions seen were reportedly those with structural or joint derangement; the highest risk conditions seen are those that are systemic. Focus group members recommended that some conditions receive higher rankings and that certain conditions be recategorized for future practice analyses. This study helps to define the current scope of practice of chiropractic radiologists and identify frequent tasks and conditions. These results inform the development of a new test outline for Part I of the chiropractic radiology certification examination to ensure that examinees are tested on the most important conditions chiropractic radiologists see in practice. Copyright © 2012 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

Computer hardware for radiologists: Part I

PubMed Central

Indrajit, IK; Alam, A

2010-01-01

Computers are an integral part of modern radiology practice. They are used in different radiology modalities to acquire, process, and postprocess imaging data. They have had a dramatic influence on contemporary radiology practice. Their impact has extended further with the emergence of Digital Imaging and Communications in Medicine (DICOM), Picture Archiving and Communication System (PACS), Radiology information system (RIS) technology, and Teleradiology. A basic overview of computer hardware relevant to radiology practice is presented here. The key hardware components in a computer are the motherboard, central processor unit (CPU), the chipset, the random access memory (RAM), the memory modules, bus, storage drives, and ports. The personnel computer (PC) has a rectangular case that contains important components called hardware, many of which are integrated circuits (ICs). The fiberglass motherboard is the main printed circuit board and has a variety of important hardware mounted on it, which are connected by electrical pathways called “buses”. The CPU is the largest IC on the motherboard and contains millions of transistors. Its principal function is to execute “programs”. A Pentium® 4 CPU has transistors that execute a billion instructions per second. The chipset is completely different from the CPU in design and function; it controls data and interaction of buses between the motherboard and the CPU. Memory (RAM) is fundamentally semiconductor chips storing data and instructions for access by a CPU. RAM is classified by storage capacity, access speed, data rate, and configuration. PMID:21042437

Officer Standardized Educational Testing Data

DTIC Science & Technology

1992-11-01

HORTICULTURE /ORNAMENTAL HORTICULTURE 422 = NATURAL RESOURCES MANAGEMENT 430 = ARCHITECTURE & ENVIRONMENTAL DESIGN, GENERAL 431 = ARCHITECTURAL...SERVICES/ TECHNOLOGY 753 = NUCLEAR MEDICAL TECHNOLOGY 754 = NURSING (PRACTICAL NURSING) 755 = NURSING (REGISTERED/BSN) 756 = OCCUPATIONAL THERAPY ...ASSISTING 757 = OPTOMETRY 758 = PHARMACY 759 = PHYSICIAN ASSISTING 760 = PHYSICAL THERAPY /ASSISTING 761 = RADIOLOGY/RADIOLOGIC TECHNOLOGY 762

Decision support systems for clinical radiological practice — towards the next generation

PubMed Central

Stivaros, S M; Gledson, A; Nenadic, G; Zeng, X-J; Keane, J; Jackson, A

2010-01-01

The huge amount of information that needs to be assimilated in order to keep pace with the continued advances in modern medical practice can form an insurmountable obstacle to the individual clinician. Within radiology, the recent development of quantitative imaging techniques, such as perfusion imaging, and the development of imaging-based biomarkers in modern therapeutic assessment has highlighted the need for computer systems to provide the radiological community with support for academic as well as clinical/translational applications. This article provides an overview of the underlying design and functionality of radiological decision support systems with examples tracing the development and evolution of such systems over the past 40 years. More importantly, we discuss the specific design, performance and usage characteristics that previous systems have highlighted as being necessary for clinical uptake and routine use. Additionally, we have identified particular failings in our current methodologies for data dissemination within the medical domain that must be overcome if the next generation of decision support systems is to be implemented successfully. PMID:20965900

The total value equation: a suggested framework for understanding value creation in diagnostic radiology.

PubMed

Heller, Richard E

2014-01-01

As a result of macroeconomic forces necessitating fundamental changes in health care delivery systems, value has become a popular term in the medical industry. Much has been written recently about the idea of value as it relates to health care services in general and the practice of radiology in particular. Of course, cost, value, and cost-effectiveness are not new topics of conversation in radiology. Not only is value one of the most frequently used and complex words in management, entire classes in business school are taught around the concept of understanding and maximizing value. But what is value, and when speaking of value creation strategies, what is it exactly that is meant? For the leader of a radiology department, either private or academic, value creation is a core function. This article provides a deeper examination of what value is, what drives value creation, and how practices and departments can evaluate their own value creation efficiencies. An equation, referred to as the Total Value Equation, is presented as a framework to assess value creation activities and strategies. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Teaching, leadership, scholarly productivity, and level of activity in the chiropractic profession: a study of graduates of the Los Angeles College of Chiropractic radiology residency program

PubMed Central

Young, Kenneth J.; Siordia, Lawrence

2012-01-01

Objective The purpose of this study was to track the graduates of the Los Angeles College of Chiropractic (LACC) radiology residency program, review their scholarly productivity, and report those involved in teaching and leadership positions. Methods Former LACC residents’ career information was identified through publicly available electronic documents including Web sites and social media. PubMed and the Index to Chiropractic Literature databases were searched for chiropractic graduate job surveys, and proportional comparisons were made between the career paths of LACC radiology residency graduates and those of non–residency-trained chiropractors. Results Of 47 former LACC residents, 28 (60%) have or previously had careers in tertiary (chiropractic) education; and 12 (26%) have attained a department chair position or higher at tertiary teaching institutions. Twenty-two (47%) have or previously had private radiology practices, whereas 11 (23%) have or previously had clinical chiropractic practices. Often, residency graduates hold or have held 2 of these positions at once; and one, all 3. Chapters or books were authored by 13 (28%). Conclusion Radiology residency LACC graduates are professionally active, particularly in education, and demonstrate scholarly productivity. PMID:23966885

[Health technology assessment (HTA). Developments in healthcare and potential for radiology].

PubMed

Gizewski, E R; Forsting, M; Krombach, G A; Schöffski, O

2014-06-01

Cost-intensive measures and procedures, such as also employed in radiology, have far-reaching economic implications in respect to increasing expenditure with limited resources. Health technology assessment (HTA) describes the systematic evaluation of medical procedures and technologies which in recent years has been introduced by many countries into healthcare politics. In many cases HTA analyses can be directly implemented into practice as shown by the examples given in this article; however, in the current form of HTA the practical implementation for radiology often presents the problem that the cost-benefit ratio does not yet have a comprehensive view in the HTA report but is limited to a subsection, e.g. current costs versus sensitivity of a method. Since its inception radiology has had a high power of innovation and new developments will also substantially determine the future years. These procedures must not only be evaluated with respect to feasibility but also in the sense of the HTA in the total concept. In radiology there are also a large number of possibilities for radiologists not only as passive consumers of HTA reports but also to become active participants in this process, an opportunity which should be taken advantage of.

[A radiological case collection with interactive character as a new element in the education of medical students].

PubMed

Heye, T; Kurz, P; Eiers, M; Kauffmann, G W; Schipp, A

2008-04-01

Evaluation of an interactive, multimedia case-based learning platform for the radiological education of medical students. An interactive electronic learning platform for the education of medical students was built in HTML format independent of the operating system in the context of the Heidelberg Curriculum Medicinale (HeiCuMed). A case collection of 30 common and authentic clinical cases is used as the central theme and clinical background. The user has to work on each case by making decisions regarding a selection of diagnostic modalities and by analyzing the chosen studies. After a reasonable selection and sequence of diagnostic radiological modalities and their interpretation, a diagnosis has to be made. An extensive collection of normal findings for any modality is available for the user as a reference in correlation with the pathology at anytime within each case. The case collection consists of 2053 files with 1109 Internet pages (HTML) and 869 image files (.jpeg) with approximately 10 000 crosslinks (links). The case collection was evaluated by a questionnaire (scale 1 - 5) at the end of the radiological student course. The development of the results of the radiological course exam was analyzed to investigate any effect on the learning performance after the case collection was introduced. 97.6 % of the course participants would use the case collection beyond the radiological student course to learn radiology in their medical studies. The handling of the case collection was rated excellent in 36.9 %, good in 54.6 %, satisfactory in 8 % and unsatisfactory in 0.4 %. 41 % felt that the case collection was overall excellent, 49.2 % good, 7.8 % satisfactory, 1.6 % unsatisfactory and 0.4 % poor. A positive trend in the development of the results in the radiological course exam with less variance after the introduction of the case collection was found but failed statistical significance. A platform-independent, interactive, multimedia learning platform with authentic clinical cases and multiple choice elements for the user is the ideal method for supporting and expanding medical education in radiology. The usefulness and the reasonable exertion of diagnostic modalities are conveyed in a practical context as teaching goals. The high acceptance among students is based on the interactivity and use of multimedia.

The role of radiology in the evolution of the understanding of articular disease.

PubMed

Huang, Mingqian; Schweitzer, Mark E

2014-11-01

Both the clinical practice of radiology and the journal Radiology have had an enormous effect on our understanding of articular disease. Early descriptions of osteoarthritis (OA) appeared in Radiology. More recently, advanced physiologic magnetic resonance (MR) techniques have furthered our understanding of the early prestructural changes in patients with OA. Sodium imaging, delayed gadolinium-enhanced MR imaging of cartilage, and spin-lattice relaxation in the rotating frame (or T1ρ) sequences have advanced understanding of the pathophysiology and pathoanatomy of OA. Many pioneering articles on rheumatoid arthritis (RA) also have been published in Radiology. In the intervening decades, our understanding of the natural history of RA has been altered by these articles. Many of the first descriptions of crystalline arthropathies, including gout, calcium pyrophosphate deposition, and hydroxyapatite deposition disease, appeared in Radiology.

Imaging of the small intestine in Crohn's disease: Joint position statement of the Indian Society of Gastroenterology and Indian Radiological and Imaging Association.

PubMed

Kedia, Saurabh; Sharma, Raju; Makharia, Govind K; Ahuja, Vineet; Desai, Devendra; Kandasamy, Devasenathipathy; Eapen, Anu; Ganesan, Karthik; Ghoshal, Uday C; Kalra, Naveen; Karthikeyan, D; Madhusudhan, Kumble Seetharama; Philip, Mathew; Puri, Amarender Singh; Puri, Sunil; Sinha, Saroj K; Banerjee, Rupa; Bhatia, Shobna; Bhat, Naresh; Dadhich, Sunil; Dhali, G K; Goswami, B D; Issar, S K; Jayanthi, V; Misra, S P; Nijhawan, Sandeep; Puri, Pankaj; Sarkar, Avik; Singh, S P; Srivastava, Anshu; Abraham, Philip; Ramakrishna, B S

2017-11-01

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

Best Practices for the Security of Radioactive Materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coulter, D.T.; Musolino, S.

2009-05-01

This work is funded under a grant provided by the US Department of Health and Human Services, Centers for Disease Control. The Department of Health and Mental Hygiene (DOHMH) awarded a contract to Brookhaven National Laboratory (BNL) to develop best practices guidance for Office of Radiological Health (ORH) licensees to increase on-site security to deter and prevent theft of radioactive materials (RAM). The purpose of this document is to describe best practices available to manage the security of radioactive materials in medical centers, hospitals, and research facilities. There are thousands of such facilities in the United States, and recent studiesmore » suggest that these materials may be vulnerable to theft or sabotage. Their malevolent use in a radiological-dispersion device (RDD), viz., a dirty bomb, can have severe environmental- and economic- impacts, the associated area denial, and potentially large cleanup costs, as well as other effects on the licensees and the public. These issues are important to all Nuclear Regulatory Commission and Agreement State licensees, and to the general public. This document outlines approaches for the licensees possessing these materials to undertake security audits to identify vulnerabilities in how these materials are stored or used, and to describe best practices to upgrade or enhance their security. Best practices can be described as the most efficient (least amount of effort/cost) and effective (best results) way of accomplishing a task and meeting an objective, based on repeatable procedures that have proven themselves over time for many people and circumstances. Best practices within the security industry include information security, personnel security, administrative security, and physical security. Each discipline within the security industry has its own 'best practices' that have evolved over time into common ones. With respect to radiological devices and radioactive-materials security, industry best practices encompass both physical security (hardware and engineering) and administrative procedures. Security regimes for these devices and materials typically use a defense-in-depth- or layered-security approach to eliminate single points of failure. The Department of Energy, the Department of Homeland Security, the Department of Defense, the American Society of Industrial Security (ASIS), the Security Industry Association (SIA) and Underwriters Laboratory (UL) all rovide design guidance and hardware specifications. With a graded approach, a physical-security specialist can tailor an integrated security-management system in the most appropriate cost-effective manner to meet the regulatory and non-regulatory requirements of the licensee or client.« less

Teleradiology in Singapore--taking stock and looking ahead.

PubMed

Cheng, Lionel T E; Ng, Samuel E S

2006-08-01

Teleradiology will have a significant impact on the delivery of healthcare and the practice of medicine. In order to ensure a positive outcome, the expected benefits, limitations and potential pitfalls of teleradiology must be carefully considered. For Singapore, teleradiology can be used to facilitate a quantum leap in the standards of radiological services. This can be achieved through the development of an integrated, nationwide, high-speed radiology network which will allow patients to have access to high-quality and responsive subspecialty radiology expertise located throughout the country. If judiciously implemented, teleradiology has the potential to propel Singapore radiology to an unprecedented level of professional quality and service delivery, and will provide the framework for sustainable radiological insourcing from other countries.

Ethical Issues in Radiology Journalism, Peer Review, and Research.

PubMed

Katz, Douglas S; Gardner, James B; Hoffmann, Jason C; Patlas, Michael N; Bhargava, Puneet; Moshiri, Mariam; Remer, Erick M; Gould, Elaine S; Smith, Stacy

2016-08-17

Although some research and publication practices are clearly unethical, including fraud and plagiarism, other areas of research and publication, such as informed consent and conflicts of interest, fall into grayer areas. The purposes of this article are, therefore, to review a variety of relevant ethical issues in radiology-related journalism, peer review, and research; to review the radiology literature to date that has addressed these issues; and to present position statements and potential solutions to these problems.

Evaluation of awareness on radiation protection and knowledge about radiological examinations in healthcare professionals who use ionized radiation at work.

PubMed

Yurt, Ayşegül; Cavuşoğlu, Berrin; Günay, Türkan

2014-06-01

In this study, we evaluated the knowledge and perception and mitigation of hazards involved in radiological examinations, focusing on healthcare personnel who are not in radiation-related occupations, but who use ionising radiation as a part of their work. A questionnaire was applied to physicians, nurses, technicians and other staff working in different clinics that use radiation in their work, in order to evaluate their knowledge levels about ionizing radiation and their awareness about radiation doses resulting from radiological examinations. The statistical comparisons between the groups were analyzed with the Kruskal Wallis test using the SPSS program. Ninety two participants took part in the study. Their level of knowledge about ionizing radiation and doses in radiological examinations were found to be very weak. The number of correct answers of physicians, nurses, medical technicians and other personnel groups were 15.7±3.7, 13.0±4.0, 10.1±2.9 and 11.8±4.0, respectively. In the statistical comparison between the groups, the level of knowledge of physicians was found to be significantly higher than the level of the other groups (p=0.005). The present study demonstrated that general knowledge in relation to radiation, radiation protection, health risks and doses used for radiological applications are insufficient among health professions using with ionizing radiation in their work.

Funds Flow in the Era of Value-Based Health Care.

PubMed

Itri, Jason N; Mithqal, Ayman; Krishnaraj, Arun

2017-06-01

Health care reform is creating significant challenges for hospital systems and academic medical centers (AMCs), requiring a new operating model to adapt to declining reimbursement, diminishing research funding, market consolidation, payers' focus on higher quality and lower cost, and greater cost sharing by patients. Maintaining and promoting the triple mission of clinical care, research, and education will require AMCs to be system-based with strong alignment around governance, operations, clinical care, and finances. Funds flow is the primary mechanism whereby an AMC maintains the triple mission through alignment of the hospital, physician practices, school of medicine, undergraduate university, and other professional schools. The purpose of this article is to discuss challenges with current funds flow models, impact of funds flow on academic and private practice radiology groups, and strategies that can increase funds flow to support radiology practices achieving clinical, research, and teaching missions in the era of value-based health care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Increasing the Efficiency on Producing Radiology Reports for Breast Cancer Diagnosis by Means of Structured Reports. A Comparative Study.

PubMed

Segrelles, J Damian; Medina, Rosana; Blanquer, Ignacio; Martí-Bonmatí, Luis

2017-05-18

Radiology reports are commonly written on free-text using voice recognition devices. Structured reports (SR) have a high potential but they are usually considered more difficult to fill-in so their adoption in clinical practice leads to a lower efficiency. However, some studies have demonstrated that in some cases, producing SRs may require shorter time than plain-text ones. This work focuses on the definition and demonstration of a methodology to evaluate the productivity of software tools for producing radiology reports. A set of SRs for breast cancer diagnosis based on BI-RADS have been developed using this method. An analysis of their efficiency with respect to free-text reports has been performed. The methodology proposed compares the Elapsed Time (ET) on a set of radiological reports. Free-text reports are produced with the speech recognition devices used in the clinical practice. Structured reports are generated using a web application generated with TRENCADIS framework. A team of six radiologists with three different levels of experience in the breast cancer diagnosis was recruited. These radiologists performed the evaluation, each one introducing 50 reports for mammography, 50 for ultrasound scan and 50 for MRI using both approaches. Also, the Relative Efficiency (REF) was computed for each report, dividing the ET of both methods. We applied the T-Student (T-S) test to compare the ETs and the ANOVA test to compare the REFs. Both tests were computed using the SPSS software. The study produced three DICOM-SR templates for Breast Cancer Diagnosis on mammography, ultrasound and MRI, using RADLEX terms based on BIRADs 5th edition. The T-S test on radiologists with high or intermediate profile, showed that the difference between the ET was only statistically significant for mammography and ultrasound. The ANOVA test performed grouping the REF by modalities, indicated that there were no significant differences between mammograms and ultrasound scans, but both have significant statistical differences with MRI. The ANOVA test of the REF for each modality, indicated that there were only significant differences in Mammography (ANOVA p = 0.024) and Ultrasound (ANOVA p = 0.008). The ANOVA test for each radiologist profile, indicated that there were significant differences on the high profile (ANOVA p = 0.028) and medium (ANOVA p = 0.045). In this work, we have defined and demonstrated a methodology to evaluate the productivity of software tools for producing radiology reports in Breast Cancer. We have evaluated that adopting Structured Reporting in mammography and ultrasound studies in breast cancer diagnosis improves the performance in producing reports.

Historical patterns in the types of procedures performed and radiation safety practices used in nuclear medicine from 1945–2009

PubMed Central

Van Dyke, Miriam E.; Drozdovitch, Vladimir; Doody, Michele M.; Lim, Hyeyeun; Bolus, Norman E.; Simon, Steven L.; Alexander, Bruce H.; Kitahara, Cari M.

2016-01-01

We evaluated historical patterns in the types of procedures performed in diagnostic and therapeutic nuclear medicine and the associated radiation safety practices used from 1945–2009 in a sample of U.S. radiologic technologists. In 2013–2014, 4,406 participants from the U.S. Radiologic Technologists (USRT) Study who previously reported working with medical radionuclides completed a detailed survey inquiring about the performance of 23 diagnostic and therapeutic radionuclide procedures and the use of radiation safety practices when performing radionuclide procedure-related tasks during five time periods: 1945–1964, 1965–1979, 1980–1989, 1990–1999, and 2000–2009. We observed an overall increase in the proportion of technologists who performed specific diagnostic or therapeutic procedures across the five time periods. Between 1945–1964 and 2000–2009, the median frequency of diagnostic procedures performed substantially increased (5 per week to 30 per week), attributable mainly to an increasing frequency of cardiac and non-brain PET scans, while the median frequency of therapeutic procedures performed modestly decreased (from 4 per month to 3 per month). We also observed a notable increase in the use of most radiation safety practices from 1945–1964 to 2000–2009 (e.g., use of lead-shielded vials during diagnostic radiopharmaceutical preparation increased from 56 to 96%), although lead apron use dramatically decreased (e.g., during diagnostic imaging procedures, from 81 to 7%). These data describe historical practices in nuclear medicine and can be used to support studies of health risks in nuclear medicine technologists. PMID:27218293

LETTER TO THE EDITOR: Response to 'Patient dose measurements in radiological practices'

NASA Astrophysics Data System (ADS)

Zoetelief, J.; Wambersie, A.

2006-06-01

A lack of suitable dosimetric quantities for application in diagnostic radiology is noted by Dr Moores. It is concluded by Dr Moores that it is not possible to adhere to the basic principles of the International Commission on Radiation Units and Measurements (ICRU) regarding patient dosimetry in diagnostic radiology due to the extremely wide variety of quantities and units employed. The conclusion of the ICRU on similar observations, however, was that there is a need for harmonization of quantities and terminology for dosimetry in diagnostic and interventional radiology and they established a Report Committee with the aim of formulating an ICRU report on 'dosimetric procedures in diagnostic radiology'. The report produced by this committee entitled 'Patient dosimetry for x rays used in medical imaging' was accepted for publication in December 2005 and is currently at press, and may serve to improve the current situation with regard to patient dose measurement in diagnostic and interventional radiology.

Model for collaboration: a rural medicine and academic health center teleradiology project

NASA Astrophysics Data System (ADS)

Van Slyke, Mark A.; Eggli, Douglas F.; Prior, Fred W.; Salmon, William; Pappas, Gregory; Vanatta, Fred; Goldfetter, Warren; Hashem, Said

1996-05-01

A pilot project was developed to explore the role of subspecialty radiology support to rural medicine sites over a long-distance network. A collaborative relationship between 2 rural radiology practices and an academic health was established. Project objectives included: (1) Does the subspecialty consultation significantly change diagnosis patterns at the rural site? (2) Is there value added as measured by improved clinical care or an overall decreased cost of care? (3) Can a collaborative model be economically self-supportive? (4) Does the collaborative model encourage and support education and collegial relationships? Two rural hospitals were selected based on the level of imaging technology and willingness to cooperate. Image capture and network technology was chosen to make the network process transparent to the users. DICOM standard interfaces were incorporated into existing CT and MRI scanners and a film digitizer. Nuclear medicine images were transferred and viewed using a proprietary vendor protocol. Relevant clinical data was managed by a custom designed PC based Lotus Notes application (Patient Study Tracking System: PaSTS) (Pennsylvania Blue Shield Institute). All data was transferred over a Frame Relay network and managed by the Pennsylvania Commonwealth sponsored PA Health Net. Images, other than nuclear medicine, were viewed on a GE Advantage viewing station using a pair of 2 X 2.5 K gray scale monitors. Patient text data was managed by the PaSTS PC and displayed on a separate 15' color monitor. A total of 476 radiology studies were networked into the AHC. Randomly chosen research studies comprised 82% of the case work. Consultative and primary read cases comprised 17% and 1% respectively. The exercise was judged effective by both rural sites. Significant findings and diagnoses were confirmed in 73% of cases with discrepant findings in only 4%. One site benefited by adopting more advanced imaging techniques increasing the sophistication of radiology services. The primary value for the referring sites was the added confidence provided by the subspecialty overreads. An educational value was recognized by all. In conclusion, the networking of rural health care sites to an AHC subspecialty radiology practice was successful primarily in increasing the diagnostic confidence at the rural site. Other benefits included: education; increased rural imaging and an opportunity to provide primary interpretation when the rural radiologist is not available. However, the rate of rural generated consultation was low (17%) and is unlikely to support the costs of a high speed network. To support, rather than replace, rural radiology requires a lower cost network and a mechanism for payment for these services.

Radiology system evolution in the new millennium.

PubMed

Nauert, R C

2001-01-01

For many decades the practice of radiology grew slowly in America and was largely a secondary function under the control of hospitals. In more recent times it has vastly expanded its array of diagnostic, interventional, and therapeutic abilities. There is increasing consumer logic for direct access. Motivations have grown to create large independent entities with broadly diverse capabilities in order to succeed in the new millennium. Most regional markets are evolving rapidly in terms of managed care penetration, health system formation, physician practice consolidation and aggressive purchaser behavior by employers and consumers. To understand the enormity of healthcare evolution, it is useful to look at the industry's paradigm shifts in recent decades. Virtually every aspect of organizational infrastructure, delivery approaches, and the business environment has evolved markedly during the past fifty years. These changes will accelerate. To succeed financially, radiology groups must strengthen their market positions, technical capabilities, continuums of care and geographic dominance. Equally important is the wisdom of diversifying incomes into related services and businesses that provide additional related revenues. Key factors for successful development include facility market growth, full coverage of managed care contracts, high efficiency and aggressive diversification. A fully evolved system generates significant revenues and profitability by protecting and strengthening its financial position in this environment. That is accomplished through the development of strategically located radiology groups, aggressive alliances with medical practices in allied disciplines, and managed radiology departments and facilities for partner health systems. Organizational success ultimately depends on the ability to accept capitated payments under risk-bearing arrangements. The strategic business plan should be organized with the appropriate levels of detail needed to establish executive focus and priorities. These should be woven into operational and capital budgets to reflect expectations of the revenues, expenses and investments tied to the plan. While formidable, all of these objectives are realistic and can be accomplished if the right decisions are made. Initially, the entity's principle business objective is to formulate and begin implementation of methodical yet aggressive strategies for growth that are sensitive to sustaining high levels of quality patient care. The next phase features mergers with large, independent radiology practices in key geographic areas and successful acquisition of smaller practices. The objective of the final phase is to aggressively expand into select metropolitan areas with regional coverage and full teleradiology capabilities. High levels of market strength and financial performance are necessary to succeed. Passive limitations to small geographic areas and narrow practices will undermine their market position and dissolve financial strength with no hope of recovery. Only the dominant systems will survive and prosper.

Artifacts Affecting Musculoskeletal Magnetic Resonance Imaging: Their Origins and Solutions.

PubMed

Roth, Eira; Hoff, Michael; Richardson, Michael L; Ha, Alice S; Porrino, Jack

2016-01-01

Among articles within the radiology literature, few present the manifestations of magnetic resonance imaging artifacts in a clinically oriented manner. Recognizing such artifacts is imperative given the increasing clinical use of magnetic resonance imaging and the emphasis by the American Board of Radiology on practical physics applications. The purpose of this article is to present magnetic resonance physics principles visually and conceptually in the context of common musculoskeletal radiology artifacts and their solutions, described using nonmathematical explanations. Copyright © 2016 Elsevier Inc. All rights reserved.

Outsourcing to teleradiology companies: bad for radiology, bad for radiologists.

PubMed

Levin, David C; Rao, Vijay M

2011-02-01

Outsourcing night and weekend call to teleradiology companies has become a common practice among private radiology groups. While this may lead to an easier lifestyle, the authors discuss the serious negative consequences for radiologists and the specialty as a whole. These include the likelihood of commoditization of the field, lowering of fees, displacement from hospital contracts and outpatient reading contracts, greater encroachment by other specialties, and lowering of quality. Copyright © 2011 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Applications of process improvement techniques to improve workflow in abdominal imaging.

PubMed

Tamm, Eric Peter

2016-03-01

Major changes in the management and funding of healthcare are underway that will markedly change the way radiology studies will be reimbursed. The result will be the need to deliver radiology services in a highly efficient manner while maintaining quality. The science of process improvement provides a practical approach to improve the processes utilized in radiology. This article will address in a step-by-step manner how to implement process improvement techniques to improve workflow in abdominal imaging.

ICRP special radiation protection issues in interventional radiology, digital and cardiac imaging.

PubMed

Vano, E; Faulkner, K

2005-01-01

The International Commission on Radiological Protection (ICRP) has published two reports giving recommendations dealing with the avoidance of deterministic injuries in interventional radiology and the management of patient dose in digital radiology in 2001 and 2004, respectively. Another document, on radiation protection for cardiologists performing fluoroscopically guided procedures, will be produced during 2005. This paper highlights some of the topics of the published reports, their relevance to European legislation on medical exposures and the importance of radiation protection research in underpinning the ICRP task groups' work in to producing these documents. It is also anticipated that the results, obtained in the cardiology work package of the European research project, will be used in the new document on radiation protection for cardiologists.

The radiology digital dashboard: effects on report turnaround time.

PubMed

Morgan, Matthew B; Branstetter, Barton F; Lionetti, David M; Richardson, Jeremy S; Chang, Paul J

2008-03-01

As radiology departments transition to near-complete digital information management, work flows and their supporting informatics infrastructure are becoming increasingly complex. Digital dashboards can integrate separate computerized information systems and summarize key work flow metrics in real time to facilitate informed decision making. A PACS-integrated digital dashboard function designed to alert radiologists to their unsigned report queue status, coupled with an actionable link to the report signing application, resulted in a 24% reduction in the time between transcription and report finalization. The dashboard was well received by radiologists who reported high usage for signing reports. Further research is needed to identify and evaluate other potentially useful work flow metrics for inclusion in a radiology clinical dashboard.

Common procedures and strategies for anaesthesia in interventional radiology.

PubMed

Landrigan-Ossar, Mary

2015-08-01

This review describes the range of cases now available in the interventional radiology suite and summarizes suggestions for their anaesthetic and perioperative management. The type and complexity of interventional radiology cases being performed increases from year to year. Anaesthesiologists' presence in interventional radiology is increasing in turn, due to increasingly ill patients and intricate procedures requiring more than local anaesthesia for well tolerated completion. The literature available describing this is largely written by radiologists, with little attention paid to anaesthetic considerations. Cases in interventional radiology are complex in terms of the logistics of working in an unfamiliar area, frequency of patient comorbidity and unfamiliar procedures. Ensuring familiarity with the variety of interventional radiology procedures and their periprocedure requirements can increase anaesthesiologists' comfort in interventional radiology.

Selected accounts receivable performance statistics for radiology practices: an analysis of the adjusted collection percentage and days charges in accounts receivable.

PubMed

Cergnul, John J; Russell, Philip J; Sunshine, Jonathan H

2005-12-01

To provide comparative data and analysis with respect to accounts receivable management performance criteria. Data from 3 sources were analyzed: the Radiology Business Management Association's (RBMA) 2003 Accounts Receivable Performance Survey; the RBMA's 2003 Accounts Receivable Survey; and Hogan and Sunshine's 2004 Radiology article "Financial Ratios in Diagnostic Radiology Practices: Variability and Trends," the data for which were drawn primarily from the ACR's 1999 Survey of Practices. The RBMA surveyed (via e-mail and postal mail) only its members, with response rates of 15% and 9%, respectively. The ACR's survey response rate was 66%, via postal mail, and was distributed without regard to the RBMA membership status of the practice manager or even whether the practice employed a practice manager. Comparison among the survey results provided information on trends. Median practice professional component adjusted collection percentage (ACP) deteriorated from 87.3% to 85.1% between the RBMA surveys. Practices limited to global fee billing faired much better when performing their billing in house, as opposed to using a billing service, with mean ACPs of 91.2% and 79.4%, respectively. Days charges in accounts receivable 2004 mean results for professional component billing and global fee billing were nearly identical at 56.11 and 55.54 days, respectively. The 2003 RBMA survey reported 63.74 days for professional component billing and 77.33 days for global fee billing. The improvement from 2003 to 2004 was highly significant for both professional component billing and global fee billing. The 2004 RBMA survey also reflected a rather dramatic improvement in days charges in accounts receivable compared with Hogan and Sunshine's results, which showed a mean of 69 days charges in accounts receivable. The conflicting trends between ACP performance and days charges in accounts receivable performance may be explained by the increasing sophistication of accounts receivable management processes (improving days charges in accounts receivable) and the deterioration in the general economy between survey periods (decreasing ACPs). Additionally, generally better accounts receivable management performance was experienced by practices employing RBMA members (RBMA survey participants) compared with those that may or may not have employed RBMA members (ACR survey participants).

Early resident-to-resident physics education in diagnostic radiology.

PubMed

Kansagra, Akash P

2014-01-01

The revised ABR board certification process has updated the method by which diagnostic radiology residents are evaluated for competency in clinical radiologic physics. In this work, the author reports the successful design and implementation of a resident-taught physics course consisting of 5 weekly, hour-long lectures intended for incoming first-year radiology residents in their first month of training. To the author's knowledge, this is the first description of a course designed to provide a very early framework for ongoing physics education throughout residency without increasing the didactic burden on faculty members. Twenty-six first-year residents spanning 2 academic years took the course and reported subjective improvement in their knowledge (90%) and interest (75%) in imaging physics and a high level of satisfaction with the use of senior residents as physics educators. Based on the success of this course and the minimal resources required for implementation, this work may serve as a blueprint for other radiology residency programs seeking to develop revised physics curricula. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Code Conversion Impact Factor and Cash Flow Impact of International Classification of Diseases, 10th Revision, on a Large Multihospital Radiology Practice.

PubMed

Jalilvand, Aryan; Fleming, Margaret; Moreno, Courtney; MacFarlane, Dan; Duszak, Richard

2018-01-01

The 2015 conversion of the International Classification of Diseases (ICD) system from the ninth revision (ICD-9) to the 10th revision (ICD-10) was widely projected to adversely impact physician practices. We aimed to assess code conversion impact factor (CCIF) projections and revenue delay impact to help radiology groups better prepare for eventual conversion to ICD, 11th revision (ICD-11). Studying 673,600 claims for 179 radiologists for the first year after ICD-10's implementation, we identified primary ICD-10 codes for the top 90th percentile of all examinations for the entire enterprise and each subspecialty division. Using established methodology, we calculated CCIFs (actual ICD-10 codes ÷ prior ICD-9 codes). To assess ICD-10's impact on cash flow, average monthly days in accounts receivable status was compared for the 12 months before and after conversion. Of all 69,823 ICD-10 codes, only 7,075 were used to report primary diagnoses across the entire practice, and just 562 were used to report 90% of all claims, compared with 348 under ICD-9. This translates to an overall CCIF of 1.6 for the department (far less than the literature-predicted 6). By subspecialty division, CCIFs ranged from 0.7 (breast) to 3.5 (musculoskeletal). Monthly average days in accounts receivable for the 12 months before and after ICD-10 conversion did not increase. The operational impact of the ICD-10 transition on radiology practices appears far less than anticipated with respect to both CCIF and delays in cash flow. Predictive models should be refined to help practices better prepare for ICD-11. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Quantitative Metrics in Clinical Radiology Reporting: A Snapshot Perspective from a Single Mixed Academic-Community Practice

PubMed Central

Abramson, Richard G.; Su, Pei-Fang; Shyr, Yu

2012-01-01

Quantitative imaging has emerged as a leading priority on the imaging research agenda, yet clinical radiology has traditionally maintained a skeptical attitude toward numerical measurement in diagnostic interpretation. To gauge the extent to which quantitative reporting has been incorporated into routine clinical radiology practice, and to offer preliminary baseline data against which the evolution of quantitative imaging can be measured, we obtained all clinical computed tomography (CT) and magnetic resonance imaging (MRI) reports from two randomly selected weekdays in 2011 at a single mixed academic-community practice and evaluated those reports for the presence of quantitative descriptors. We found that 44% of all reports contained at least one “quantitative metric” (QM), defined as any numerical descriptor of a physical property other than quantity, but only 2% of reports contained an “advanced quantitative metric” (AQM), defined as a numerical parameter reporting on lesion function or composition, excluding simple size and distance measurements. Possible reasons for the slow translation of AQMs into routine clinical radiology reporting include perceptions that the primary clinical question may be qualitative in nature or that a qualitative answer may be sufficient; concern that quantitative approaches may obscure important qualitative information, may not be adequately validated, or may not allow sufficient expression of uncertainty; the feeling that “gestalt” interpretation may be superior to quantitative paradigms; and practical workflow limitations. We suggest that quantitative imaging techniques will evolve primarily as dedicated instruments for answering specific clinical questions requiring precise and standardized interpretation. Validation in real-world settings, ease of use, and reimbursement economics will all play a role in determining the rate of translation of AQMs into broad practice. PMID:22795791

A four-alternative forced choice (4AFC) software for observer performance evaluation in radiology

NASA Astrophysics Data System (ADS)

Zhang, Guozhi; Cockmartin, Lesley; Bosmans, Hilde

2016-03-01

Four-alternative forced choice (4AFC) test is a psychophysical method that can be adopted for observer performance evaluation in radiological studies. While the concept of this method is well established, difficulties to handle large image data, perform unbiased sampling, and keep track of the choice made by the observer have restricted its application in practice. In this work, we propose an easy-to-use software that can help perform 4AFC tests with DICOM images. The software suits for any experimental design that follows the 4AFC approach. It has a powerful image viewing system that favorably simulates the clinical reading environment. The graphical interface allows the observer to adjust various viewing parameters and perform the selection with very simple operations. The sampling process involved in 4AFC as well as the speed and accuracy of the choice made by the observer is precisely monitored in the background and can be easily exported for test analysis. The software has also a defensive mechanism for data management and operation control that minimizes the possibility of mistakes from user during the test. This software can largely facilitate the use of 4AFC approach in radiological observer studies and is expected to have widespread applicability.

The mandate and work of ICRP Committee 3 on radiological protection in medicine.

PubMed

Miller, D L; Martin, C J; Rehani, M M

2018-01-01

The mandate of Committee 3 of the International Commission on Radiological Protection (ICRP) is concerned with the protection of persons and unborn children when ionising radiation is used in medical diagnosis, therapy, and biomedical research. Protection in veterinary medicine has been newly added to the mandate. Committee 3 develops recommendations and guidance in these areas. The most recent documents published by ICRP that relate to radiological protection in medicine are 'Radiological protection in cone beam computed tomography' (ICRP Publication 129) and 'Radiological protection in ion beam radiotherapy' (ICRP Publication 127). A report in cooperation with ICRP Committee 2 entitled 'Radiation dose to patients from radiopharmaceuticals: a compendium of current information related to frequently used substances' (ICRP Publication 128) has also been published. 'Diagnostic reference levels in medical imaging' (ICRP Publication 135), published in 2017, provides specific advice on the setting and use of diagnostic reference levels for diagnostic and interventional radiology, digital imaging, computed tomography, nuclear medicine, paediatrics, and multi-modality procedures. 'Occupational radiological protection in interventional procedures' was published in March 2018 as ICRP Publication 139. A document on radiological protection in therapy with radiopharmaceuticals is likely to be published in 2018. Work is in progress on several other topics, including appropriate use of effective dose in collaboration with the other ICRP committees, guidance for occupational radiological protection in brachytherapy, justification in medical imaging, and radiation doses to patients from radiopharmaceuticals (an update to ICRP Publication 128). Committee 3 is also considering the development of guidance on radiological protection in medicine related to individual radiosusceptibility, in collaboration with ICRP Committee 1.

Expanding the scope of practice for radiology managers: radiation safety duties.

PubMed

Orders, Amy B; Wright, Donna

2003-01-01

In addition to financial responsibilities and patient care duties, many medical facilities also expect radiology department managers to wear "safety" hats and complete fundamental quality control/quality assurance, conduct routine safety surveillance in the department, and to meet regulatory demands in the workplace. All managers influence continuous quality improvement initiatives, from effective utilization of resource and staffing allocations, to efficacy of patient scheduling tactics. It is critically important to understand continuous quality improvement (CQI) and its relationship with the radiology manager, specifically quality assurance/quality control in routine work, as these are the fundamentals of institutional safety, including radiation safety. When an institution applies for a registration for radiation-producing devices or a license for the use of radioactive materials, the permit granting body has specific requirements, policies and procedures that must be satisfied in order to be granted a permit and to maintain it continuously. In the 32 U.S. Agreement states, which are states that have radiation safety programs equivalent to the Nuclear Regulatory Commission programs, individual facilities apply for permits through the local governing body of radiation protection. Other states are directly licensed by the Nuclear Regulatory Commission and associated regulatory entities. These regulatory agencies grant permits, set conditions for use in accordance with state and federal laws, monitor and enforce radiation safety activities, and audit facilities for compliance with their regulations. Every radiology department and associated areas of radiation use are subject to inspection and enforcement policies in order to ensure safety of equipment and personnel. In today's business practice, department managers or chief technologists may actively participate in the duties associated with institutional radiation safety, especially in smaller institutions, while other facilities may assign the duties and title of "radiation safety officer" to a radiologist or other management, per the requirements of regulatory agencies in that state. Radiation safety in a medical setting can be delineated into two main categories--equipment and personnel requirements--each having very specific guidelines. The literature fails to adequately address the blatant link between radiology department managers and radiation safety duties. The breadth and depth of this relationship is of utmost concern and warrants deeper insight as the demands of the regulatory agencies increase with the new advances in technology, procedures and treatments associated with radiation-producing devices and radioactive materials.

Radiology applications of financial accounting.

PubMed

Leibenhaut, Mark H

2005-03-01

A basic knowledge of financial accounting can help radiologists analyze business opportunities and examine the potential impacts of new technology or predict the adverse consequences of new competitors entering their service area. The income statement, balance sheet, and cash flow statement are the three basic financial statements that document the current financial position of the radiology practice and allow managers to monitor the ongoing financial operations of the enterprise. Pro forma, or hypothetical, financial statements can be generated to predict the financial impact of specific business decisions or investments on the profitability of the practice. Sensitivity analysis, or what-if scenarios, can be performed to determine the potential impact of changing key revenue, investment, operating cost or financial assumptions. By viewing radiology as both a profession and a business, radiologists can optimize their use of scarce economic resources and maximize the return on their financial investments.

Fostering Diversity and Inclusion: A Summary of the 2017 Intersociety Summer Conference.

PubMed

Kruskal, Jonathan B; Patel, Amy K; Levine, Deborah; Canon, Cheri L; Macura, Katarzyna J; Allen, Brenda J; Meltzer, Carolyn

2018-05-01

The 39th radiology Intersociety Committee reviewed the current state of diversity among trainees and in our workplaces and addressed future strategies for fostering diversity through inclusion. The assembled participants addressed the imperatives and drivers for diversity and developed a road map to foster diversity. Themes included the need to be proactive in increasing awareness of our own biases and their potential impact on workplace decisions, overcoming blind spots, and being culturally sensitive. The need to identify and eliminate barriers to diversity was discussed at both the organizational and practice level and included efforts to break down structural and clinical barriers, such as training in multicultural awareness. Additional strategies that were addressed included building inclusive work environments; facilitating debate, conversations, and community building; and pipelining medical students through mentoring pathways. The conference ended with a call to action to develop toolkits with effective resources to support the necessary diversity and inclusion initiatives we must all undertake. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Blending online techniques with traditional face to face teaching methods to deliver final year undergraduate radiology learning content.

PubMed

Howlett, David; Vincent, Tim; Watson, Gillian; Owens, Emma; Webb, Richard; Gainsborough, Nicola; Fairclough, Jil; Taylor, Nick; Miles, Ken; Cohen, Jon; Vincent, Richard

2011-06-01

To review the initial experience of blending a variety of online educational techniques with traditional face to face or contact-based teaching methods to deliver final year undergraduate radiology content at a UK Medical School. The Brighton and Sussex Medical School opened in 2003 and offers a 5-year undergraduate programme, with the final 5 spent in several regional centres. Year 5 involves several core clinical specialities with onsite radiology teaching provided at regional centres in the form of small-group tutorials, imaging seminars and also a one-day course. An online educational module was introduced in 2007 to facilitate equitable delivery of the year 5 curriculum between the regional centres and to support students on placement. This module had a strong radiological emphasis, with a combination of imaging integrated into clinical cases to reflect everyday practice and also dedicated radiology cases. For the second cohort of year 5 students in 2008 two additional online media-rich initiatives were introduced, to complement the online module, comprising imaging tutorials and an online case discussion room. In the first year for the 2007/2008 cohort, 490 cases were written, edited and delivered via the Medical School managed learning environment as part of the online module. 253 cases contained a form of image media, of which 195 cases had a radiological component with a total of 325 radiology images. Important aspects of radiology practice (e.g. consent, patient safety, contrast toxicity, ionising radiation) were also covered. There were 274,000 student hits on cases the first year, with students completing a mean of 169 cases each. High levels of student satisfaction were recorded in relation to the online module and also additional online radiology teaching initiatives. Online educational techniques can be effectively blended with other forms of teaching to allow successful undergraduate delivery of radiology. Efficient IT links and good image quality are essential ingredients for successful student/clinician engagement. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

Bridging the Gap between Basic and Clinical Sciences: A Description of a Radiological Anatomy Course

ERIC Educational Resources Information Center

Torres, Anna; Staskiewicz, Grzegorz J.; Lisiecka, Justyna; Pietrzyk, Lukasz; Czekajlo, Michael; Arancibia, Carlos U.; Maciejewski, Ryszard; Torres, Kamil

2016-01-01

A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images…

Hands-on Physics Education of Residents in Diagnostic Radiology.

PubMed

Zhang, Jie; Hardy, Peter A; DiSantis, David J; Oates, M Elizabeth

2017-06-01

The American Board of Radiology Core Examination integrates assessment of physics knowledge into its overall testing of clinical radiology, with an emphasis on understanding image quality and artifacts, radiation dose, and patient safety for each modality or subspecialty organ system. Accordingly, achieving a holistic approach to physics education of radiology residents is a huge challenge. The traditional teaching of radiological physics-simply through didactic lectures-was not designed for such a holistic approach. Admittedly, time constraints and clinical demands can make incorporation of physics teaching into clinical practice problematic. We created and implemented a week-long, intensive physics rotation for fledgling radiology residents and evaluated its effectiveness. The dedicated physics rotation is held for 1 week during the first month of radiology residency. It comprises three components: introductory lectures, hands-on practical clinical physics operations, and observation of clinical image production. A brief introduction of the physics pertinent to each modality is given at the beginning of each session. Hands-on experimental demonstrations are emphasized, receiving the greatest allotment of time. The residents perform experiments such as measuring radiation dose, studying the relationship between patient dose and clinical practice (eg, fluoroscopy technique), investigating the influence of acquisition parameters (kV, mAs) on radiographs, and evaluating image quality using computed tomography, magnetic resonance imaging, ultrasound, and gamma camera/single-photon emission computed tomography/positron emission tomography phantoms. Quantitative assessment of the effectiveness of the rotation is based on an examination that tests the residents' grasp of basic medical physics concepts along with written course evaluations provided by each resident. The pre- and post-rotation tests show that after the physics rotation, the average correct score of 25 questions improved from 13.6 ± 2.4 to 19 ± 1.2. The survey shows that the physics rotation during the first week of residency is favored by all residents and that 1 week's duration is appropriate. All residents are of the opinion that the intensive workshop would benefit them in upcoming clinical rotations. Residents acknowledge becoming more comfortable regarding the use of radiation and providing counsel regarding radiation during pregnancy. An immersive, short-duration, clinically oriented physics rotation is well received by new or less experienced radiology trainees, correlates basic physics concepts with their relevance to clinical imaging, and more closely parallels expectations of the American Board of Radiology Core Examination. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Interactive Radiology teaching file system: the development of a MIRC-compliant and user-centered e-learning resource.

PubMed

dos-Santos, M; Fujino, A

2012-01-01

Radiology teaching usually employs a systematic and comprehensive set of medical images and related information. Databases with representative radiological images and documents are highly desirable and widely used in Radiology teaching programs. Currently, computer-based teaching file systems are widely used in Medicine and Radiology teaching as an educational resource. This work addresses a user-centered radiology electronic teaching file system as an instance of MIRC compliant medical image database. Such as a digital library, the clinical cases are available to access by using a web browser. The system has offered great opportunities to some Radiology residents interact with experts. This has been done by applying user-centered techniques and creating usage context-based tools in order to make available an interactive system.

[Attitude survey of radiological technologists toward qualification acquisition of licentiate and degrees in Mie prefecture].

PubMed

Nakanishi, Satoshi; Kamigiri, Akira; Yamada, Tsuyoshi; Nanba, Kazuyoshi; Kitano, Tokio; Ito, Morihiro

2011-01-01

We conducted a questionnaire consciousness survey concerning qualification acquisition of licentiate and degrees among 406 radiological technologists working for medical facility in Mie Prefecture. We employed a mail-back questionnaire method. Then we analyzed relationships between progressive purpose and gender, age, and membership of the Japanese Society of Radiological Technology (JSRT). Results derived note the most common licentiate the participants wanted to acquire was the license concerning emergency medical care. On the other hand, they had limited interest in radiation therapy, nuclear medicine areas and the working environment measurement expert class I. In conclusion, the results of this study revealed the present condition that the necessity of qualification acquisition of licentiate is not recognized incorrectly. In addition, there was a mountain of issues for working radiological technologists to attend graduate school to get degrees. It is important to utilize the results of this study to enlighten their consciousness for limited interest licentiate, and interest them in attending graduate schools.

INL@Work Radiological Search & Response Training

DOE Office of Scientific and Technical Information (OSTI.GOV)

Turnage, Jennifer

Dealing with radiological hazards is just part of the job for many INL scientists and engineers. Dodging bullets isn't. But some Department of Defense personnel may have to do both. INL employee Jennifer Turnage helps train soldiers in the art of detecting radiological and nuclear material. For more information about INL's research projects, visit http://www.facebook.com/idahonationallaboratory.

INL@Work Radiological Search & Response Training

ScienceCinema

Turnage, Jennifer

2017-12-13

Dealing with radiological hazards is just part of the job for many INL scientists and engineers. Dodging bullets isn't. But some Department of Defense personnel may have to do both. INL employee Jennifer Turnage helps train soldiers in the art of detecting radiological and nuclear material. For more information about INL's research projects, visit http://www.facebook.com/idahonationallaboratory.

Technology as an Occasion for Structuring: Evidence from Observations of CT Scanners and the Social Order of Radiology Departments.

ERIC Educational Resources Information Center

Barley, Stephen R.

1986-01-01

New technologies such as the CT scanner are challenging traditional role relations among radiology workers and may be altering the organizational and occupational structure of radiological work. This paper expands recent sociological thought by showing how identical CT scanners occasion similar structuring processes and created divergent forms of…

Traditional text-only versus multimedia-enhanced radiology reporting: referring physicians' perceptions of value.

PubMed

Sadigh, Gelareh; Hertweck, Timothy; Kao, Cristine; Wood, Paul; Hughes, Danny; Henry, Travis S; Duszak, Richard

2015-05-01

The aim of this study was to evaluate referring physicians' perceptions of multimedia-enhanced radiology reporting (MERR) as an alternative to traditional text-only radiology reporting. MERR supplements text-only reports by embedding user-friendly interactive hyperlinks to key images and graphically plotting target lesion size longitudinally over time. Of 402 physicians responding to a web-based survey, 200 (50 each medical oncologists, radiation oncologists, neurosurgeons, and pulmonologists) practicing in the United States fulfilled criteria to complete an online survey with questions focusing on satisfaction with current text-only reports and the perceived value of image- and data-enriched reporting. The mean respondent age was 46 years, with a mean of 15 years in posttraining clinical practice (85% men; 47% from academic medical centers). Although 80% were satisfied with the format of their current text-only radiology reports, 80% believed that MERR would represent an improvement. The most commonly reported advantages of MERR were "improved understanding of radiology findings by correlating images to text reports" (86%) and "easier access to images while monitoring progression of a disease/condition" (79%). Of the 28% of physicians with concerns about MERR implementation, the most common were that it was "too time intensive" (53%) and "the clinic workflow does not allow itself to view reports in such a fashion" (42%). Physicians indicated a strong increased likelihood of preferentially referring patients to (80%) and recommending peers to (79%) facilities that offer MERR. Most specialist referring physicians believe that interactive image- and data-embedded MERR represents an improvement over current text-only radiology reporting. Compared with current report formatting, most would preferentially refer patients and peers to facilities offering more meaningful image- and graphically enriched reporting platforms. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Resident iPad use: has it really changed the game?

PubMed

Berkowitz, Seth J; Kung, Justin W; Eisenberg, Ronald L; Donohoe, Kevin; Tsai, Leo L; Slanetz, Priscilla J

2014-02-01

The purpose of this study was to assess residents' usage patterns and opinions of the iPad as a tool for radiology education and clinical practice at an academic medical center. All 38 radiology residents in our radiology program (postgraduate years 2 to 5) were provided with iPad 2 tablets and subscriptions to e-Anatomy and STATdx. After 6 months of device use, residents were surveyed to assess their opinions regarding the technology as a tool for education and clinical practice. A total of 36 residents (95%) completed the survey. Eighty-six percent reported daily iPad use. Radiology-specific applications, particularly e-Anatomy, were used weekly or daily by 88% of respondents. Most preferred to read journal articles on the iPad (70%), but the number of respondents preferring to read textbooks on the iPad (48.5%) compared with the traditional bound form (48.5%) was evenly divided. Residents were also divided on the clinical utility of the iPad. Most had not used the iPad to view radiologic examinations (75%). Fewer than half (47%) used their iPads during readout. Finally, only 12% had used the iPad to edit dictated reports. The iPad has generated excitement within the radiology community, particularly among resident educators, who are increasingly recognizing the unique needs of "millennial learners." This study showed that the majority of residents at the authors' institution have incorporated the iPad as an educational tool and use it as a learning aid. Incorporation of the iPad into clinical workflow has been less pronounced. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Interventional radiology peer, a newly developed peer-review scoring system designed for interventional radiology practice.

PubMed

d'Othée, Bertrand Janne; Haskal, Ziv J

2013-10-01

Existing diagnostic radiology peer-review systems do not address the specificities of interventional radiology (IR) practice. The purpose of this study was to assess the feasibility of a specifically developed interventional peer review method, IR Peer. Retrospective review of a prospectively encoded pilot database aimed at demonstrating the feasibility of IR Peer in a multiphysician practice was performed. This scoring system used morning peer review of selected IR cases from the previous day in the form of a five-item questionnaire and an ordinal answer scale that grades reviewers' agreement with imaging findings, procedural/technical management, early outcomes, and follow-up plan. Patient lists from IR Peer and morbidity and mortality (M&M) conferences were compared to evaluate the amount of overlap and capability of IR Peer to help detect adverse events (AEs). A total of 417 consecutive reviews of IR attending physician cases by peers were performed in 163 consecutive patients over 18 months, and 94% of cases were reviewed by two or three IR attending physicians. Each question was answered 99%-100% of the time. Answers showed disagreement in 10% of cases (2% by a single reviewer, 8% by several), most related to procedural technique. Overall AE incidence was 1.8%. IR Peer contributed 10.7% of cases to the M&M list. IR Peer is feasible, relevant, and easy to implement in a multiphysician IR practice. When used along with other quality-assurance processes, it might help in the detection of AEs for M&M; the latter will require further confirmatory research. © SIR, 2013.

The job market in diagnostic radiology 1999: updated findings from a help wanted index of job advertisements.

PubMed

Covey, A M; Sunshine, J; Forman, H P

2000-10-01

The purpose of this article is to report 1999 data on the job market in diagnostic radiology detected using a help wanted index of job advertisements and to profile trends in practice type, location, and subspecialty using our previously published data as a basis for comparison. Each advertised job for a diagnostic radiologist in the American Journal of Roentgenology and RADIOLOGY: between January 1991 and December 1999 was coded by practice type, location, and subspecialty. In 1999, 3926 positions were advertised for diagnostic radiologists, representing a 75% increase from 1998. Private practice jobs, which represented 53% of advertisements from 1991 through 1994 and 64% of ads from 1995 through 1998, increased to 66% of ads in 1999. Geographic trends in 1999 were characterized by a relative increase of jobs in the Midwest and California and a decrease in percentage (but increase in total number of ads) in the Northeast and Southwest. The demand for subspecialists continued in 1999, with only 34% of ads placed for general radiologists. A relative increase in demand for neuroradiologists, mammographers, and abdominal imagers was also seen in 1999 in comparison with previously published data from 1995 through 1998. The demand for diagnostic radiologists continues to rise, with more ads placed in 1999 than any other year from 1991 through 1998. Using a help wanted index of job advertisements, we have created an indicator of changes in the diagnostic radiology job market with specific reference to practice type, geographic location, and subspecialty training.

Interventional radiology delivers high-value health care and is an Imaging 3.0 vanguard.

PubMed

Charalel, Resmi A; McGinty, Geraldine; Brant-Zawadzki, Michael; Goodwin, Scott C; Khilnani, Neil M; Matsumoto, Alan H; Min, Robert J; Soares, Gregory M; Cook, Philip S

2015-05-01

Given the changing climate of health care and the imperative to add value, radiologists must join forces with the rest of medicine to deliver better patient care in a more cost-effective, evidence-based manner. For several decades, interventional radiology has added value to the health care system through innovation and the provision of alternative and effective minimally invasive treatments, which have decreased morbidity, mortality, and overall cost. The clinical practice of interventional radiology embodies many of the features of Imaging 3.0, the program recently launched by the ACR. We provide a review of some of the major contributions made by interventional radiology and offer general principles from that experience, which are applicable to all radiologists. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The social media revolution.

PubMed

Dubose, Cheryl

2011-01-01

The growing popularity and use of social media tools such as Facebook, YouTube, Twitter, blogging, and wikis have led to a social media revolution. Given this widespread influence, it is important for educators, administrators, and technologists to understand the risks of using social media in the classroom and workplace. To investigate popular social media sites and their effect on radiologic technology education and business practices. A comprehensive search of literature was performed to examine social media and its applications in education, health care, and business. Social media use is on the rise, affecting all aspects of mainstream society. Leaders in the radiologic sciences should be familiar with social media and cognizant of its risks. Future studies regarding social media use in the radiologic sciences are necessary to determine its effect on the radiologic science community. ©2011 by the American Society of Radiologic Technologists.

Radiology journals in transition: a summary of the 2013 Intersociety Committee Summer Conference.

PubMed

Dodd, Gerald D

2015-01-01

The digital and online revolution is having a profound impact on radiology journals, forcing a migration from print to online publication and altering traditional revenue streams needed to sustain the journals. The 2013 Intersociety Committee Summer Conference attendees reviewed the history of the development of radiology journals, explored the forces driving the transition from print to electronic publication, and examined the impact of the alteration of the traditional revenue streams, such as subscription and advertisement dollars, on the financial sustainability of journals. The attendees also discussed the international movement toward open access to journal content and its impact on a journal's financial viability. Lastly, the committee explored the perceived value of radiology journals based on readership type: academic, private practice, or industry. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Viewpoint: exploring the human interior: the roles of cadaver dissection and radiologic imaging in teaching anatomy.

PubMed

Gunderman, Richard B; Wilson, Philip K

2005-08-01

For a variety of reasons, new radiological imaging techniques are supplanting traditional cadaver dissection in the teaching of human anatomy. The authors briefly review the historical forces behind this transition, and then explore the advantages and drawbacks of each approach. Cadaver dissection offers an active, hands-on exploration of human structure, provides deep insights into the meaning of human embodiment and mortality, and represents a profound rite of passage into the medical profession. Radiological imaging permits in vivo visualization, offers physiologic as well as anatomic insights, and represents the context in which contemporary practicing physicians most frequently encounter their patients' otherwise hidden internal anatomy. Despite its important strengths, radiology cannot simply substitute for cadaver dissection, and the best models for teaching gross anatomy will incorporate both cadaver dissection and radiological imaging.

Changing radiology resident education to meet today's and tomorrow's needs.

PubMed

Halsted, Mark J; Perry, Laurie; Racadio, John M; Medina, L Santiago; LeMaster, Thomas

2004-09-01

Radiology education has evolved significantly in the past several decades, but there is considerable room for improvement. While some improvements depend on the availability of new technology, others are low tech, requiring merely that we be aware of and apply findings in the education literature. We teachers of radiology could benefit from recent studies investigating the processes underlying adult learning to improve the methods we use to train residents and fellows, and to improve the way we teach our colleagues and even ourselves. In this review, adult learning and the expert learner are briefly discussed, as are the important elements of effective learning tools. The strengths and weaknesses of radiology education as it is commonly practiced today are explored. Specific suggestions for improving education in radiology using both low tech and high tech methods are then discussed.

Uranium mining industry views on ICRP statement on radon.

PubMed

Takala, J

2012-01-01

In 2009, the International Commission on Radiological Protection issued a statement on radon which stated that the dose conversion factor for radon progeny would likely double, and the calculation of risk from radon should move to a dosimetric approach, rather than the longstanding epidemiological approach. Through the World Nuclear Association, whose members represent over 90% of the world's uranium production, industry has been examining this issue with a goal of offering expertise and knowledge to assist with the practical implementation of these evolutionary changes to evaluating the risk from radon progeny. Industry supports the continuing use of the most current epidemiological data as a basis for risk calculation, but believes that further examination of these results is needed to better understand the level of conservatism in the potential epidemiological-based risk models. With regard to adoption of the dosimetric approach, industry believes that further work is needed before this is a practical option. In particular, this work should include a clear demonstration of the validation of the dosimetric model which includes how smoking is handled, the establishment of a practical measurement protocol, and the collection of relevant data for modern workplaces. Industry is actively working to address the latter two items. Copyright © 2012. Published by Elsevier Ltd.

Scenario analysis and strategic planning: practical applications for radiology practices.

PubMed

Lexa, Frank James; Chan, Stephen

2010-05-01

Modern business science has many tools that can be of great value to radiologists and their practices. One of the most important and underused is long-term planning. Part of the problem has been the pace of change. Making a 5-year plan makes sense only if your develop robust scenarios of possible future conditions you will face. Scenario analysis is one of many highly regarded tools that can improve your predictive capability. However, as with many tools, it pays to have some training and to get practical tips on how to improve their value. It also helps to learn from other people's mistakes rather than your own. The authors discuss both theoretical and practical issues in using scenario analysis to improve your planning process. They discuss actionable ways this set of tools can be applied in a group meeting or retreat. Copyright (c) 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

"It depends on us": employee perspective of healthy working conditions during continual reorganisations in a radiology department.

PubMed

Nilsson, Kerstin; Hertting, Anna; Petterson, Inga-Lill

2009-01-01

This study focuses on employees' experience of occupational health in a radiology department within a Swedish university hospital during years of continual reorganisations. This department's stable personal health trends in terms of self-rated mental health and sick-leave rates diverged from the general trends of deteriorating working conditions in the hospital. The aim was to identify dimensions of working conditions as positive determinants contributing to occupational health in a department of radiology undergoing continual reorganisations. Open-ended interviews with twelve employees were transcribed and analyzed using content-analysis. The employees experienced their new stimulating working tasks and a supporting organizational climate as important contributors to the healthy work condition. The positive effects of handling new technical challenges and the positive organisational climate, which were characterized by mutual trust, as well as work-confidence and respect for each others' competence, seem to function as buffering factors, balancing the negative effects of parallel downsizing and restructuring processes.

A practical approach for inexpensive searches of radiology report databases.

PubMed

Desjardins, Benoit; Hamilton, R Curtis

2007-06-01

We present a method to perform full text searches of radiology reports for the large number of departments that do not have this ability as part of their radiology or hospital information system. A tool written in Microsoft Access (front-end) has been designed to search a server (back-end) containing the indexed backup weekly copy of the full relational database extracted from a radiology information system (RIS). This front end-/back-end approach has been implemented in a large academic radiology department, and is used for teaching, research and administrative purposes. The weekly second backup of the 80 GB, 4 million record RIS database takes 2 hours. Further indexing of the exported radiology reports takes 6 hours. Individual searches of the indexed database typically take less than 1 minute on the indexed database and 30-60 minutes on the nonindexed database. Guidelines to properly address privacy and institutional review board issues are closely followed by all users. This method has potential to improve teaching, research, and administrative programs within radiology departments that cannot afford more expensive technology.

Using radiology reports to encourage evidence-based practice in the evaluation of small, incidentally detected pulmonary nodules. A preliminary study.

PubMed

Woloshin, Steven; Schwartz, Lisa M; Dann, Elizabeth; Black, William C

2014-02-01

Standard radiology report forms do not guide ordering clinicians toward evidence-based practice. To test an enhanced radiology report that estimates the probability that a pulmonary nodule is malignant and provides explicit, professional guideline recommendations. Anonymous, institutional review board-approved, internet-based survey of all clinicians with privileges at the Dartmouth-Hitchcock Medical Center comparing a standard versus an enhanced chest computed tomography report for a 65-year-old former smoker with an incidentally detected 7-mm pulmonary nodule. A total of 43% (n = 447) of 1045 eligible clinicians answered patient management questions after reading a standard and then an enhanced radiology report (which included the probability of malignancy and Fleischner Society guideline recommendations). With the enhanced report, more clinicians chose the correct management strategy (72% with enhanced versus 32% with standard report [40% difference; 95% confidence interval (CI) = 35-45%]), appropriately made fewer referrals to pulmonary for opinions or biopsy (21 vs. 41% [-40% difference; 95% CI = -25 to -16%]), ordered fewer positron emission tomography scans (3 versus 13%; -10% difference; 95% CI = -13 to -7%), and fewer computed tomography scans outside the recommended time interval (2 versus 7%; -5% difference; 95% CI = -7 to -2%). Most clinicians preferred or strongly preferred the enhanced report, and thought they had a better understanding of the nodule's significance and management. An enhanced radiology report with probability estimates for malignancy and management recommendations was associated with improved clinicians' response to incidentally detected small pulmonary nodules in an internet-based survey of clinicians at one academic medical center, and was strongly preferred. The utility of this approach should be tested next in clinical practice.

The effects of expanding outpatient and inpatient evaluation and management services in a pediatric interventional radiology practice.

PubMed

Edalat, Faramarz; Lindquester, Will S; Gill, Anne E; Simoneaux, Stephen F; Gaines, Jennifer; Hawkins, C Matthew

2017-03-01

Despite a continuing emphasis on evaluation and management clinical services in adult interventional radiology (IR) practice, the peer-reviewed literature addressing these services - and their potential economic benefits - is lacking in pediatric IR practice. To measure the effects of expanding evaluation and management (E&M) services through the establishment of a dedicated pediatric interventional radiology outpatient clinic and inpatient E&M reporting system. We collected and analyzed E&M current procedural terminology (CPT) codes from all patients seen in a pediatric interventional radiology outpatient clinic between November 2014 and August 2015. We also calculated the number of new patients seen in the clinic who had a subsequent procedure (procedural conversion rate). For comparison, we used historical data comprising pediatric patients seen in a general interventional radiology (IR) clinic for the 2 years immediately prior. An inpatient E&M reporting system was implemented and all inpatient E&M (and subsequent procedural) services between July 2015 and September 2015 were collected and analyzed. We estimated revenue for both outpatient and inpatient services using the Medicare Physician Fee Schedule global non-facility price as a surrogate. Following inception of a pediatric IR clinic, the number of new outpatients (5.5/month; +112%), procedural conversion rate (74.5%; +19%), estimated E&M revenue (+158%), and estimated procedural revenue from new outpatients (+228%) all increased. Following implementation of an inpatient clinic reporting system, there were 8.3 consults and 7.3 subsequent hospital encounters per month, with a procedural conversion rate of 88%. Growth was observed in all meaningful metrics following expansion of outpatient and inpatient pediatric IR E&M services.

Patient dose in interventional radiology: a multicentre study of the most frequent procedures in France.

PubMed

Etard, Cécile; Bigand, Emeline; Salvat, Cécile; Vidal, Vincent; Beregi, Jean Paul; Hornbeck, Amaury; Greffier, Joël

2017-10-01

A national retrospective survey on patient doses was performed by the French Society of Medical physicists to assess reference levels (RLs) in interventional radiology as required by the European Directive 2013/59/Euratom. Fifteen interventional procedures in neuroradiology, vascular radiology and osteoarticular procedures were analysed. Kerma area product (KAP), fluoroscopy time (FT), reference air kerma and number of images were recorded for 10 to 30 patients per procedure. RLs were calculated as the 3rd quartiles of the distributions. Results on 4600 procedures from 36 departments confirmed the large variability in patient dose for the same procedure. RLs were proposed for the four dosimetric estimators and the 15 procedures. RLs in terms of KAP and FT were 90 Gm.cm 2 and 11 mins for cerebral angiography, 35 Gy.cm 2 and 16 mins for biliary drainage, 75 Gy.cm 2 and 6 mins for lower limbs arteriography and 70 Gy.cm 2 and 11 mins for vertebroplasty. For these four procedures, RLs were defined according to the complexity of the procedure. For all the procedures, the results were lower than most of those already published. This study reports RLs in interventional radiology based on a national survey. Continual evolution of practices and technologies requires regular updates of RLs. • Delivered dose in interventional radiology depends on procedure, practice and patient. • National RLs are proposed for 15 interventional procedures. • Reference levels (RLs) are useful to benchmark practices and optimize protocols. • RLs are proposed for kerma area product, air kerma, fluoroscopy time and number of images. • RLs should be adapted to the procedure complexity and updated regularly.

Building the Body: Active Learning Laboratories that Emphasize Practical Aspects of Anatomy and Integration with Radiology

ERIC Educational Resources Information Center

Zumwalt, Ann C.; Lufler, Rebecca S.; Monteiro, Joseph; Shaffer, Kitt

2010-01-01

Active learning exercises were developed to allow advanced medical students to revisit and review anatomy in a clinically meaningful context. In our curriculum, students learn anatomy two to three years before they participate in the radiology clerkship. These educational exercises are designed to review anatomy content while highlighting its…

A case series of interventional radiology in postpartum haemorrhage.

PubMed

Agarwal, N; Deinde, O; Willmott, F; Bojahr, H; MacCallum, P; Renfrew, I; Beski, S

2011-08-01

Postpartum haemorrhage (PPH) remains a significant cause of maternal morbidity and mortality in both developed and developing countries. In some instances, PPH can be anticipated and recent improvements in obstetric imaging techniques allow earlier and more reliable diagnosis of abnormalities associated with haemorrhage such as morbid placentation. However, the majority of PPH is unpredicted. Good practice notes published by the Royal College of Obstetricians and Gynaecologists state interventional radiology should be used as emergency intervention in PPH and should be considered when primary management has failed allowing arteries to be embolised to achieve haemostasis. Through collaboration between interventional radiology and maternity, appropriate guidelines need to be developed, on both emergency and elective of interventional radiology in the prevention and management of PPH. As there is mapping for neonatal services, in the future there should be consideration to develop obstetric trauma units. Maternity units which lack facilities for interventional radiology would be able to refer their cases (like placenta accreta) for safe management in units with 24 h interventional radiology services.

Radiation in medicine: Origins, risks and aspirations

PubMed Central

Donya, Mohamed; Radford, Mark; ElGuindy, Ahmed; Firmin, David; Yacoub, Magdi H.

2014-01-01

The use of radiation in medicine is now pervasive and routine. From their crude beginnings 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy have all evolved into advanced techniques, and are regarded as essential tools across all branches and specialties of medicine. The inherent properties of ionizing radiation provide many benefits, but can also cause potential harm. Its use within medical practice thus involves an informed judgment regarding the risk/benefit ratio. This judgment requires not only medical knowledge, but also an understanding of radiation itself. This work provides a global perspective on radiation risks, exposure and mitigation strategies. PMID:25780797

Radiation in medicine: Origins, risks and aspirations.

PubMed

Donya, Mohamed; Radford, Mark; ElGuindy, Ahmed; Firmin, David; Yacoub, Magdi H

2014-01-01

The use of radiation in medicine is now pervasive and routine. From their crude beginnings 100 years ago, diagnostic radiology, nuclear medicine and radiation therapy have all evolved into advanced techniques, and are regarded as essential tools across all branches and specialties of medicine. The inherent properties of ionizing radiation provide many benefits, but can also cause potential harm. Its use within medical practice thus involves an informed judgment regarding the risk/benefit ratio. This judgment requires not only medical knowledge, but also an understanding of radiation itself. This work provides a global perspective on radiation risks, exposure and mitigation strategies.

Impact of Patient Protection and Affordable Care Act on academic radiology departments' clinical, research, and education missions.

PubMed

Mansoori, Bahar; Vidal, Lorenna L; Applegate, Kimberly; Rawson, James V; Novak, Ronald D; Ros, Pablo R

2013-10-01

The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment. Copyright © 2013. Published by Elsevier Inc.

Feminist theoretical perspectives on ethics in radiology.

PubMed

Condren, Mary

2009-07-01

The substantive safety of radiological and other medical procedures can be radically reduced by unconscious factors governing scientific thought. In addition, the historical exclusion of women from these disciplines has possibly skewed their development in directions that now need to be addressed. This paper focuses on three such factors: gendered libidos that privilege risk taking over prevention, fragmented forms of knowledge that encourage displaced forms of responsibility and group dynamics that discourage critique of accepted practices and limit the definition of one's group. The substantive safety of the practice and scientific contribution of radiologists might be considerably enhanced were the focus to switch from radiology to diagnosis. Such enlargement might redefine the brief of radiologists towards preventing as well as curing; evaluating some non-invasive and low-tech options, adopting some inclusive paradigms of clinical ecology and enlarging group identities to include those currently excluded through geography or social class from participating in the benefits of science.

ACR-SPR-STR Practice Parameter for the Performance of Cardiac Positron Emission Tomography - Computed Tomography (PET/CT) Imaging.

PubMed

Subramaniam, Rathan M; Janowitz, Warren R; Johnson, Geoffrey B; Lodge, Martin A; Parisi, Marguerite T; Ferguson, Mark R; Hellinger, Jeffrey C; Gladish, Gregory W; Gupta, Narainder K

2017-12-01

This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death. Optimum utility of cardiac PET/CT is achieved when images are interpreted in conjunction with clinical information and laboratory data. Measurement of myocardial blood flow, coronary flow reserve and detection of balanced ischemia are significant advantages of cardiac PET perfusion studies. Increasingly cardiac PET/CT is used in diagnosis and treatment response assessment for cardiac sarcoidosis.

[Digital radiography in young children. Considerations based on experiences in practice].

PubMed

Berkhout, W E R; Mileman, P A; Weerheijm, K L

2004-10-01

In dentistry, digital radiology techniques, such as a charge-coupled device and a storage phosphor plate, are gaining popularity. It was the objective of this study to assess the importance of the advantages and disadvantages of digital radiology techniques for bitewing radiography in young children, when compared to conventional film. A group of dentists received a questionnaire regarding their experiences with digital radiology techniques or conventional films among young children. Using the Simple Multi-Attributive Rating Technique (SMART) a final weighted score was calculated for the charge-coupled device, the phosphor plate, and conventional film. The scores were 7.40, 7.38, and 6.98 respectively. The differences were not statistically significant (p > 0.47). It could be concluded that, on the basis of experiences in practice, there are no statistically significant preferences for the use of digital radioogy techniques for bitewing radiography in young children.

Radiology Exposure in the Undergraduate Curriculum: A Medical Student Perspective on Quality and Opportunities for Positive Change.

PubMed

Visscher, Kari L; Faden, Lisa; Nassrallah, Georges; Speer, Stacey; Wiseman, Daniele

2017-08-01

This article is a continuation of a qualitative study designed to explore how radiology exposures can impact medical student opinions and perceptions of radiology and radiologists. We focused on: 1) conducting a radiology exposure inventory from the perspective of the medical student; 2) student evaluation of the quality of the radiology exposures and suggestions for positive change; and 3) development of a framework to address the needs of medical students as it relates to radiology education in the undergraduate medical curriculum. Research methodology and design for this qualitative study were described in detail in a previous article by Visscher et al [1]. Participants included 28 medical students; 18 were in medical school years 1 and 2 (preclerkship), and 10 were in years 3 and 4 (clerkship). Specific to the focus of this article, the data revealed 3 major findings: 1) multiple exposures to radiology exist, and they are received and valued differently depending on the medical student's stage of professional development; 2) medical students value radiology education and want their radiology exposure to be comprehensive and high quality; 3) Medical students have constructive suggestions for improving the quality of both formal and informal radiology exposures. Performing a radiology exposure inventory from a medical student perspective is a useful way to explore how students receive and value radiology instruction. Medical students want a more comprehensive radiology education that can be summarized using the 5 C's of Radiology Education framework. The 5 C's (curriculum, coaching, collaborating, career and commitment) reflect medical students' desires to learn content that will support them in clinical practice, be supported in their professional development, and have the necessary information to make informed career decisions. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Personalized Oncology in Interventional Radiology

PubMed Central

Abi-Jaoudeh, Nadine; Duffy, Austin G.; Greten, Tim F.; Kohn, Elise C.; Clark, Timothy W.I.; Wood, Bradford J.

2013-01-01

As personalized medicine becomes more applicable to oncologic practice, image-guided biopsies will be integral for enabling predictive and pharmacodynamic molecular pathology. Interventional radiology has a key role in defining patient-specific management. Advances in diagnostic techniques, genomics, and proteomics enable a window into subcellular mechanisms driving hyperproliferation, metastatic capabilities, and tumor angiogenesis. A new era of personalized medicine has evolved whereby clinical decisions are adjusted according to a patient’s molecular profile. Several mutations and key markers already have been introduced into standard oncologic practice. A broader understanding of personalized oncology will help interventionalists play a greater role in therapy selection and discovery. PMID:23885909

MO-DE-204-01: Radiation Doses in Over 50 Developing Countries of Asia, Africa, Eastern European and Latin America

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rehani, M.

2016-06-15

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented.more » Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.« less

MO-DE-204-02: Optimization of the Patient CT Dose in Europe

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tsapaki, V.

2016-06-15

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented.more » Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kofler, J.

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions. A multi-national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management. An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented.more » Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown. Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented. In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts. Learning Objectives: Understand importance of the dose optimization in Diagnostic Radiology. See how this goal is achieved in different regions of the World. Learn about the global trend in the dose optimization and future prospectives. M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization.« less

Core curriculum for medical physicists in radiology. Recommendations from an EFOMP/ESR working group.

PubMed

Geleijns, Jacob; Breatnach, Eamann; Cantera, Alfonso Calzado; Damilakis, John; Dendy, Philip; Evans, Anthony; Faulkner, Keith; Padovani, Renato; Van Der Putten, Wil; Schad, Lothar; Wirestam, Ronnie; Eudaldo, Teresa

2012-06-01

Some years ago it was decided that a European curriculum should be developed for medical physicists professionally engaged in the support of clinical diagnostic imaging departments. With this in mind, EFOMP (European Federation of Organisations for Medical Physics) in association with ESR (European Society of Radiology) nominated an expert working group. This curriculum is now to hand. The curriculum is intended to promote best patient care in radiology departments through the harmonization of education and training of medical physicists to a high standard in diagnostic radiology. It is recommended that a medical physicist working in a radiology department should have an advanced level of professional expertise in X-ray imaging, and additionally, depending on local availability, should acquire knowledge and competencies in overseeing ultrasound imaging, nuclear medicine, and MRI technology. By demonstrating training to a standardized curriculum, medical physicists throughout Europe will enhance their mobility, while maintaining local high standards of medical physics expertise. This document also provides the basis for improved implementation of articles in the European medical exposure directives related to the medical physics expert. The curriculum is divided into three main sections: The first deals with general competencies in the principles of medical physics. The second section describes specific knowledge and skills required for a medical physicist (medical physics expert) to operate clinically in a department of diagnostic radiology. The final section outlines research skills that are also considered to be necessary and appropriate competencies in a career as medical physicist.

Gun Shot Wound to the Chest of a Military Working Dog

DTIC Science & Technology

2009-06-01

special care ought to be taken when either human or dog is on isolation precautions. Also, animals without airway compromise should be muzzled , as...Gun Shot Wound to Chest of Military Working Dog Military Medicine Radiology Corner, Volume 174, June, 2009 Radiology Corner Gun Shot Wound to...the Chest of a Military Working Dog Guarantor: 2LT Meghan Galer, MSC, USA1 Contributors: 2LT Meghan Galer, MSC, USA1; Donna Magid, MD, MEd2; Les

Software tools for interactive instruction in radiologic anatomy.

PubMed

Alvarez, Antonio; Gold, Garry E; Tobin, Brian; Desser, Terry S

2006-04-01

To promote active learning in an introductory Radiologic Anatomy course through the use of computer-based exercises. DICOM datasets from our hospital PACS system were transferred to a networked cluster of desktop computers in a medical school classroom. Medical students in the Radiologic Anatomy course were divided into four small groups and assigned to work on a clinical case for 45 minutes. The groups used iPACS viewer software, a free DICOM viewer, to view images and annotate anatomic structures. The classroom instructor monitored and displayed each group's work sequentially on the master screen by running SynchronEyes, a software tool for controlling PC desktops remotely. Students were able to execute the assigned tasks using the iPACS software with minimal oversight or instruction. Course instructors displayed each group's work on the main display screen of the classroom as the students presented the rationale for their decisions. The interactive component of the course received high ratings from the students and overall course ratings were higher than in prior years when the course was given solely in lecture format. DICOM viewing software is an excellent tool for enabling students to learn radiologic anatomy from real-life clinical datasets. Interactive exercises performed in groups can be powerful tools for stimulating students to learn radiologic anatomy.

Physical and cognitive task analysis in interventional radiology.

PubMed

Johnson, S; Healey, A; Evans, J; Murphy, M; Crawshaw, M; Gould, D

2006-01-01

To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model.

Educational Technology Network: a computer conferencing system dedicated to applications of computers in radiology practice, research, and education.

PubMed

D'Alessandro, M P; Ackerman, M J; Sparks, S M

1993-11-01

Educational Technology Network (ET Net) is a free, easy to use, on-line computer conferencing system organized and funded by the National Library of Medicine that is accessible via the SprintNet (SprintNet, Reston, VA) and Internet (Merit, Ann Arbor, MI) computer networks. It is dedicated to helping bring together, in a single continuously running electronic forum, developers and users of computer applications in the health sciences, including radiology. ET Net uses the Caucus computer conferencing software (Camber-Roth, Troy, NY) running on a microcomputer. This microcomputer is located in the National Library of Medicine's Lister Hill National Center for Biomedical Communications and is directly connected to the SprintNet and the Internet networks. The advanced computer conferencing software of ET Net allows individuals who are separated in space and time to unite electronically to participate, at any time, in interactive discussions on applications of computers in radiology. A computer conferencing system such as ET Net allows radiologists to maintain contact with colleagues on a regular basis when they are not physically together. Topics of discussion on ET Net encompass all applications of computers in radiological practice, research, and education. ET Net has been in successful operation for 3 years and has a promising future aiding radiologists in the exchange of information pertaining to applications of computers in radiology.

PearlTrees web-based interface for teaching informatics in the radiology residency

NASA Astrophysics Data System (ADS)

Licurse, Mindy Y.; Cook, Tessa S.

2014-03-01

Radiology and imaging informatics education have rapidly evolved over the past few decades. With the increasing recognition that future growth and maintenance of radiology practices will rely heavily on radiologists with fundamentally sound informatics skills, the onus falls on radiology residency programs to properly implement and execute an informatics curriculum. In addition, the American Board of Radiology may choose to include even more informatics on the new board examinations. However, the resources available for didactic teaching and guidance most especially at the introductory level are widespread and varied. Given the breadth of informatics, a centralized web-based interface designed to serve as an adjunct to standardized informatics curriculums as well as a stand-alone for other interested audiences is desirable. We present the development of a curriculum using PearlTrees, an existing web-interface based on the concept of a visual interest graph that allows users to collect, organize, and share any URL they find online as well as to upload photos and other documents. For our purpose, the group of "pearls" includes informatics concepts linked by appropriate hierarchal relationships. The curriculum was developed using a combination of our institution's current informatics fellowship curriculum, the Practical Imaging Informatics textbook1 and other useful online resources. After development of the initial interface and curriculum has been publicized, we anticipate that involvement by the informatics community will help promote collaborations and foster mentorships at all career levels.

Pre-surgical road map for thyroid cancer and large goiters: Practical benefits of detailed radiological evaluation by surgeon.

PubMed

Panchangam, Ramakanth Bhargav; Guntupalli, Satyam; Seetharamaiah, Thotakura; Kumbhar, Uday Shamrao

2015-01-01

Pre-surgical radiological evaluation of neck is often mandatory for surgical planning in high risk thyroid cancer and large goiters. Frequently, surgeons are overdependent on radiologist's report. In this context, we analysed the practical benefits of surgeon's independent radiological evaluation in our institutional experience. This prospective study was conducted in Endocrine Surgery department of a teaching hospital in South India. Cases operated between January 2011 and June 2012 (18 months) were included. Films of cross-sectional imaging were read in detail by primary and assistant surgeons in correlation with stepwise operative planning and documented. Cases with additional radiological signs on surgeon's evaluation, which were missing in radiologist's report are discussed in detail. F: M ratio is 67:24. Mean age was 45.3 ± 9.8 years (37 - 76). Forty-seven cases of thyroid cancer and 44 cases of large goiters were analysed. Surgeon read additional signs such as obliterated fat plane between goiter and subcutaneous plane; level I lymph nodes; bilateral cervical lymphadenopathy, internal jugular vein thrombus, and pharyngeal invasion helped in pre-operatively planned modification of operative steps for optimal R0 resection and total thyroidectomy. A mean of 1.42 ± 0.83 (1 - 6), additional signs were detected on surgeon's radiological evaluation compared to radiologist's report in 41.7% of cases. These findings modified the pre-operative plan, facilitating better surgical outcome in 28.6% of cases. In high-risk thyroid cancer and large goiters, detailed radiological evaluation by surgeon facilitates optimal surgical resection and superior outcome compared to radiologist report-guided surgery.

Findings in 2002 from a help wanted index of job advertisements: is the job-market shortage of diagnostic radiologists easing?

PubMed

Saketkhoo, Daniel D; Sunshine, Jonathan H; Covey, Anne M; Forman, Howard P

2003-08-01

The goal of this study is to present the most recent data on the diagnostic radiology job market in the United States using a help wanted index of job advertisements. All diagnostic radiology positions advertised in the American Journal of Roentgenology and Radiology from January through December 2002 were coded by practice type, geographic location, and subspecialty. Data were compared with the previously published results from 1991 through 2001. From January through December 2002, 5117 positions were advertised for diagnostic radiologists, representing a 10.4% decrease from 2001. The 12-month rolling average of job advertisements peaked at 488 in February 2002 and dropped to 432 by December 2002, a level not seen since August 2000. In 2002, 42.7% of positions advertised were academic, representing a steady increase from 34.0% in 1999. When comparing the 4-year periods 1999-2002 and 1995-1998, a statistically significant proportional increase was found for positions advertised in the Midwest. Statistically significant relative increases were also observed for the subspecialties of abdominal radiology, mammography, neuroradiology, pediatric radiology, chest radiology, and nuclear medicine. Statistically significant relative decreases were seen in general and vascular and interventional positions. The absolute demand for diagnostic radiologists nationwide appears to have stabilized during 2002, albeit at a level much higher than in previous years, and may be decreasing. A split seems to have appeared in the market between academia and private practice. Current policy should be directed toward increasing the supply of diagnostic radiologists, especially academicians.

Practical Implications for an Effective Radiology Residency Quality Improvement Program for Milestone Assessment.

PubMed

Leddy, Rebecca; Lewis, Madelene; Ackerman, Susan; Hill, Jeanne; Thacker, Paul; Matheus, Maria; Tipnis, Sameer; Gordon, Leonie

2017-01-01

Utilization of a radiology resident-specific quality improvement (QI) program and curriculum based on the Accreditation Council for Graduate Medical Education (ACGME) milestones can enable a program's assessment of the systems-based practice component and prepare residents for QI implementation post graduation. This article outlines the development process, curriculum, QI committee formation, and resident QI project requirements of one institution's designated radiology resident QI program. A method of mapping the curriculum to the ACGME milestones and assessment of resident competence by postgraduate year level is provided. Sample projects, challenges to success, and lessons learned are also described. Survey data of current trainees and alumni about the program reveal that the majority of residents and alumni responders valued the QI curriculum and felt comfortable with principles and understanding of QI. The most highly valued aspect of the program was the utilization of a resident education committee. The majority of alumni responders felt the residency quality curriculum improved understanding of QI, assisted with preparation for the American Board of Radiology examination, and prepared them for QI in their careers. In addition to the survey results, outcomes of resident project completion and resident scholarly activity in QI are evidence of the success of this program. It is hoped that this description of our experiences with a radiology resident QI program, in accordance with the ACGME milestones, may facilitate the development of successful QI programs in other diagnostic radiology residencies. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

The Radiologist Is in, but Was it Worth the Wait? Radiology Resident Note Quality in an Outpatient Interventional Radiology Clinic.

PubMed

Abboud, Salim E; Soriano, Stephanie; Abboud, Rayan; Patel, Indravadan; Davidson, Jon; Azar, Nami R; Nakamoto, Dean A

Preprocedural evaluation of patients in an interventional radiology (IR) clinic is a complex synthesis of physical examination and imaging findings, and as IR transitions to an independent clinical specialty, such evaluations will become an increasingly critical component of a successful IR practice and quality patient care. Prior research suggests that preprocedural evaluations increased patient's perceived quality of care and may improve procedural technical success rates. Appropriate documentation of a preprocedural evaluation in the medical record is also paramount for an interventional radiologist to add value and function as an effective member of a larger IR service and multidisciplinary health care team. The purpose of this study is to examine the quality of radiology resident notes for patients seen in an outpatient IR clinic at a single academic medical center before and after the adoption of clinic note template with reminders to include platelet count, international normalized ratio, glomerular filtration rate, and plan for periprocedural coagulation status. Before adoption of the template, platelet count, international normalized ratio, glomerular filtration rate and an appropriate plan for periprocedural coagulation status were documented in 72%, 82%, 42%, and 33% of patients, respectively. After adoption of the template, appropriate documentation of platelet count, international normalized ratio, and glomerular filtration rate increased to 96%, and appropriate plan for periprocedural coagulation status was documented in 83% of patients. Patient evaluation and clinical documentation skills may not be adequately practiced during radiology residency, and tools such as templates may help increase documentation quality by radiology residents. Copyright © 2017 Elsevier Inc. All rights reserved.

A Vertically Integrated Online Radiology Curriculum Developed as a Cognitive Apprenticeship: Impact on Student Performance and Learning.

PubMed

Lim-Dunham, Jennifer E; Ensminger, David C; McNulty, John A; Hoyt, Amy E; Chandrasekhar, Arcot J

2016-02-01

The principles of Collins' cognitive apprenticeship model were used to design a radiology curriculum in which medical students practice radiological skills using online case-based modules. The modules are embedded within clinical third-year clerkships, and students are provided with personalized feedback from the instructors. We describe the development of the vertical online radiology curriculum and evaluate its impact on student achievement and learning process using a mixed method approach. The curriculum was developed over a 2-year period. Student participation was voluntary in the first year and mandatory in the second year. For quantitative curriculum evaluation, student metrics for voluntary versus mandatory groups were assessed using independent sample t tests and variable entry method regression analysis. For qualitative analysis, responses from a survey of students about the value of the curriculum were organized into defined themes using consensus coding. Mandatory participation significantly improved (p = .001) the mean radiology examination score (82 %) compared to the voluntary group (73%), suggesting that mandatory participation had a beneficial effect on student performance. Potential preexisting differences in underlying general academic performance were accounted for by including mean basic science grades as the first variable in the regression model. The significant increase in R(2) from .16 to .28 when number of radiology cases completed was added to the original model, and the greater value of the standardized beta for this variable, suggest that the curriculum made a significant contribution to students' radiology examination scores beyond their baseline academic performance. Five dominant themes about curricular characteristics that enhanced student learning and beneficial outcomes emerged from consensus coding. These themes were (1) self-paced design, (2) receiving feedback from faculty, (3) clinical relevance of cases, (4) gaining confidence in interpreting radiological images, and (5) transfer of conceptual knowledge to actual practice. The vertically integrated online radiology curriculum can positively impact student performance and learning process in the context of the cognitive apprenticeship model. Copyright © 2015 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Leadership and management in quality radiology

PubMed Central

2007-01-01

The practice of medical imaging and interventional radiology are undergoing rapid change in recent years due to technological advances, workload escalation, workforce shortage, globalisation, corporatisation, commercialisation and commoditisation of healthcare. These professional and economical changes are challenging the established norm but may bring new opportunities. There is an increasing awareness of and interest in the quality of care and patient safety in medical imaging and interventional radiology. Among the professional organisations, a range of quality systems are available to address individual, facility and system needs. To manage the limited resources successfully, radiologists and professional organisations must be leaders and champion for the cause of quality care and patient safety. Close collaboration with other stakeholders towards the development and management of proactive, long-term, system-based strategies and infrastructures will underpin a sustainable future in quality radiology. The International Radiology Quality Network can play a useful facilitating role in this worthwhile but challenging endeavour. PMID:21614284

Telemedicine and pediatric radiology: a new environment for training, learning, and interactive discussions.

PubMed

Monteiro, Alexandra M V; Corrêa, Diogo Goulart; Santos, Alair Augusto Sarmet M D; Cavalcanti, Silvio A; Sakuno, Telma; Filgueiras, Tereza; Just, Eduardo; Santos, Munique; Messina, Luiz Ary; Haddad, Ana Estela; Marchiori, Edson

2011-12-01

To report the experience of the Brazilian Program of Pediatric Teleradiology in combining teleconferencing and a virtual learning environment for services integration, collaborative research, and continuing education in pediatric radiology. We performed virtual meetings from March 2005 to October 2010 on pediatric radiology-related themes, using a combination of videoconferences and Web conferences, which were recorded and made available in an open-source software (Moodle) for reuse. We performed 58 virtual sessions: 29 anatomical-clinical-radiological sessions, 28 on upgrading themes, and 1 virtual symposium. The average of connected points was 12 by videoconference and 39 by Web conference, and of 450 participants per event. At the time of this writing, 318 physicians and students are registered in the virtual learning environment, with a total of 14,678 accesses. Telemedicine is being included in pediatric radiology practice, as a means for distance education, training, and continuing integration between groups.

Proceedings from the first Global Summit on Radiological Quality and Safety.

PubMed

Stern, Eric J; Adam, E Jane; Bettman, Michael A; Brink, James A; Dreyer, Keith J; Frija, Guy; Keefer, Raina; Mildenberger, Peter; Remedios, Denis; Vock, Peter

2014-10-01

The ACR, the European Society of Radiology, and the International Society of Radiology held the first joint Global Summit on Radiological Quality and Safety in May 2013. The program was divided into 3 day-long themes: appropriateness of imaging, radiation protection/infrastructure, and quality and safety. Participants came from global organizations, including the International Atomic Energy Agency, the World Health Organization, and other institutions; industry and patient advocacy groups with an interest in imaging were also represented. The goal was to exchange ideas and solutions and share concerns to arrive at a better and more uniform approach to quality and safety. Participants were asked to use the information presented to develop strategies and tactics to harmonize and promote best practices worldwide. These strategies were summarized at the conclusion of the meeting. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology Architecture Project Primer.

PubMed

Sze, Raymond W; Hogan, Laurie; Teshima, Satoshi; Davidson, Scott

2017-12-19

The rapid pace of technologic advancement and increasing expectations for patient- and family-friendly environments make it common for radiology leaders to be involved in imaging remodel and construction projects. Most radiologists and business directors lack formal training in architectural and construction processes but are expected to play significant and often leading roles in all phases of an imaging construction project. Avoidable mistakes can result in significant increased costs and scheduling delays; knowledgeable participation and communication can result in a final product that enhances staff workflow and morale and improves patient care and experience. This article presents practical guidelines for preparing for and leading a new imaging architectural and construction project. We share principles derived from the radiology and nonradiology literature and our own experience over the past decade completely remodeling a large pediatric radiology department and building a full-service outpatient imaging center. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Practice Variation and Effects of E-mail-only Performance Feedback on Resource Use in the Emergency Department.

PubMed

Tavarez, Melissa M; Ayers, Brandon; Jeong, Jong H; Coombs, Carmen M; Thompson, Ann; Hickey, Robert W

2017-08-01

Higher resource utilization in the management of pediatric patients with undifferentiated vomiting and/or diarrhea does not correlate consistently with improved outcomes or quality of care. Performance feedback has been shown to change physician practice behavior and may be a mechanism to minimize practice variation. We aimed to evaluate the effects of e-mail-only, provider-level performance feedback on the ordering and admission practice variation of pediatric emergency physicians for patients presenting with undifferentiated vomiting and/or diarrhea. We conducted a prospective, quality improvement intervention and collected data over 3 consecutive fiscal years. The setting was a single, tertiary care pediatric emergency department. We collected admission and ordering practices data on 19 physicians during baseline, intervention, and postintervention periods. We provided physicians with quarterly e-mail-based performance reports during the intervention phase. We measured admission rate and created four categories for ordering practices: no orders, laboratory orders, pharmacy orders, and radiology orders. There was wide (two- to threefold) practice variation among physicians. Admission rates ranged from 15% to 30%, laboratory orders from 19% to 43%, pharmacy orders from 29% to 57%, and radiology orders from 11% to 30%. There was no statistically significant difference in the proportion of patients admitted or with radiology or pharmacy orders placed between preintervention, intervention, or postintervention periods (p = 0.58, p = 0.19, and p = 0.75, respectively). There was a significant but very small decrease in laboratory orders between the preintervention and postintervention periods. Performance feedback provided only via e-mail to pediatric emergency physicians on a quarterly basis does not seem to significantly impact management practices for patients with undifferentiated vomiting and/or diarrhea. © 2017 by the Society for Academic Emergency Medicine.

MO-C-BRB-03: RSNA President [Diagnostic radiology and radiation oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Arenson, R.

Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, andmore » the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.« less

MO-C-BRB-01: Introduction [Diagnostic radiology and radiation oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boone, J.

Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, andmore » the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.« less

MO-C-BRB-02: ASTRO President [Diagnostic radiology and radiation oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Minsky, B.

Diagnostic radiology and radiation oncology are arguably two of the most technologically advanced specialties in medicine. The imaging and radiation medicine technologies in clinical use today have been continuously improved through new advances made in the commercial and academic research arenas. This symposium explores the translational path from research through clinical implementation. Dr. Pettigrew will start this discussion by sharing his perspectives as director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). The NIBIB has focused on promoting research that is technological in nature and has high clinical impact. We are in the age of precision medicine, andmore » the technological innovations and quantitative tools developed by engineers and physicists working with physicians are providing innovative tools that increase precision and improve outcomes in health care. NIBIB funded grants lead to a very high patenting rate (per grant dollar), and these patents have higher citation rates by other patents, suggesting greater clinical impact, as well. Two examples of clinical translation resulting from NIH-funded research will be presented, in radiation therapy and diagnostic imaging. Dr. Yu will describe a stereotactic radiotherapy device developed in his laboratory that is designed for treating breast cancer with the patient in the prone position. It uses 36 rotating Cobalt-60 sources positioned in an annular geometry to focus the radiation beam at the system’s isocenter. The radiation dose is delivered throughout the target volume in the breast by constantly moving the patient in a planned trajectory relative to the fixed isocenter. With this technique, the focal spot dynamically paints the dose distribution throughout the target volume in three dimensions. Dr. Jackson will conclude this symposium by describing the RSNA Quantitative Imaging Biomarkers Alliance (QIBA), which is funded in part by NIBIB and is a synergistic collaboration between medical physicists, radiologists, oncologists, industry representatives, and other stakeholders. The mission of QIBA is to improve the accuracy and practicality of quantitative image-based biomarkers by increasing precision across devices, patients, and time, an essential step in incorporating quantitative imaging biomarkers into radiology practice. Validated quantitative imaging biomarkers are necessary to support precision medicine initiatives, multimodality / multiparametric applications in medicine, treatment planning and response assessment, and radiogenomics applications. Current applications in the QIBA portfolio extend to cancer diagnosis and treatment, pulmonary diseases, and neurological disorders. The overall goal of this symposium is to illustrate the bidirectional exchange between medical research and clinical practice. Revitalizing scientific excellence in clinical medical physics challenges practitioners to identify clinical limitations, which then drive research innovation; research funded by the NIH and other agencies develops technological solutions to these limitations, which are translated to the care environment to ultimately improve clinical practice in radiology and radiation oncology.« less

Stress management for the radiologic technologist.

PubMed

Romano, Jeannine M

2012-01-01

Changes in technology in the radiology department and an emphasis on multitasking can lead to stress and burnout, along with the potential for medical errors. A shift in viewpoint and exercises in self-evaluation can help radiologic technologists learn to manage change in a positive manner. Learning to approach change through a series of transitions and positive steps can reduce stress at work and at home.

Radiologists' preferences for just-in-time learning.

PubMed

Kahn, Charles E; Ehlers, Kevin C; Wood, Beverly P

2006-09-01

Effective learning can occur at the point of care, when opportunities arise to acquire information and apply it to a clinical problem. To assess interest in point-of-care learning, we conducted a survey to explore radiologists' attitudes and preferences regarding the use of just-in-time learning (JITL) in radiology. Following Institutional Review Board approval, we invited 104 current radiology residents and 86 radiologists in practice to participate in a 12-item Internet-based survey to assess their attitudes toward just-in-time learning. Voluntary participation in the survey was solicited by e-mail; respondents completed the survey on a web-based form. Seventy-nine physicians completed the questionnaire, including 47 radiology residents and 32 radiologists in practice; the overall response rate was 42%. Respondents generally expressed a strong interest for JITL: 96% indicated a willingness to try such a system, and 38% indicated that they definitely would use a JITL system. They expressed a preference for learning interventions of 5-10 min in length. Current and recent radiology trainees have expressed a strong interest in just-in-time learning. The information from this survey should be useful in pursuing the design of learning interventions and systems for delivering just-in-time learning to radiologists.

Radiology 24/7 In-House Attending Coverage: Do Benefits Outweigh Cost?

PubMed

Coleman, Stephanie; Holalkere, Nagaraj Setty; O׳Malley, Julie; Doherty, Gemma; Norbash, Alexander; Kadom, Nadja

2016-01-01

Many radiology practices, including academic centers, are moving to in-house 24/7 attending coverage. This could be costly and may not be easily accepted by radiology trainees and attending radiologists. In this article, we evaluated the effects of 24/7 in-house attending coverage on patient care, costs, and qualitative aspects such as trainee education. We retrospectively collected report turnaround times (TAT) and work relative value units (wRVU). We compared these parameters between the years before and after the implementation of 24/7 in-house attending coverage. The cost to provide additional attending coverage was estimated from departmental financial reports. A qualitative survey of radiology residents and faculty was performed to study perceived effects on trainee education. There were decreases in report TAT following 24/7 attending implementation: 69% reduction in computed tomography, 43% reduction in diagnostic radiography, 7% reduction in magnetic resonance imaging, and 43% reduction in ultrasound. There was an average daytime wRVU decrease of 9%, although this was compounded by a decrease in total RVUs of the 2013 calendar year. The financial investment by the institution was estimated at $850,000. Qualitative data demonstrated overall positive feedback from trainees and faculty in radiology, although loss of independence was reported as a negative effect. TAT and wRVU metrics changed with implementation of 24/7 attending coverage, although these metrics do not directly relate to patient outcomes. Additional clinical benefits may include fewer discrepancies between preliminary and final reports that may improve emergency and inpatient department workflows and liability exposure. Radiologists reported the impression that clinicians appreciated 24/7 in-house attending coverage, particularly surgical specialists. Loss of trainee independence on call was a perceived disadvantage of 24/7 attending coverage and raised a concern that residency education outcomes could be adversely affected. Copyright © 2016 Elsevier Inc. All rights reserved.

IT infrastructure in the era of imaging 3.0.

PubMed

McGinty, Geraldine B; Allen, Bibb; Geis, J Raymond; Wald, Christoph

2014-12-01

Imaging 3.0 is a blueprint for the future of radiology modeled after the description of Web 3.0 as "more connected, more open, and more intelligent." Imaging 3.0 involves radiologists' using their expertise to manage all aspects of imaging care to improve patient safety and outcomes and to deliver high-value care. IT tools are critical elements and drivers of success as radiologists embrace the concepts of Imaging 3.0. Organized radiology, specifically the ACR, is the natural convener and resource for the development of this Imaging 3.0 toolkit. The ACR's new Imaging 3.0 Informatics Committee is actively working to develop the informatics tools radiologists need to improve efficiency, deliver more value, and provide quantitative ways to demonstrate their value in new health care delivery and payment systems. This article takes each step of the process of delivering high-value Imaging 3.0 care and outlines the tools available as well as additional resources available to support practicing radiologists. From the moment when imaging is considered through the delivery of a meaningful and actionable report that is communicated to the referring clinician and, when appropriate, to the patient, Imaging 3.0 IT tools will enable radiologists to position themselves as vital constituents in cost-effective, high-value health care. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Professional efficiencies for diagnostic imaging services rendered by different physicians: analysis of recent medicare multiple procedure payment reduction policy.

PubMed

Duszak, Richard; Silva, Ezequiel; Kim, Angela J; Barr, Robert M; Donovan, William D; Kassing, Pamela; McGinty, Geraldine; Allen, Bibb

2013-09-01

The aim of this study was to quantify potential physician work efficiencies and appropriate multiple procedure payment reductions for different same-session diagnostic imaging studies interpreted by different physicians in the same group practice. Medicare Resource-Based Relative Value Scale data were analyzed to determine the relative contributions of various preservice, intraservice, and postservice physician diagnostic imaging work activities. An expert panel quantified potential duplications in professional work activities when separate examinations were performed during the same session by different physicians within the same group practice. Maximum potential work duplications for various imaging modalities were calculated and compared with those used as the basis of CMS payment policy. No potential intraservice work duplication was identified when different examination interpretations were rendered by different physicians in the same group practice. When multiple interpretations within the same modality were rendered by different physicians, maximum potential duplicated preservice and postservice activities ranged from 5% (radiography, fluoroscopy, and nuclear medicine) to 13.6% (CT). Maximum mean potential duplicated work relative value units ranged from 0.0049 (radiography and fluoroscopy) to 0.0413 (CT). This equates to overall potential total work reductions ranging from 1.39% (nuclear medicine) to 2.73% (CT). Across all modalities, this corresponds to maximum Medicare professional component physician fee reductions of 1.23 ± 0.38% (range, 0.95%-1.87%) for services within the same modality, much less than an order of magnitude smaller than those implemented by CMS. For services from different modalities, potential duplications were too small to quantify. Although potential efficiencies exist in physician preservice and postservice work when same-session, same-modality imaging services are rendered by different physicians in the same group practice, these are relatively minuscule and have been grossly overestimated by current CMS payment policy. Greater transparency and methodologic rigor in government payment policy development are warranted. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A presentation system for just-in-time learning in radiology.

PubMed

Kahn, Charles E; Santos, Amadeu; Thao, Cheng; Rock, Jayson J; Nagy, Paul G; Ehlers, Kevin C

2007-03-01

There is growing interest in bringing medical educational materials to the point of care. We sought to develop a system for just-in-time learning in radiology. A database of 34 learning modules was derived from previously published journal articles. Learning objectives were specified for each module, and multiple-choice test items were created. A web-based system-called TEMPO-was developed to allow radiologists to select and view the learning modules. Web services were used to exchange clinical context information between TEMPO and the simulated radiology work station. Preliminary evaluation was conducted using the System Usability Scale (SUS) questionnaire. TEMPO identified learning modules that were relevant to the age, sex, imaging modality, and body part or organ system of the patient being viewed by the radiologist on the simulated clinical work station. Users expressed a high degree of satisfaction with the system's design and user interface. TEMPO enables just-in-time learning in radiology, and can be extended to create a fully functional learning management system for point-of-care learning in radiology.

77 FR 71804 - Request for Notification From Industry Organizations Interested in Participating in the Selection...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

... Representatives on the Device Good Manufacturing Practice Advisory Committee AGENCY: Food and Drug Administration... Device Good Manufacturing Practice Advisory Committee (DGMPAC) in the Center for Devices and Radiological... regarding good manufacturing practices governing the methods used in, and the facilities and controls used...

Natural Language Processing in Radiology: A Systematic Review.

PubMed

Pons, Ewoud; Braun, Loes M M; Hunink, M G Myriam; Kors, Jan A

2016-05-01

Radiological reporting has generated large quantities of digital content within the electronic health record, which is potentially a valuable source of information for improving clinical care and supporting research. Although radiology reports are stored for communication and documentation of diagnostic imaging, harnessing their potential requires efficient and automated information extraction: they exist mainly as free-text clinical narrative, from which it is a major challenge to obtain structured data. Natural language processing (NLP) provides techniques that aid the conversion of text into a structured representation, and thus enables computers to derive meaning from human (ie, natural language) input. Used on radiology reports, NLP techniques enable automatic identification and extraction of information. By exploring the various purposes for their use, this review examines how radiology benefits from NLP. A systematic literature search identified 67 relevant publications describing NLP methods that support practical applications in radiology. This review takes a close look at the individual studies in terms of tasks (ie, the extracted information), the NLP methodology and tools used, and their application purpose and performance results. Additionally, limitations, future challenges, and requirements for advancing NLP in radiology will be discussed. (©) RSNA, 2016 Online supplemental material is available for this article.

An evaluation of the impact of digital imaging on radiographic practice and patient doses

NASA Astrophysics Data System (ADS)

Horrocks, J.; Violaki, K.

2015-09-01

Direct digital imaging technology was implemented in all areas in general and mobile radiology at Barts and the Royal London Hospitals in 2012. Evidence from recent radiation incident investigations indicates optimum exposure factors are not consistently selected, with the greater dynamic range of the digital detectors allowing sub-optimal practice. To investigate further patient dose data were extracted from the Radiology Information System for adult chest X-ray examinations in 2014, covering over 50,000 studies in the Trust. Chest X-ray examinations were selected as they are low dose but frequent examinations. The patient dose data were evaluated taking into account X-ray system type and detector performance measurements, and individual cases studies were used to highlight where practice can be improved.

DR AVRAM JOZEF VINAVER (1862-1915) - PIONEER OF RADIOLOGY IN SERBIA.

PubMed

Babić, Rade Radomir; Stanković Babić, Gordana

2015-01-01

Dr Abraham Joseph Vinaver (1862-1915), a Jew from Poland, was a pioneer of radiology in Serbia. He graduated from the Faculty of Medicine in Warsaw (1887), but lived and worked in abac (the Kingdom of Serbia) since 1890. Dr Abraham Joseph Vinarev - Career Development. He procured the first X-ray machine and developed radiological service in Sabac five years after the discovery of X-rays. These were the beginnings of radiology in Serbia. He introduced the application of artesian wells. Dr Abraham Joseph Vinarev - a Participant at the First Congress of Serbian Physicians and Naturalists, Belgrade 1904. "The diagnostic importance of X-rays in lung disease, especially in initial tuberculosis" and "Five Years of Treatment by X-Ray Machines" were the first works in the field of radiology in Serbia by this author. Dr Abraham Joseph Vinaver - Reserve Medical Officer in the Serbian Army. During the Balkan Wars, he was a volunteer with the rank of major engaged in military corps and he participated in the First World War as well. He died of malaria in 1915 in Gevgelija. "Dr Avram Vinaver"- Stanislav Vinarev. His dedication to work during the typhus epidemics was put into verses of a poem by his son Stanislav Vinarev. Dr Avram Vinaver Joseph was a noble man with a great heart, who selflessly sacrificed himself for the Serbian people and Serbia. He gave his contribution to the development of health services in Serbia, both in peacetime and wartime conditions. Dr Abraham Joseph Vinaver laid the foundations for today's radiology in Serbia.

Fluor Hanford ALARA Center is a D and D Resource

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waggoner, L.O.

2008-01-15

The mission at the Hanford Nuclear Reservation changed when the last reactor plant was shut down in 1989 and work was started to place all the facilities in a safe condition and begin decontamination, deactivation, decommissioning, and demolition (D and D). These facilities consisted of old shutdown reactor plants, spent fuel pools, processing facilities, and 177 underground tanks containing 53 million gallons of highly radioactive and toxic liquids and sludge. New skills were needed by the workforce to accomplish this mission. By 1995, workers were in the process of getting the facilities in a safe condition and it became obviousmore » improvements were needed in their tools, equipment and work practices. The Hanford ALARA Program looked good on paper, but did little to help contractors that were working in the field. The Radiological Control Director decided that the ALARA program needed to be upgraded and a significant improvement could be made if workers had a place they could visit that had samples of the latest technology and could talk to experienced personnel who have had success doing D and D work. Two senior health physics personnel who had many years experience in doing radiological work were chosen to obtain tools and equipment from vendors and find a location centrally located on the Hanford site. Vendors were asked to loan their latest tools and equipment for display. Most vendors responded and the Hanford ALARA Center of Technology opened on October 1, 1996. Today, the ALARA Center includes a classroom for conducting training and a mockup area with gloveboxes. Two large rooms have a containment tent, several glove bags, samples of fixatives/expandable foam, coating displays, protective clothing, heat stress technology, cutting tools, HEPA filtered vacuums, ventilation units, pumps, hydraulic wrenches, communications equipment, shears, nibblers, shrouded tooling, and several examples of innovative tools developed by the Hanford facilities. See Figures I and II. The ALARA Center staff routinely researches and tests new technology, sponsor vendor demonstrations, and redistribute tools, equipment and temporary shielding that may not be needed at one facility to another facility that needs it. The ALARA Center staff learns about new technology in several ways. This includes past radiological work experience, interaction with vendors, lessons learned, networking with other DOE sites, visits to the Hanford Technical Library, attendance at off-site conferences and ALARA Workshops. Personnel that contact the ALARA Center for assistance report positive results when they implement the tools, equipment and work practices recommended by the ALARA Center staff. This has translated to reduced exposure for workers and reduced the risk of contamination spread. For example: using a hydraulic shear on one job saved 16 Rem of exposure that would have been received if workers had used saws-all tools to cut piping in twenty-nine locations. Currently, the ALARA Center staff is emphasizing D and D techniques on size-reducing materials, decontamination techniques, use of remote tools/video equipment, capture ventilation, fixatives, using containments and how to find lessons learned. The ALARA Center staff issues a weekly report that discusses their interaction with the workforce and any new work practices, tools and equipment being used by the Hanford contractors. Distribution of this weekly report is to about 130 personnel on site and 90 personnel off site. This effectively spreads the word about ALARA throughout the DOE Complex. DOE EM-23, in conjunction with the D and D and Environmental Restoration work group of the Energy Facility Contractors Organization (EFCOG) established the Hanford ALARA Center as the D and D Hotline for companies who have questions about how D and D work is accomplished. The ALARA Center has become a resource to the nuclear industry and routinely helps contractors at other DOE Sites, power reactors, DOD sites, and sites in England, Europe and Indonesia. Other ALARA Centers are located at the Savannah River Site and Los Alamos National Lab.« less

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know—Part I: Standard Post-procedural Instructions and Follow-Up Care

DOE Office of Scientific and Technical Information (OSTI.GOV)

Taslakian, Bedros, E-mail: Bedros.Taslakian@nyumc.org; Sridhar, Divya

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part I: Standard Post-procedural Instructions and Follow-Up Care.

PubMed

Taslakian, Bedros; Sridhar, Divya

2017-04-01

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

Ethical foundations of the radiological protection system.

PubMed

Cho, K W

2016-06-01

The International Commission on Radiological Protection (ICRP) has established Task Group 94 under Committee 4 to develop a report on the ethical foundations of the system of radiological protection. The aim of this report is to consolidate the basis of ICRP recommendations, to improve understanding of the system, and to provide a basis for communication on radiation risk and its perception. Through a series of workshops organised by the Commission in cooperation with the International Radiation Protection Association and its associate societies involving radiological protection professionals and specialists of ethics around the world, Task Group 94 has identified the key ethical and social values underpinning the system of radiological protection. The purpose of eliciting the ethical principles and values of the radiological protection system is not only to clarify the rationale for recommendations made by the Commission, but also to assist in discussions related to its practical implementation. A clear understanding of the ethical principles will help resolve dilemmas caused by potential conflicts in actions that might be considered, or decisions that must be made. © The International Society for Prosthetics and Orthotics.

Knee degeneration in concrete reinforcement workers.

PubMed Central

Wickström, G; Hänninen, K; Mattsson, T; Niskanen, T; Riihimäki, H; Waris, P; Zitting, A

1983-01-01

The loads on the knees in concrete reinforcement work and maintenance painting were analysed on eight construction work sites. A total of 352 reinforcement workers and 231 painters. Finnish men aged 20-64, were clinically and radiologically examined to determine the condition of the knee joints in active workers. The loads on the knees and the occurrence of minor injuries and accidents were higher in reinforcement work than in painting, but the occurrence of symptoms, clinical signs, and radiological findings was equally common in both groups. Reinforcement work seemed to provoke more symptoms from degenerated knees than painting. PMID:6830721

Radiation Protection Knowledge, Attitude and Practice (RP-KAP) as Predictors of Job Stress Among Radiation Workers in Tehran Province, Iran

PubMed Central

Alavi, S. Shohreh; Taghizadeh Dabbagh, Sima; Abbasi, Mahya; Mehrdad, Ramin

2016-01-01

Background In recent years, much attention has been paid to occupational stress, but relatively little or no research has been conducted on the influence of knowledge, attitude, and practice of radiation protection (RP-KAP) on job stress among radiation workers Objectives This study aims to assess job stress among health care workers in Iran who are occupationally exposed to radiation in order to determine the effects of KAP on self-protection against radiation on their job stress. Materials and Methods The population in this descriptive cross-sectional study comprised 670 healthcare workers, including 428 staff with a degree in radiology and 242 other medical personnel who were working in 16 hospitals affiliated with Tehran University of Medical Sciences (TUMS) in Tehran, Iran. The census method was used to sample the workers. In total, 264 staff with a degree in radiology and 149 other medical personnel completed the job content questionnaire (JCQ) and the RP-KAP questionnaire from May to November 2014. Results The prevalence rate of job stress was 22.5% based on calculation formulas and possible scores on the JCQ. Sex, RP-knowledge, attitude, practice, and in-service training predicted 41.8% of the variance in job stress. According to the results of the binary logistic regression, workers with higher scores on knowledge (OR = 0.82, 95% CI: 0.75 - 0.90), attitude (OR = 0.71, 95% CI: 0.63 - 0.82), and practice (OR = 0.78, 95% CI: 0.72 - 0.86) and those who had participated in training programs had significantly lower rates of job stress (OR = 0.51, 95% CI: 0.28 - 0.93). Conclusions The effects of RP knowledge, attitude, and practice on job stress were significant. In order to reduce job stress in radiation environments, ongoing training programs related to self-care and protection principles are recommended. PMID:28180020

Radiation Protection Knowledge, Attitude and Practice (RP-KAP) as Predictors of Job Stress Among Radiation Workers in Tehran Province, Iran.

PubMed

Alavi, S Shohreh; Taghizadeh Dabbagh, Sima; Abbasi, Mahya; Mehrdad, Ramin

2016-10-01

In recent years, much attention has been paid to occupational stress, but relatively little or no research has been conducted on the influence of knowledge, attitude, and practice of radiation protection (RP-KAP) on job stress among radiation workers. This study aims to assess job stress among health care workers in Iran who are occupationally exposed to radiation in order to determine the effects of KAP on self-protection against radiation on their job stress. The population in this descriptive cross-sectional study comprised 670 healthcare workers, including 428 staff with a degree in radiology and 242 other medical personnel who were working in 16 hospitals affiliated with Tehran University of Medical Sciences (TUMS) in Tehran, Iran. The census method was used to sample the workers. In total, 264 staff with a degree in radiology and 149 other medical personnel completed the job content questionnaire (JCQ) and the RP-KAP questionnaire from May to November 2014. The prevalence rate of job stress was 22.5% based on calculation formulas and possible scores on the JCQ. Sex, RP-knowledge, attitude, practice, and in-service training predicted 41.8% of the variance in job stress. According to the results of the binary logistic regression, workers with higher scores on knowledge (OR = 0.82, 95% CI: 0.75 - 0.90), attitude (OR = 0.71, 95% CI: 0.63 - 0.82), and practice (OR = 0.78, 95% CI: 0.72 - 0.86) and those who had participated in training programs had significantly lower rates of job stress (OR = 0.51, 95% CI: 0.28 - 0.93). The effects of RP knowledge, attitude, and practice on job stress were significant. In order to reduce job stress in radiation environments, ongoing training programs related to self-care and protection principles are recommended.

An audit of rejected repeated x-ray films as a quality assurance element in a radiology department.

PubMed

Eze, K C; Omodia, N; Okegbunam, B; Adewonyi, T; Nzotta, C C

2008-12-01

To find out the causes, number, percentage and sizes of rejected radiographic films with a view of adopting measures that will reduce the rate and number of rejected films. Radiology Department of a University Teaching Hospital. Over a two-year period (1st April 2002 to 31st March 2004), the total number of x-ray films utilized for radiographic examinations, rejected films and sizes of rejected films were collected retrospectively from the medical record of radiology department. All the rejected films were viewed by a radiologist and three radiographers for the causes of the rejects which was arrived at by consensus. The data was analysed. A total of 15,095 films were used in the study period and 1,338 films (8.86%) were rejected or wasted. The rate of rejected films varied from 7.69% to 13.82% with average of 8.86%. The greatest cause of film rejects was radiographers' faults 547 (40.88%), followed by equipments faults 255 (19.06%), and patients' faults 250 (18.90%). The highest reject rate (13.82%) was for films used for examination of the spine (15 x 30) cm size. This is followed by 9.92% for skull (18 x 24) cm films and 8.83% for small sized films (24 x 30) cm used for paediatric patients. Of a total of 1,338 rejected films, 1276 (95.37%) additional exposure were done to obtain the basic desired diagnostic information involving 1151 patients; 885 (76.89%) of these patients needed at least one additional hospital visit to take the repeat exposure. Rejected films are not billable; patients receive additional radiation and may even come to hospital in another day for the repeat. Radiographer's work is increased as well as that of the support staff. The waiting room may be congested and waiting time increased. The cost of processing chemical and films are increased, thus if work is quantified in monetary terms, the cost of repeats is high. Rejected-repeated film analysis is cheap, simple, practicable, easy to interpret and an effective indictor of quality assurance of radiology departments.

Use of personal digital assistants in diagnostic radiology resident education.

PubMed

Nishino, Mizuki; Busch, James M; Wei, Jesse; Barbaras, Larry; Yam, Chun-Shan; Hatabu, Hiroto

2004-10-01

Personal digital assistants (PDAs) are gaining widespread use in the medical community. We introduced a PDA-based mobile system that provides departmental and educational information with a seamless connection to the intranet. The objective of this study is to determine the impact a PDA has on educational resources (learning or data reference) brought to work and used at home by a radiology resident based on user surveys. Survey was performed on 32 radiology residents in our department before and 6 months after the release of the PDA-based system. We assessed the changes in (1) sources of learning at home and at work, and in (2) data reference. The second survey also evaluated the usefulness of each component of the system. After the release of the PDA-based mobile system, the use of "digital books and references" as data references and educational resources that were brought to work every day significantly increased (P = .016, P < .0001, respectively). "Traditional books and references" remained the "most useful source in learning radiology"; however, "digital books and references" increased as the residents' first choice from 0% to 16% within 6 months of introducing the package (P = .125). The introduction of a PDA-based system consisting of educational and departmental information had a statistically significant impact in increasing the use of digitized information in radiology resident education.

Radiology preparedness in ebola virus disease: guidelines and challenges for disinfection of medical imaging equipment for the protection of staff and patients.

PubMed

Mollura, Daniel J; Palmore, Tara N; Folio, Les R; Bluemke, David A

2015-05-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. (©) RSNA, 2015.

Metrix Matrix: A Cloud-Based System for Tracking Non-Relative Value Unit Value-Added Work Metrics.

PubMed

Kovacs, Mark D; Sheafor, Douglas H; Thacker, Paul G; Hardie, Andrew D; Costello, Philip

2018-03-01

In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets. Value-added work metrics selected for tracking included interdisciplinary conferences, hospital committee meetings, consulting on nonbilled outside studies, and practice-based quality improvement. Over a period of 4 months, value-added work data were collected for all clinical attending faculty members in a university-based radiology department (n = 39). Time required for data entry was analyzed for 2 faculty members over the same time period. Thirty-nine faculty members (equivalent to 36.4 full-time equivalents) reported a total of 1,223.5 hours of value-added work time (VAWT). A formula was used to calculate "value-added RVUs" (vRVUs) from VAWT. VAWT amounted to 5,793.6 vRVUs or 6.0% of total work performed (vRVUs plus work RVUs [wRVUs]). Were vRVUs considered equivalent to wRVUs for staffing purposes, this would require an additional 2.3 full-time equivalents, on the basis of average wRVU calculations. Mean data entry time was 56.1 seconds per day per faculty member. As health care reimbursement evolves with an emphasis on value-based medicine, it is imperative that radiologists demonstrate the value they add to patient care beyond wRVUs. This free and easy-to-use cloud-based system allows the efficient quantification of value-added work activities. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

A Platform-Independent Plugin for Navigating Online Radiology Cases.

PubMed

Balkman, Jason D; Awan, Omer A

2016-06-01

Software methods that enable navigation of radiology cases on various digital platforms differ between handheld devices and desktop computers. This has resulted in poor compatibility of online radiology teaching files across mobile smartphones, tablets, and desktop computers. A standardized, platform-independent, or "agnostic" approach for presenting online radiology content was produced in this work by leveraging modern hypertext markup language (HTML) and JavaScript web software technology. We describe the design and evaluation of this software, demonstrate its use across multiple viewing platforms, and make it publicly available as a model for future development efforts.

Radiology information system: a workflow-based approach.

PubMed

Zhang, Jinyan; Lu, Xudong; Nie, Hongchao; Huang, Zhengxing; van der Aalst, W M P

2009-09-01

Introducing workflow management technology in healthcare seems to be prospective in dealing with the problem that the current healthcare Information Systems cannot provide sufficient support for the process management, although several challenges still exist. The purpose of this paper is to study the method of developing workflow-based information system in radiology department as a use case. First, a workflow model of typical radiology process was established. Second, based on the model, the system could be designed and implemented as a group of loosely coupled components. Each component corresponded to one task in the process and could be assembled by the workflow management system. The legacy systems could be taken as special components, which also corresponded to the tasks and were integrated through transferring non-work- flow-aware interfaces to the standard ones. Finally, a workflow dashboard was designed and implemented to provide an integral view of radiology processes. The workflow-based Radiology Information System was deployed in the radiology department of Zhejiang Chinese Medicine Hospital in China. The results showed that it could be adjusted flexibly in response to the needs of changing process, and enhance the process management in the department. It can also provide a more workflow-aware integration method, comparing with other methods such as IHE-based ones. The workflow-based approach is a new method of developing radiology information system with more flexibility, more functionalities of process management and more workflow-aware integration. The work of this paper is an initial endeavor for introducing workflow management technology in healthcare.

JOURNAL CLUB: Redefining the Radiology Curriculum in Medical School: Vertical Integration and Global Accessibility.

PubMed

Retrouvey, Michele; Trace, Anthony Paul; Goodmurphy, Craig W; Shaves, Sarah

2018-01-01

Radiology interconnects medical disciplines given that a working understanding of imaging is essential to clinicians of every specialty. Using online education, we created a globally accessible, web-based undergraduate medical radiology curriculum modeled after the National Medical Student Curriculum in Radiology program of the Alliance of Medical Student Educators in Radiology. Seventy-four radiology faculty-mentored video modules were produced, 50 of which were integrated into the 1st-year anatomy course. We administered tests to medical students before and after students saw the videos to assess the effectiveness of the modules. We surveyed students on their interests in pursuing radiology as a career before and after participating in this curriculum. On the preexamination questions, the mean score was 58.0%, which increased to 83.6% on the pair-matched imaging-related questions on the actual examination. Before participating in the new curriculum, 88% of students did not express an interest in radiology, and 9% were undecided about radiology as a future career. There was an increase in students who reported that they would definitely or most likely pursue a career in radiology (7%) after they had viewed the lectures. Radiology education is now available to a greater number of multidisciplinary learners worldwide. This project produced a comprehensive, globally accessible radiology curriculum in a self-paced, flexible learning format for new generations of physicians.

Applying ethical and legal principles to new technology: the University of Auckland Faculty of Medical and Health Sciences' policy 'Taking and Sharing Images of Patients.'

PubMed

Jonas, Monique; Malpas, Phillipa; Kersey, Kate; Merry, Alan; Bagg, Warwick

2017-01-27

To develop a policy governing the taking and sharing of photographic and radiological images by medical students. The Rules of the Health Information Privacy Code 1994 and the Code of Health and Disability Services Consumers' Rights were applied to the taking, storing and sharing of photographic and radiological images by medical students. Stakeholders, including clinicians, medical students, lawyers at district health boards in the Auckland region, the Office of the Privacy Commissioner and the Health and Disability Commissioner were consulted and their recommendations incorporated. The policy 'Taking and Sharing Images of Patients' sets expectations of students in relation to: photographs taken for the purpose of providing care; photographs taken for educational or professional practice purposes and photographic or radiological images used for educational or professional practice purposes. In addition, it prohibits students from uploading images of patients onto image-sharing apps such as Figure 1. The policy has since been extended to apply to all students at the Faculty of Medical and Health Sciences at the University of Auckland. Technology-driven evolutions in practice necessitate regular review to ensure compliance with existing legal regulations and ethical frameworks. This policy offers a starting point for healthcare providers to review their own policies and practice, with a view to ensuring that patients' trust in the treatment that their health information receives is upheld.

The new radiology workforce: changing expectations.

PubMed

Cronan, John J

2004-05-01

The zeitgeist of the new radiology workforce can best be described by a Bob Dylan song title: "The Times They Are A-Changin'." The new generation of physicians, although embracing the same foundations of medical practice as previous generations, places greater emphasis on personal satisfaction than its predecessors. Gone are the days when physicians operated as sole practitioners; today's workforce member is content to function in the role of "employee" in a trade-off for more lifestyle flexibility. This change has occurred not because of one specific factor but because of a change in the profession of medicine coupled with a combination of factors; familial responsibilities, avocational activities, and personal satisfaction have surfaced as motivating factors in choosing a profession. Today's workforce has a personal perception of success that may not be fulfilled solely by the contemporary practice of medicine. With the radiologist shortages that are now occurring and anticipated increased demand for staff radiologists, today's radiology workforce has helped shape the specialty into one that is altering its structure to attract and retain its workforce.

Imaging Practice Patterns: Referral Network Analysis of a Single State of Origination.

PubMed

Grayson, James; Basciano, Peter; Rawson, James V; Klein, Kandace

2015-12-01

The aim of this study was to examine the referral pattern of imaging studies requested in a single state compared with the potential location of interpretation. Analysis of Medicare patients in a DocGraph data set was performed to identify sequential different physician services claims for the same patient for which the second claim was for services provided by a radiologist. In the 2011 Medicare population, radiology referrals from physicians practicing in Georgia resulted in 76.5% of radiology interpretations by radiologists inside the state of Georgia. The states bordering Georgia accounted for 11.6% of interpretations in the Georgia market. The remaining interpretations were distributed throughout the remainder of the country. A significant proportion of routine imaging interpretation occurs outside the state in which an examination is performed. Additional studies are needed to identify complex drivers of imaging referral patterns, such as patient geographic location and demographics, radiologist workforce distribution, contractual obligations, and social relationships. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

The radiology informed consent form: recommendations from the European Society of Cardiology position paper.

PubMed

Carpeggiani, Clara; Picano, Eugenio

2016-06-01

Every radiological and nuclear medicine examination confers a definite long-term risk of cancer, but most patients undergoing such examinations receive no or inaccurate information about radiation dose and corresponding risk related to the dose received. Informed consent is a procedure to support (not substitute) the physician/patient dialogue and relationship, facilitating a free, informed and aware expression of the patient's will in the principle of patient autonomy. Physicians are responsible for providing patients with all the information on risks, benefits and alternatives useful to the patient to make the decision. In current radiological practice the information on the radiation dose and long-term cancer risks is difficult to find and not easy to understand. The form using plain language should spell-out the type of examination, the effective dose (mSv), the effective dose expressed in number of chest radiographs and the risk of cancer. The current practice clashes against the guidelines and the law.

Jordanian dentists' knowledge and implementation of eco-friendly dental office strategies.

PubMed

Al Shatrat, Sabha M; Shuman, Deanne; Darby, Michele L; Jeng, Hueiwang A

2013-06-01

To investigate the implementation of eco-friendly dental office strategies by Jordanian dentists. Self-designed questionnaires were provided to 150 dentists working in private dental practices in the city of Amman, the capital of Jordan. Dentists' names and addresses were obtained from the Jordanian Dental Association. Overall, the level of knowledge about eco-friendly dental offices strategies was high for amalgam, radiology, paper waste, infection control and energy and water conservation. In terms of implementation, the majority of Jordanian dentists apply few eco-friendly dental offices strategies. The most frequently identified barriers to implementation of eco-friendly dental offices strategies were cost and lack of incentives from the government. Most Jordanian dental practices are not eco-friendly. A continued focus on the impact of dental practices on the environment is needed through formal and continuing dental education. Results of this study can guide policy development to encourage implementation of eco-friendly strategies. © 2013 FDI World Dental Federation.

Intracranial imaging of uncommon diseases is more frequently reported in clinical publications than in radiology publications.

PubMed

Lehman, V T; Doolittle, D A; Hunt, C H; Eckel, L J; Black, D F; Schwartz, K M; Diehn, F E

2014-01-01

Descriptions of uncommon diseases with intracranial imaging abnormalities are often difficult to find in the radiology literature. We hypothesized that reported imaging findings of such conditions in the recent literature were more frequent in clinical compared with radiology journals. PubMed searches from December 1, 2007 to December 1, 2012 were performed for 5 uncommon CNS diseases with intracranial imaging manifestations: 1) Susac syndrome; 2) amyloid β-related angiitis; 3) Parry-Romberg syndrome/en coup de sabre; 4) transient lesion of the splenium of the corpus callosum; and 5) reversible cerebral vasoconstriction syndrome. Articles were classified as a case report, case series, or original research. Journals were categorized as radiology or clinical. The 1- and 5-year Impact Factors of the journals were recorded. Two hundred two articles were identified for the 5 diseases, including 151 (74%) case reports, 26 case series (13%), and 25 original research articles (13%); 179 (89%) were published in nonradiology journals, compared with 23 (11%) in radiology journals. There was no significant difference between the mean 1- and 5-year Impact Factors of the radiology and clinical journals. Recent reports of the selected uncommon diseases with intracranial manifestations are more frequent in clinical journals when compared with dedicated radiology publications. Most publications are case reports. Radiologists should review both radiology and clinical journals when reviewing imaging features of uncommon diseases affecting the brain. Lack of reporting on such disease in the radiology literature may have significant practice, educational, and research implications for the radiology community.

Inpatient Complexity in Radiology-a Practical Application of the Case Mix Index Metric.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Flacke, Sebastian; Thomas, Shiby; Wald, Christoph

2017-06-01

With ongoing healthcare payment reforms in the USA, radiology is moving from its current state of a revenue generating department to a new reality of a cost-center. Under bundled payment methods, radiology does not get reimbursed for each and every inpatient procedure, but rather, the hospital gets reimbursed for the entire hospital stay under an applicable diagnosis-related group code. The hospital case mix index (CMI) metric, as defined by the Centers for Medicare and Medicaid Services, has a significant impact on how much hospitals get reimbursed for an inpatient stay. Oftentimes, patients with the highest disease acuity are treated in tertiary care radiology departments. Therefore, the average hospital CMI based on the entire inpatient population may not be adequate to determine department-level resource utilization, such as the number of technologists and nurses, as case length and staffing intensity gets quite high for sicker patients. In this study, we determine CMI for the overall radiology department in a tertiary care setting based on inpatients undergoing radiology procedures. Between April and September 2015, CMI for radiology was 1.93. With an average of 2.81, interventional neuroradiology had the highest CMI out of the ten radiology sections. CMI was consistently higher across seven of the radiology sections than the average hospital CMI of 1.81. Our results suggest that inpatients undergoing radiology procedures were on average more complex in this hospital setting during the time period considered. This finding is relevant for accurate calculation of labor analytics and other predictive resource utilization tools.

General practitioners’ views on radiology reports of plain radiography for back pain

PubMed Central

Espeland, Ansgar; Baerheim, Anders

2007-01-01

Objective To identify and describe general practitioners’ (GPs’) views on radiology reports, using plain radiography for back pain as the case. Design Qualitative study with three focus-group interviews analysed using Giorgi's method as modified by Malterud. Setting Southern Norway. Subjects Five female and eight male GPs aged 32–57 years who had practised for 3–15 years and were from 11 different practices. Main outcome measures Descriptions of GPs’ views. Results GPs wanted radiology reports to indicate more clearly the meaning of radiological terminology, the likelihood of disease, the clinical relevance of the findings, and/or the need for further investigations. GPs stated that good referral information leads to better reports. Conclusion These results can help to improve communication between radiologists and GPs. The issues identified in this study could be further investigated in studies that can quantify GPs’ satisfaction with radiology reports in relation to characteristics of the GP, the radiologist, and the referral information. PMID:17354154

Occupational Exposure of the Eye Lens in Interventional Procedures: How to Assess and Manage Radiation Dose.

PubMed

Ciraj-Bjelac, Olivera; Carinou, Eleftheria; Ferrari, Paolo; Gingaume, Merce; Merce, Marta Sans; O'Connor, Una

2016-11-01

Occupational exposure from interventional x-ray procedures is one of the areas in which increased eye lens exposure may occur. Accurate dosimetry is an important element to investigate the correlation of observed radiation effects with radiation dose, to verify the compliance with regulatory dose limits, and to optimize radiation protection practice. The objective of this work is to review eye lens dose levels in clinical practice that may occur from the use of ionizing radiation. The use of a dedicated eye lens dosimeter is the recommended methodology; however, in practice it cannot always be easily implemented. Alternatively, the eye lens dose could be assessed from measurements of other dosimetric quantities or other indirect parameters, such as patient dose. The practical implementation of monitoring eye lens doses and the use of adequate protective equipment still remains a challenge. The use of lead glasses with a good fit to the face, appropriate lateral coverage, and/or ceiling-suspended screens is recommended in workplaces with potential high eye lens doses. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

History and Organizations for Radiological Protection.

PubMed

Kang, Keon Wook

2016-02-01

International Commission on Radiological Protection (ICRP), an independent international organization established in 1925, develops, maintains, and elaborates radiological protection standards, legislation, and guidelines. United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) provides scientific evidence. World Health Organization (WHO) and International Atomic Energy Agency (IAEA) utilise the ICRP recommendations to implement radiation protection in practice. Finally, radiation protection agencies in each country adopt the policies, and adapt them to each situation. In Korea, Nuclear Safety and Security Commission is the governmental body for nuclear safety regulation and Korea Institute of Nuclear Safety is a public organization for technical support and R&D in nuclear safety and radiation protection.

[The future of radiology: What can we expect within the next 10 years?].

PubMed

Nensa, F; Forsting, M; Wetter, A

2016-03-01

More than other medical discipline, radiology is marked by technical innovation and continuous development, as well as the optimization of the underlying physical principles. In this respect, several trends that will crucially change and develop radiology over the next decade can be observed. Through the use of ever faster computer tomography, which also shows an ever-decreasing radiation exposure, the "workhorse" of radiology will have an even greater place and displace conventional X‑ray techniques further. In addition, hybrid imaging, which is based on a combination of nuclear medicine and radiological techniques (keywords: PET/CT, PET/MRI) will become much more established and, in particular, will improve oncological imaging further, allowing increasingly individualized imaging for specific tracers and techniques of functional magnetic resonance imaging for a particular tumour. Future radiology will be strongly characterized by innovations in the software and Internet industry, which will enable new image viewing and processing methods and open up new possibilities in the context of the organization of radiological work.

Ineffective Leadership.

PubMed

Itri, Jason N; Lawson, Leslie M

2016-07-01

Radiology leaders can have a profound impact on the success and working environment of a radiology department, promoting core values and inspiring staff members to achieve the organization's mission. On the other hand, ineffective leaders can have a devastating effect on a radiology department by impairing communication among members, undermining staff commitment to the organization's success, and stifling the development of other staff members and leaders in the organization. One of the most important investments a radiology department can make is in identifying, cultivating, and promoting new leaders. The authors describe 13 habits and characteristics of new leaders that lead these individuals to address situations in both ineffective and counterproductive ways, impeding the performance of a radiology department and its capacity to play a meaningful role in shaping the future of radiology. New leaders must continually learn and improve their leadership skills if they are to avoid the destructive habits of ineffective leaders and successfully overcome the challenges facing radiology today. Senior leaders may also benefit from understanding the pitfalls that make leaders ineffective and should strive to continually improve their leadership skills given the critical role of leadership in the success of radiology departments. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiation risk assessment in professionals working in dental radiology area using buccal micronucleus cytome assay.

PubMed

Sadatullah, Syed; Dawasaz, Ali Azhar; Luqman, Master; Assiry, Ali A; Almeshari, Ahmed A; Togoo, Rafi Ahmad

2013-11-01

The aim of this study was to assess the incidence of micronuclei (MN) in buccal mucosal cells of professionals working in radiology area to determine the risk of stochastic effects of radiation. All the professionals and students working in King Khalid University - College of Dentistry radiology area were included in the Risk Group (RG = 27). The Control Group (CG = 27) comprised of healthy individual matching the gender and age of the RG. Buccal mucosal scraping from all the 54 subjects of RG and CG were stained with Papanicolaou stain and observed under oil immersion lens (×100) for the presence of micronuclei (MN) in the exfoliated epithelial cells. There was no significant difference between the incidence of MN in RG and CG (p = >0.05) using t-test. Routine radiation protection protocol does minimize the risk of radiation induced cytotoxicity, however, screening of professionals should be carried out at regular intervals.

Radiology corner. Answer to last month's radiology case and image: gun shot wound to the chest of a military working dog.

PubMed

Galer, Meghan; Magid, Donna; Folio, Les

2009-06-01

This Military Working Dog (MWD) was shot in the chest during combat operations in Iraq. Military Working Dogs are critical to the safety and well-being of deployed troops in combat operations and, as such, they are triaged and treated in our combat hospitals just like any other soldier; their speciation is not a factor in their triage status. This case familiarizes military physicians with the basic canine anatomy, positioning, and radiological technique they should be aware of before deploying. We also strive to raise awareness of the vital roles that these MWDs play for our forces, counterany concerns that may arise over the issue of treating these dogs in human facilities, and leave the reader feeling better prepared to handle the situation should they ever find themselves poised to save one of our four-legged warriors.

Anesthesia Practice and Clinical Trends in Interventional Radiology: A European Survey

DOE Office of Scientific and Technical Information (OSTI.GOV)

Haslam, Philip J.; Yap, Bernard; Mueller, Peter R.

Purpose: To determine current European practice in interventional radiology regarding nursing care, anesthesia, and clinical care trends.Methods: A survey was sent to 977 European interventional radiologists to assess the use of sedoanalgesia, nursing care, monitoring equipment, pre- and postprocedural care, and clinical trends in interventional radiology. Patterns of sedoanalgesia were recorded for both vascular and visceral interventional procedures. Responders rated their preferred level of sedoanalgesia for each procedure as follows: (a) awake/alert, (b) drowsy/arousable, (c) asleep/arousable, (d) deep sedation, and (e) general anesthesia. Sedoanalgesic drugs and patient care trends were also recorded. A comparison was performed with data derived frommore » a similar survey of interventional practice in the United States.Results: Two hundred and forty-three of 977 radiologists responded (25%). The total number of procedures analyzed was 210,194. The majority (56%) of diagnostic and therapeutic vascular procedures were performed at the awake/alert level of sedation, 32% were performed at the drowsy/arousable level, and 12% at deeper levels of sedation. The majority of visceral interventional procedures were performed at the drowsy/arousable level of sedation (41%), 29% were performed at deeper levels of sedation, and 30% at the awake/alert level. In general, more sedoanalgesia is used in the United States. Eighty-three percent of respondents reported the use of a full-time radiology nurse, 67% used routine blood pressure/pulse oximetry monitoring, and 46% reported the presence of a dedicated recovery area. Forty-nine percent reported daily patient rounds, 30% had inpatient hospital beds, and 51% had day case beds.Conclusion: This survey shows clear differences in the use of sedation for vascular and visceral interventional procedures. Many, often complex, procedures are performed at the awake/alert level of sedation in Europe, whereas deeper levels of sedation are used in the United States. Trends toward making interventional radiology a clinical specialty are evident, with 51% of respondents having day case beds, and 30% having inpatient beds.« less

Importance of establishing radiation protection culture in Radiology Department.

PubMed

Ploussi, Agapi; Efstathopoulos, Efstathios P

2016-02-28

The increased use of ionization radiation for diagnostic and therapeutic purposes, the rapid advances in computed tomography as well as the high radiation doses delivered by interventional procedures have raised serious safety and health concerns for both patients and medical staff and have necessitated the establishment of a radiation protection culture (RPC) in every Radiology Department. RPC is a newly introduced concept. The term culture describes the combination of attitudes, beliefs, practices and rules among the professionals, staff and patients regarding to radiation protection. Most of the time, the challenge is to improve rather than to build a RPC. The establishment of a RPC requires continuing education of the staff and professional, effective communication among stakeholders of all levels and implementation of quality assurance programs. The RPC creation is being driven from the highest level. Leadership, professionals and associate societies are recognized to play a vital role in the embedding and promotion of RPC in a Medical Unit. The establishment of a RPC enables the reduction of the radiation dose, enhances radiation risk awareness, minimizes unsafe practices, and improves the quality of a radiation protection program. The purpose of this review paper is to describe the role and highlight the importance of establishing a strong RPC in Radiology Departments with an emphasis on promoting RPC in the Interventional Radiology environment.

Radiology Preparedness in Ebola Virus Disease: Guidelines and Challenges for Disinfection of Medical Imaging Equipment for the Protection of Staff and Patients

PubMed Central

Palmore, Tara N.; Folio, Les R.; Bluemke, David A.

2015-01-01

The overlap of early Ebola virus disease (EVD) symptoms (eg, fever, headache, abdominal pain, diarrhea, emesis, and fatigue) with symptoms of other more common travel-related diseases (eg, malaria, typhoid fever, pneumonia, and meningococcemia) may result in delayed diagnosis of EVD before isolation of infected patients. Radiology departments should consider policies for and approaches to decontamination of expensive and potentially easily damaged radiology equipment. In addition, the protection of radiology personnel must be considered during the work-up phase of undiagnosed EVD patients presenting to emergency departments. The purpose of this article is to consider the effect of EVD on radiology departments and imaging equipment, with particular consideration of guidelines currently available from the Centers for Disease Control and Prevention that may be applicable to radiology. © RSNA, 2015 PMID:25654616

Contracts in radiology practices: breaches and remedies.

PubMed

Muroff, Julie A; Muroff, Lawrence R

2004-08-01

Contracts between radiology groups and their physician members are often ambiguous. Key clauses may not be precise as to the intent of the contracting parties. For example, the requirements for a group member to achieve shareholder status may be discussed but not reduced to a written form. Other contract provisions, such as termination or noncompete clauses, may be subject to different interpretations. The ambiguities of these provisions often generate disparate expectations regarding the parties' obligations to one another. When this occurs, the results may vary from disappointment to litigation. This paper discusses the causes and consequences of common breaches of radiology contracts. The types of remedies that may be available to the parties of the contract are also enumerated, and case law is cited to illustrate the challenges that radiology groups and their members may encounter. Finally, alternative forms of dispute resolution are discussed.

Image Gently(SM): a national education and communication campaign in radiology using the science of social marketing.

PubMed

Goske, Marilyn J; Applegate, Kimberly E; Boylan, Jennifer; Butler, Priscilla F; Callahan, Michael J; Coley, Brian D; Farley, Shawn; Frush, Donald P; Hernanz-Schulman, Marta; Jaramillo, Diego; Johnson, Neil D; Kaste, Sue C; Morrison, Gregory; Strauss, Keith J

2008-12-01

Communication campaigns are an accepted method for altering societal attitudes, increasing knowledge, and achieving social and behavioral change particularly within public health and the social sciences. The Image Gently(SM) campaign is a national education and awareness campaign in radiology designed to promote the need for and opportunities to decrease radiation to children when CT scans are indicated. In this article, the relatively new science of social marketing is reviewed and the theoretical basis for an effective communication campaign in radiology is discussed. Communication strategies are considered and the type of outcomes that should be measured are reviewed. This methodology has demonstrated that simple, straightforward safety messages on radiation protection targeted to medical professionals throughout the radiology community, utilizing multiple media, can affect awareness potentially leading to change in practice.

Implications of Direct Patient Online Access to Radiology Reports Through Patient Web Portals.

PubMed

Lee, Christoph I; Langlotz, Curtis P; Elmore, Joann G

2016-12-01

In an era of increasing health information transparency and informed decision making, more patients are being provided with direct online access to their medical records, including radiology reports, via web-based portals. Although radiologists' narrative reports have previously been the purview of referring physicians, patients are now reading these on their own. Many potential benefits may result from patients reviewing their radiology reports, including improvements in patients' own understanding of their health, promotion of shared decision making and patient-physician communication, and, ultimately, improvements in patient outcomes. However, there may also be negative consequences, including confusion and anxiety among patients and longer patient-physician interactions. The rapid adoption of this new technology has led to major questions regarding ethics and professionalism for radiologists, including the following: Who is the intended audience of radiology reports? How should content be presented or worded? How will open access influence radiologists' relationships with patients and referring physicians? What legal ramifications may arise from increased patient access? The authors describe the current practices and research findings associated with patient online access to medical records, including radiology reports, and discuss several implications of this growing trend for the radiology profession. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Application of the Commission's recommendations: the 2013-2017 Committee 4 programme of work.

PubMed

Lochard, J

2015-06-01

Committee 4 of the International Commission on Radiological Protection (ICRP) is responsible for developing principles, recommendations, and guidance on the protection of people against radiation exposure, and to consider their practical application in all exposure situations. Currently, the Committee's efforts are focused on the completion of a series of future ICRP publications on the implementation of its 2007 Recommendations to the various existing exposure situations. A report on protection against radon exposure was published recently (ICRP Publication 126), and two documents on protection against cosmic radiation in aviation, and naturally occurring radioactive material are under development. The programme of work for the forthcoming 2013-2017 period comprises the update of ICRP Publication 109 on protection of people in emergency exposure situations, and the update of ICRP Publication 111 on protection of people living in long-term contaminated areas after a nuclear accident, as well as the development of a future ICRP publication on the ethics of radiological protection. It also includes the preparation of task groups on the application of the Commission's recommendations for contaminated sites from past activities and for surface and near-surface disposal of radioactive waste. Another important task for Committee 4 will be to develop a reflection on the tolerability of risk from radiation. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Medical examinations for radiation workers

NASA Technical Reports Server (NTRS)

Alexander, R. E.

1969-01-01

The NASA radiological protection policy allows an employee to be assigned work in a radiologically controlled area only if all of the following conditions are met: (1) The area must be radiologically safe for the intended operations; (2) the employee must be medically fit; (3) the employee must be properly trained; (4) appropriate radiation protection procedures must be prepared; (5) appropriate dosimetric, survey, surveillance and reporting procedures must be implemented; and (6) adequate controls and records must be established.

Radiological protection in computed tomography and cone beam computed tomography.

PubMed

Rehani, M M

2015-06-01

The International Commission on Radiological Protection (ICRP) has sustained interest in radiological protection in computed tomography (CT), and ICRP Publications 87 and 102 focused on the management of patient doses in CT and multi-detector CT (MDCT) respectively. ICRP forecasted and 'sounded the alarm' on increasing patient doses in CT, and recommended actions for manufacturers and users. One of the approaches was that safety is best achieved when it is built into the machine, rather than left as a matter of choice for users. In view of upcoming challenges posed by newer systems that use cone beam geometry for CT (CBCT), and their widened usage, often by untrained users, a new ICRP task group has been working on radiological protection issues in CBCT. Some of the issues identified by the task group are: lack of standardisation of dosimetry in CBCT; the false belief within the medical and dental community that CBCT is a 'light', low-dose CT whereas mobile CBCT units and newer applications, particularly C-arm CT in interventional procedures, involve higher doses; lack of training in radiological protection among clinical users; and lack of dose information and tracking in many applications. This paper provides a summary of approaches used in CT and MDCT, and preliminary information regarding work just published for radiological protection in CBCT. © The International Society for Prosthetics and Orthotics Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Assessment of the occupational eye lens dose for clinical staff in interventional radiology, cardiology and neuroradiology.

PubMed

Omar, Artur; Kadesjö, Nils; Palmgren, Charlotta; Marteinsdottir, Maria; Segerdahl, Tony; Fransson, Annette

2017-03-20

In accordance with recommendations by the International Commission on Radiological Protection, the current European Basic Safety Standards has adopted a reduced occupational eye lens dose limit of 20 mSv yr -1 . The radiation safety implications of this dose limit is of concern for clinical staff that work with relatively high dose x-ray angiography and interventional radiology. Presented in this work is a thorough assessment of the occupational eye lens dose based on clinical measurements with active personal dosimeters worn by staff during various types of procedures in interventional radiology, cardiology and neuroradiology. Results are presented in terms of the estimated equivalent eye lens dose for various medical professions. In order to compare the risk of exceeding the regulatory annual eye lens dose limit for the widely different clinical situations investigated in this work, the different medical professions were separated into categories based on their distinct work pattern: staff that work (a) regularly beside the patient, (b) in proximity to the patient and (c) typically at a distance from the patient. The results demonstrate that the risk of exceeding the annual eye lens dose limit is of concern for staff category (a), i.e. mainly the primary radiologist/cardiologist. However, the results also demonstrate that the risk can be greatly mitigated if radiation protection shields are used in the clinical routine. The results presented in this work cover a wide range of clinical situations, and can be used as a first indication of the risk of exceeding the annual eye lens dose limit for staff at other medical centres.

NNSA B-Roll: Second Line of Defense

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2010-05-21

The NNSA Office of Second Line of Defense (SLD) works to prevent illicit trafficking in nuclear and radiological materials by securing international land borders, seaports and airports that may be used as smuggling routes for materials needed for a nuclear device or a radiological dispersal device.

Hand-held digital books in radiology: convenient access to information.

PubMed

D'Alessandro, M P; Galvin, J R; Santer, D M; Erkonen, W E

1995-02-01

Radiologists need constant, convenient access to current information throughout the course of their daily work. Today most learning in radiology is obtained from the printed word in books, journals, and teaching files, supplemented by the spoken word in lectures and conferences. Although learning from printed material and lectures has been proved efficacious over time, these media share the disadvantage of not being conveniently available for reference during the course of daily work at the alternator or in the examination room when accurate and up-to-date information is needed the most. As a result, many important questions about patient care go unanswered. We have developed a technique--hand-held digital books--to lower this barrier to searching and retrieval. When radiologists have a digital library that can be carried with them, they will be able to incorporate current radiology information into their daily decision making. We describe a technique for creating hand-held digital books and their future use in radiology.

Practical Approaches to Quality Improvement for Radiologists.

PubMed

Kelly, Aine Marie; Cronin, Paul

2015-10-01

Continuous quality improvement is a fundamental attribute of high-performing health care systems. Quality improvement is an essential component of health care, with the current emphasis on adding value. It is also a regulatory requirement, with reimbursements increasingly being linked to practice performance metrics. Practice quality improvement efforts must be demonstrated for credentialing purposes and for certification of radiologists in practice. Continuous quality improvement must occur for radiologists to remain competitive in an increasingly diverse health care market. This review provides an introduction to the main approaches available to undertake practice quality improvement, which will be useful for busy radiologists. Quality improvement plays multiple roles in radiology services, including ensuring and improving patient safety, providing a framework for implementing and improving processes to increase efficiency and reduce waste, analyzing and depicting performance data, monitoring performance and implementing change, enabling personnel assessment and development through continued education, and optimizing customer service and patient outcomes. The quality improvement approaches and underlying principles overlap, which is not surprising given that they all align with good patient care. The application of these principles to radiology practices not only benefits patients but also enhances practice performance through promotion of teamwork and achievement of goals. © RSNA, 2015.

Intravenous contrast extravasation during CT: a national data registry and practice quality improvement initiative.

PubMed

Dykes, Thomas M; Bhargavan-Chatfield, Mythreyi; Dyer, Raymond B

2015-02-01

Establish 3 performance benchmarks for intravenous contrast extravasation during CT examinations: extravasation frequency, distribution of extravasation volumes, and severity of injury. Evaluate the effectiveness of implementing practice quality improvement (PQI) methodology in improving performance for these 3 benchmarks. The Society of Abdominal Radiology and ACR developed a registry collecting data for contrast extravasation events. The project includes a PQI initiative allowing for process improvement. As of December 2013, a total of 58 radiology practices have participated in this project, and 32 practices have completed the 2-cycle PQI. There were a total of 454,497 contrast-enhanced CT exams and 1,085 extravasation events. The average extravasation rate is 0.24%. The median extravasation rate is 0.21%. Most extravasations (82.9%) were between 10 mL and 99 mL. The majority of injuries, 94.6%, are mild in severity, with 4.7% having moderate and 0.8% having severe injuries. Data from practices that completed the PQI process showed a change in the average extravasation rate from 0.28% in the first 6 months to 0.23% in the second 6 months, and the median extravasation rate dropped from 0.25% to 0.16%, neither statistically significant. The distribution of extravasation volumes and the severity of injury did not change between the first and second measurement periods. National performance benchmarks for contrast extravasation rate, distribution of volumes of extravasate, and distribution of severity of injury are established through this multi-institutional practice registry. The application of PQI failed to have a statistically significant positive impact on any of the 3 benchmarks. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Quality of life and job performance resulting from operatively treated tibial plateau fractures].

PubMed

Roßbach, B P; Faymonville, C; Müller, L P; Stützer, H; Isenberg, J

2016-01-01

The aim of this article is to present the functional results and the effect on quality of life of surgically treated tibial plateau fractures in physically active and working patients with multiple and serious injuries. In addition, the relationships between functional and radiological outcome were evaluated and compared with activity in daily and professional life. In all, 41 injured patients were followed up a mean of 47 months after surgical treatment and examined with radiological, functional, as well as quality of life score. In the radiological scoring, a mean value of 72 points (max 100 points) was achieved. In the activity score, there was an average of 63.5 points (max 100 points). When evaluating the health-related quality of life, an average score of 69.6 points was achieved. There was a significant relationship between radiological and activity scores and the radiological and life quality scores. Furthermore, the relationship between activity and quality of life scores was considered significant. Surgeon's influence on the functional outcome could be confirmed. The functional and the radiological results were moderate. Quality of life was permanently affected by the consequences of tibial plateau fracture in 12 patients; 11 patients were not re-employed. However, the quality of life was assessed as good or very good and 28 patients had returned to work. The quality of life was firmly linked to the radiological and functional parameters, which tended to be influenced by the quality of the primary surgical treatment when looking at the overall population.

3D simulation as a tool for improving the safety culture during remediation work at Andreeva Bay.

PubMed

Chizhov, K; Sneve, M K; Szőke, I; Mazur, I; Mark, N K; Kudrin, I; Shandala, N; Simakov, A; Smith, G M; Krasnoschekov, A; Kosnikov, A; Kemsky, I; Kryuchkov, V

2014-12-01

Andreeva Bay in northwest Russia hosts one of the former coastal technical bases of the Northern Fleet. Currently, this base is designated as the Andreeva Bay branch of Northwest Center for Radioactive Waste Management (SevRAO) and is a site of temporary storage (STS) for spent nuclear fuel (SNF) and other radiological waste generated during the operation and decommissioning of nuclear submarines and ships. According to an integrated expert evaluation, this site is the most dangerous nuclear facility in northwest Russia. Environmental rehabilitation of the site is currently in progress and is supported by strong international collaboration. This paper describes how the optimization principle (ALARA) has been adopted during the planning of remediation work at the Andreeva Bay STS and how Russian-Norwegian collaboration greatly contributed to ensuring the development and maintenance of a high level safety culture during this process. More specifically, this paper describes how integration of a system, specifically designed for improving the radiological safety of workers during the remediation work at Andreeva Bay, was developed in Russia. It also outlines the 3D radiological simulation and virtual reality based systems developed in Norway that have greatly facilitated effective implementation of the ALARA principle, through supporting radiological characterisation, work planning and optimization, decision making, communication between teams and with the authorities and training of field operators.

National Alliance for Radiation Readiness: Leveraging Partnerships to Increase Preparedness.

PubMed

Blumenstock, James S; Allen, Meredith

2016-02-01

The National Alliance for Radiation Readiness (NARR) is an alliance of 16 national member organizations that have banded together to serve as the collective "voice of health" in radiological preparedness through: • participation in national dialogues on radiological emergency issues; • provision of thoughtful feedback on documents, policies, and guidelines; and • convening of partners to raise awareness of and resolve radiological emergency issues. NARR benefits from the intersection and interaction of public health, radiation control, healthcare, and emergency management professionals--all with an interest in bolstering the nation's preparedness for a radiological or nuclear incident. NARR is able to provide a unique perspective on radiological and nuclear preparedness by creating multi-disciplinary workgroups to develop guidance, recommendations, and provide subject matter feedback. NARR aims to build response and recovery capacity and capabilities by supporting the sharing of resources and tools, including technical methods and information through the development of an online clearinghouse. NARR also aims to identify and disseminate best practices, as well as define and educate on the roles and responsibilities of local, state, and federal government and the numerous agencies involved with the response to a radiological emergency.

[Definition and specification requirements for PAC-systems (picture archiving and communication system). A performance index with reference to the standard "IEEE Recommended Practice for Software Requirement Specifications"].

PubMed

König, H; Klose, K J

1999-04-01

The formulation of requirements is necessary to control the goals of a PACS project. Furthermore, in this way, the scope of functionality necessary to support radiological working processes becomes clear. Definitions of requirements and specification are formulated independently of systems according to the IEEE standard "Recommended Practice for Software Requirements Specifications". Definitions are given in the Request for Information, specifications in the Request for Proposal. Functional and non-functional requirements are distinguished. The solutions are rated with respect to scope, appropriateness and quality of implementation. A PACS checklist was created according to the methods described above. It is published on the homepage of the "Arbeitsgemeinschaft Informationstechnologie" (AGIT) within the "Deutsche Röntgengesellschaft" (DRG) (http://www.uni-marburg.de/mzr/agit). The checklist provides a discussion forum which should contribute to an agreement on accepted basic PACS functionalities.

Value of trainees in a radiology department. A retrospective semi-quantitative analysis.

PubMed

Vardhanabhuti, V; Bhatnagar, G; Brown, S; James, J; Shuen, V; Sidhu, H; Thomas, R; Fox, B

2011-07-01

To examine the productivity (both economic and otherwise) of trainees within a radiology department at our institution. Productivity was measured in three ways: (1) independent workload contribution, (2) impact on on-call services, and (3) impact on day-to-day practice as perceived by consultant radiologists. Data were collected using retrospective searches on computerized radiology information system (CRIS), analysis of trainees and consultant rotas, and a questionnaire to consultants and trainees. Where possible, productivity was quantified in terms of number of programmed activities (PAs). The contribution of independent work by trainees in a single week was 52.75 PAs (or 1.45 PAs per trainee per week). In addition, the on-call contribution was 23.1 PAs per week (or 0.93 PAs per trainee per week). When both trainees and consultants report independently, productivity in a single list in most cases increased and can be as much as 197%. On calculating the economic impact, this amounts to significant savings of around £1.2million per year at our institution. Based upon objectively measurable areas of service provision, the employment of trainees yields considerable economic benefit. Furthermore, based upon qualitative methods we have shown that trainees contribute positively in those areas, which are much harder to quantifiably evaluate. These are benefits in addition to fundamental requirement to train future competent radiologists. Copyright © 2011 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

ACR Imaging IT Reference Guide: Image Sharing: Evolving Solutions in the Age of Interoperability

PubMed Central

Erickson, Bradley J.; Choy, Garry

2014-01-01

Interoperability is a major focus of the quickly evolving world of Health Information Technology. Easy, yet secure and confidential exchange of imaging exams and the associated reports must be a part of the solutions that are implemented. The availability of historical exams is essential in providing a quality interpretation and reducing inappropriate utilization of imaging services. Today exchange of imaging exams is most often achieved via a CD. We describe the virtues of this solution as well as challenges that have surfaced. Internet and cloud based technologies employed for many consumer services can provide a better solution. Vendors are making these solutions available. Standards for internet based exchange are emerging. Just as Radiology converged on DICOM as a standard to store and view images we need a common exchange standard. We will review the existing standards, and how they are organized into useful workflows through Integrating the Healthcare Enterprise (IHE) profiles. IHE and standards development processes are discussed. Healthcare and the domain of Radiology must stay current with quickly evolving internet standards. The successful use of the “cloud” will depend upon both the technologies we discuss and the policies put into place around these technologies. We discuss both aspects. The Radiology community must lead the way and provide a solution that works for radiologists and clinicians in the Electronic Medical Record (EMR). Lastly we describe the features we believe radiologists should consider when considering adding internet based exchange solutions to their practice. PMID:25467903

Quality initiatives: planning, setting up, and carrying out radiology process improvement projects.

PubMed

Tamm, Eric P; Szklaruk, Janio; Puthooran, Leejo; Stone, Danna; Stevens, Brian L; Modaro, Cathy

2012-01-01

In the coming decades, those who provide radiologic imaging services will be increasingly challenged by the economic, demographic, and political forces affecting healthcare to improve their efficiency, enhance the value of their services, and achieve greater customer satisfaction. It is essential that radiologists master and consistently apply basic process improvement skills that have allowed professionals in many other fields to thrive in a competitive environment. The authors provide a step-by-step overview of process improvement from the perspective of a radiologic imaging practice by describing their experience in conducting a process improvement project: to increase the daily volume of body magnetic resonance imaging examinations performed at their institution. The first step in any process improvement project is to identify and prioritize opportunities for improvement in the work process. Next, an effective project team must be formed that includes representatives of all participants in the process. An achievable aim must be formulated, appropriate measures selected, and baseline data collected to determine the effects of subsequent efforts to achieve the aim. Each aspect of the process in question is then analyzed by using appropriate tools (eg, flowcharts, fishbone diagrams, Pareto diagrams) to identify opportunities for beneficial change. Plans for change are then established and implemented with regular measurements and review followed by necessary adjustments in course. These so-called PDSA (planning, doing, studying, and acting) cycles are repeated until the aim is achieved or modified and the project closed.

Radiological Safety Handbook.

ERIC Educational Resources Information Center

Army Ordnance Center and School, Aberdeen Proving Ground, MD.

Written to be used concurrently with the U.S. Army's Radiological Safety Course, this publication discusses the causes, sources, and detection of nuclear radiation. In addition, the transportation and disposal of radioactive materials are covered. The report also deals with the safety precautions to be observed when working with lasers, microwave…

Predicting Malignant and Paramalignant Pleural Effusions by Combining Clinical, Radiological and Pleural Fluid Analytical Parameters.

PubMed

Herrera Lara, Susana; Fernández-Fabrellas, Estrella; Juan Samper, Gustavo; Marco Buades, Josefa; Andreu Lapiedra, Rafael; Pinilla Moreno, Amparo; Morales Suárez-Varela, María

2017-10-01

The usefulness of clinical, radiological and pleural fluid analytical parameters for diagnosing malignant and paramalignant pleural effusion is not clearly stated. Hence this study aimed to identify possible predictor variables of diagnosing malignancy in pleural effusion of unknown aetiology. Clinical, radiological and pleural fluid analytical parameters were obtained from consecutive patients who had suffered pleural effusion of unknown aetiology. They were classified into three groups according to their final diagnosis: malignant, paramalignant and benign pleural effusion. The CHAID (Chi-square automatic interaction detector) methodology was used to estimate the implication of the clinical, radiological and analytical variables in daily practice through decision trees. Of 71 patients, malignant (n = 31), paramalignant (n = 15) and benign (n = 25), smoking habit, dyspnoea, weight loss, radiological characteristics (mass, node, adenopathies and pleural thickening) and pleural fluid analytical parameters (pH and glucose) distinguished malignant and paramalignant pleural effusions (all with a p < 0.05). Decision tree 1 classified 77.8% of malignant and paramalignant pleural effusions in step 2. Decision tree 2 classified 83.3% of malignant pleural effusions in step 2, 73.3% of paramalignant pleural effusions and 91.7% of benign ones. The data herein suggest that the identified predictor values applied to tree diagrams, which required no extraordinary measures, have a higher rate of correct identification of malignant, paramalignant and benign effusions when compared to techniques available today and proved most useful for usual clinical practice. Future studies are still needed to further improve the classification of patients.

Evidence-based radiology: how to quickly assess the validity and strength of publications in the diagnostic radiology literature.

PubMed

Dodd, Jonathan D; MacEneaney, Peter M; Malone, Dermot E

2004-05-01

The aim of this study was to show how evidence-based medicine (EBM) techniques can be applied to the appraisal of diagnostic radiology publications. A clinical scenario is described: a gastroenterologist has questioned the diagnostic performance of magnetic resonance cholangiopancreatography (MRCP) in a patient who may have common bile duct (CBD) stones. His opinion was based on an article on MRCP published in "Gut." The principles of EBM are described and then applied to the critical appraisal of this paper. Another paper on the same subject was obtained from the radiology literature and was also critically appraised using explicit EBM criteria. The principles for assessing the validity and strength of both studies are outlined. All statistical parameters were generated quickly using a spreadsheet in Excel format. The results of EBM assessment of both papers are presented. The calculation and application of confidence intervals (CIs) and likelihood ratios (LRs) for both studies are described. These statistical results are applied to individual patient scenarios using graphs of conditional probability (GCP). Basic EBM principles are described and additional points relevant to radiologists discussed. Online resources for EBR practice are identified. The principles of EBM and their application to radiology are discussed. It is emphasized that sensitivity and specificity are point estimates of the "true" characteristics of a test in clinical practice. A spreadsheet can be used to quickly calculate CIs, LRs and GCPs. These give the radiologist a better understanding of the meaning of diagnostic test results in any patient or population of patients.

Referral criteria and clinical decision support: radiological protection aspects for justification.

PubMed

Pérez, M del Rosario

2015-06-01

Advanced imaging technology has opened new horizons for medical diagnostics and improved patient care. However, many procedures are unjustified and do not provide a net benefit. An area of particular concern is the unnecessary use of radiation when clinical evaluation or other imaging modalities could provide an accurate diagnosis. Referral criteria for medical imaging are consensus statements based on the best-available evidence to assist the decision-making process when choosing the best imaging procedure for a given patient. Although they are advisory rather than compulsory, physicians should have good reasons for deviation from these criteria. Voluntary use of referral criteria has shown limited success compared with integration into clinical decision support systems. These systems support good medical practice, can improve health service delivery, and foster safer, more efficient, fair, cost-effective care, thus contributing to the strengthening of health systems. Justification of procedures and optimisation of protection, the two pillars of radiological protection in health care, are implicit in the notion of good medical practice. However, some health professionals are not familiar with these principles, and have low awareness of radiological protection aspects of justification. A stronger collaboration between radiation protection and healthcare communities could contribute to improve the radiation protection culture in medical practice. © The Chartered Institution of Building Services Engineers 2014.

Maintenance of Certification for Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kun, Larry E.; Ang, Kian; Erickson, Beth

2005-06-01

Maintenance of Certification (MOC) recognizes that in addition to medical knowledge, several essential elements involved in delivering quality care must be developed and maintained throughout one's career. The MOC process is designed to facilitate and document professional development of American Board of Radiology (ABR) diplomates in the essential elements of quality care in Radiation Oncology and Radiologic Physics. ABR MOC has been developed in accord with guidelines of the American Board of Medical Specialties. All Radiation Oncology certificates issued since 1995 are 10-year, time-limited certificates; diplomates with time-limited certificates who wish to maintain specialty certification must complete specific requirements ofmore » the American Board of Radiology MOC program. Diplomates with lifelong certificates are not required to participate but are strongly encouraged to do so. Maintenance of Certification is based on documentation of participation in the four components of MOC: (1) professional standing, (2) lifelong learning and self-assessment, (3) cognitive expertise, and (4) performance in practice. Through these components, MOC addresses six competencies-medical knowledge, patient care, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Details of requirements for components 1, 2, and 3 of MOC are outlined along with aspects of the fourth component currently under development.« less

Medical health physics: a review.

PubMed

Vetter, Richard J

2004-05-01

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

Medical health physics: a review.

PubMed

Vetter, Richard J

2005-06-01

Medical health physics is the profession dedicated to the protection of healthcare providers, members of the public, and patients from unwarranted radiation exposure. Medical health physicists must be knowledgeable in the principles of health physics and in the applications of radiation in medicine. Advances in medical health physics require the definition of problems, testing of hypotheses, and gathering of evidence to defend changes in health physics practice and to assist medical practitioners in making changes in their practices as appropriate. Advances in radiation medicine have resulted in new modalities and procedures, some of which have significant potential to cause serious harm. Examples included in this review include radiologic procedures that require very long fluoroscopy times, radiolabeled monoclonal antibodies, and intravascular brachytherapy. This review summarizes evidence that supports changes in consensus recommendations, regulations, and health physics practices associated with recent advances in radiology, nuclear medicine, and radiation oncology. Medical health physicists must continue to gather evidence to support intelligent but practical methods for protection of personnel, the public, and patients as modalities and applications evolve in the practice of medicine.

New trends in radiology workstation design

NASA Astrophysics Data System (ADS)

Moise, Adrian; Atkins, M. Stella

2002-05-01

In the radiology workstation design, the race for adding more features is now morphing into an iterative user centric design with the focus on ergonomics and usability. The extent of the list of features for the radiology workstation used to be one of the most significant factors for a Picture Archiving and Communication System (PACS) vendor's ability to sell the radiology workstation. Not anymore is now very much the same between the major players in the PACS market. How these features work together distinguishes different radiology workstations. Integration (with the PACS/Radiology Information System (RIS) systems, with the 3D tool, Reporting Tool etc.), usability (user specific preferences, advanced display protocols, smart activation of tools etc.) and efficiency (what is the output a radiologist can generate with the workstation) are now core factors for selecting a workstation. This paper discusses these new trends in radiology workstation design. We demonstrate the importance of the interaction between the PACS vendor (software engineers) and the customer (radiologists) during the radiology workstation design. We focus on iterative aspects of the workstation development, such as the presentation of early prototypes to as many representative users as possible during the software development cycle and present the results of a survey of 8 radiologists on designing a radiology workstation.

Focal role of tolerability and reasonableness in the radiological protection system.

PubMed

Schneider, T; Lochard, J; Vaillant, L

2016-06-01

The concepts of tolerability and reasonableness are at the core of the International Commission on Radiological Protection (ICRP) system of radiological protection. Tolerability allows the definition of boundaries for implementing ICRP principles, while reasonableness contributes to decisions regarding adequate levels of protection, taking into account the prevailing circumstances. In the 1970s and 1980s, attempts to find theoretical foundations in risk comparisons for tolerability and cost-benefit analysis for reasonableness failed. In practice, the search for a rational basis for these concepts will never end. Making a wise decision will always remain a matter of judgement and will depend on the circumstances as well as the current knowledge and past experience. This paper discusses the constituents of tolerability and reasonableness at the heart of the radiological protection system. It also emphasises the increasing role of stakeholder engagement in the quest for tolerability and reasonableness since Publication 103. © The International Society for Prosthetics and Orthotics.

Pinworm infection masquerading as colorectal liver metastasis.

PubMed

Roberts, K J; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

2012-09-01

Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E. vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur.

Pinworm infection masquerading as colorectal liver metastasis

PubMed Central

Roberts, KJ; Hubscher, S; Mangat, K; Sutcliffe, R; Marudanayagam, R

2012-01-01

Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis due to typical radiological features and subsequently resected. At pathological assessment, however, a necrotic nodule containing E vermicularis was identified. Solitary necrotic nodules of the liver are usually benign but misdiagnosed frequently as malignant due to radiological features. It is standard practice to diagnose colorectal liver metastases solely on radiological evidence. Without obtaining tissue prior to liver resection, misdiagnosis of solitary necrotic nodules of the liver will continue to occur. PMID:22943320

Radiology and Ethics Education.

PubMed

Camargo, Aline; Liu, Li; Yousem, David M

2017-09-01

The purpose of this study is to assess medical ethics knowledge among trainees and practicing radiologists through an online survey that included questions about the American College of Radiology Code of Ethics and the American Medical Association Code of Medical Ethics. Most survey respondents reported that they had never read the American Medical Association Code of Medical Ethics or the American College of Radiology Code of Ethics (77.2% and 67.4% of respondents, respectively). With regard to ethics education during medical school and residency, 57.3% and 70.0% of respondents, respectively, found such education to be insufficient. Medical ethics training should be highlighted during residency, at specialty society meetings, and in journals and online resources for radiologists.

Using computational modeling to compare X-ray tube Practical Peak Voltage for Dental Radiology

NASA Astrophysics Data System (ADS)

Holanda Cassiano, Deisemar; Arruda Correa, Samanda Cristine; de Souza, Edmilson Monteiro; da Silva, Ademir Xaxier; Pereira Peixoto, José Guilherme; Tadeu Lopes, Ricardo

2014-02-01

The Practical Peak Voltage-PPV has been adopted to measure the voltage applied to an X-ray tube. The PPV was recommended by the IEC document and accepted and published in the TRS no. 457 code of practice. The PPV is defined and applied to all forms of waves and is related to the spectral distribution of X-rays and to the properties of the image. The calibration of X-rays tubes was performed using the MCNPX Monte Carlo code. An X-ray tube for Dental Radiology (operated from a single phase power supply) and an X-ray tube used as a reference (supplied from a constant potential power supply) were used in simulations across the energy range of interest of 40 kV to 100 kV. Results obtained indicated a linear relationship between the tubes involved.

76 FR 58520 - Proposed Collection; Comment Request; Cancer Risk in U.S. Radiologic Technologists: Fourth Survey...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-21

... medical outcomes, personal medical radiation procedures, and other risk factors from all participants... worked with radioisotopes and interventional radiography procedures, and new or updated risk factors that... Request; Cancer Risk in U.S. Radiologic Technologists: Fourth Survey (NCI) SUMMARY: In compliance with the...

[Radiologic risk and INAIL insurance].

PubMed

Matarasso, S; Coraggio, F; Martuscelli, R; D'Antonio, F

1990-09-01

The Authors examine in this scientific work the radiological risk to which the dentist is exposed during his daily professional activity. They underline, moreover, the partial interpretation of the regulation in force by INAIL and ANPEQ that bind the dentist to a series of accomplishments that seem unjustified as regards the laws in force.

Visual Expertise as Embodied Practice

ERIC Educational Resources Information Center

Ivarsson, Jonas

2017-01-01

This study looks at the practice of thoracic radiology and follows a group of radiologists and radiophysicists in their efforts to find, discuss, and formulate issues or troubles ensuing the implementation of a new radiographic imaging technology. Based in the theoretical tradition of ethnomethodology it examines the local endogenous practices…

Work history and mortality risks in 90,268 US radiological technologists.

PubMed

Liu, Jason J; Freedman, D Michal; Little, Mark P; Doody, Michele M; Alexander, Bruce H; Kitahara, Cari M; Lee, Terrence; Rajaraman, Preetha; Miller, Jeremy S; Kampa, Diane M; Simon, Steven L; Preston, Dale L; Linet, Martha S

2014-12-01

There have been few studies of work history and mortality risks in medical radiation workers. We expanded by 11 years and more outcomes our previous study of mortality risks and work history, a proxy for radiation exposure. Using Cox proportional hazards models, we estimated mortality risks according to questionnaire work history responses from 1983 to 1989 through 2008 by 90,268 US radiological technologists. We controlled for potential confounding by age, birth year, smoking history, body mass index, race and gender. There were 9566 deaths (3329 cancer and 3020 circulatory system diseases). Mortality risks increased significantly with earlier year began working for female breast (p trend=0.01) and stomach cancers (p trend=0.01), ischaemic heart (p trend=0.03) and cerebrovascular diseases (p trend=0.02). The significant trend with earlier year first worked was strongly apparent for breast cancer during baseline through 1997, but not 1998-2008. Risks were similar in the two periods for circulatory diseases. Radiological technologists working ≥5 years before 1950 had elevated mortality from breast cancer (HR=2.05, 95% CI 1.27 to 3.32), leukaemia (HR=2.57, 95% CI 0.96 to 6.68), ischaemic heart disease (HR=1.13, 95% CI 0.96 to 1.33) and cerebrovascular disease (HR=1.28, 95% CI 0.97 to 1.69). No other work history factors were consistently associated with mortality risks from specific cancers or circulatory diseases, or other conditions. Radiological technologists who began working in early periods and for more years before 1950 had increased mortality from a few cancers and some circulatory system diseases, likely reflecting higher occupational radiation exposures in the earlier years. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Measuring and improving productivity in general radiology.

PubMed

Wilt, Michelle A; Miranda, Rafael; Johnson, C Daniel; Love, Peggy Sue

2010-10-01

The aim of this study was to determine a method of measuring productivity among general radiographers in a moderate-sized hospital and to improve and sustain productivity within that work area. The average times needed to perform the 13 most common examinations were measured. Performance of the various examinations was tracked and multiplied by the time allocated per procedure; this measure was divided by the length of the work shift to determine productivity. Productivity measures were shared among the work group, and decisions to improve productivity (eg, whether to fill open positions) were made by group members. Average time spent per examination type was calculated (range, 10 minutes to 1 hour 16 minutes). At baseline (February 2008), group productivity was 50%. Productivity increased during the first year of monitoring and was sustained through November 2009 (productivity range, 57%-63%). Yearly savings from not filling open positions were estimated to be $174,000. Productivity in a general radiology work area can be measured. Consensus among the work group helped increase productivity and assess progress. This methodology, if widely adopted, could be standardized and used to compare productivity across departments and institutions. Copyright © 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiological emergency: Malaysian preparedness and response.

PubMed

Yusof, Mohd Abd Wahab; Ali, Hamrah Mohd

2011-07-01

Planning and preparation in advance for radiological emergencies can help to minimise potential public health and environmental threats if and when an actual emergency occurs. During the planning process, emergency response organisations think through how they would respond to each type of incident and the resources that will be needed. In Malaysia, planning, preparation for and response to radiological emergencies involve many parties. In the event of a radiological emergency and if it is considered a disaster, the National Security Council, the Atomic Energy Licensing Board and the Malaysian Nuclear Agency (Nuclear Malaysia) will work together with other federal agencies, state and local governments, first responders and international organisations to monitor the situation, contain the release, and clean up the contaminated site. Throughout the response, these agencies use their protective action guidelines. This paper discusses Malaysian preparedness for, and response to, any potential radiological emergency.

Ergonomics in radiology.

PubMed

Goyal, N; Jain, N; Rachapalli, V

2009-02-01

The use of computers is increasing in every field of medicine, especially radiology. Filmless radiology departments, speech recognition software, electronic request forms and teleradiology are some of the recent developments that have substantially increased the amount of time a radiologist spends in front of a computer monitor. Computers are also needed for searching literature on the internet, communicating via e-mails, and preparing for lectures and presentations. It is well known that regular computer users can suffer musculoskeletal injuries due to repetitive stress. The role of ergonomics in radiology is to ensure that working conditions are optimized in order to avoid injury and fatigue. Adequate workplace ergonomics can go a long way in increasing productivity, efficiency, and job satisfaction. We review the current literature pertaining to the role of ergonomics in modern-day radiology especially with the development of picture archiving and communication systems (PACS) workstations.

[Diagnostic radiology in the technological era. Comparison between two models].

PubMed

Andrade-Barreto, O A; Villa-Caballero, Leonel

2005-01-01

Diagnostic Radiology is a medical specialty that has played a dynamic role in the medical arena during the last three decades of the XX century. As a part of the evolution of this specialty, medicine and society at large have received diverse benefits in areas of diagnosis and for the decision making process in the clinical practice. Modern radiology has provided numerous advances and refined tools that give more convenience speed and precise diagnosis in the current medical practice. At the present time, these technologies are part of the standard of care in the US and other industrialized countries, representing the ultimate desire or goal to reach for other healthcare systems in developing countries as well. Unfortunately, many of the clinical skills in the health care personal have not evolved at the same pace of those modern technologies, conditioning a reduction in the performance of sensitive areas to the patient's interest, such as the caring, compassion and quality of health care. It is unquestionable the value and benefits that technologies such as CAT and MRI scans have brought to the standard practice in the recent time. Nonetheless, it is desirable to maintain the highest possible level of clinical skills despite the extended use of modern technologies by the health personnel, without compromising the quality of care. Yet is pending the future role and rational use for those technologies in radiology, especially in times when delivering good, reliable health care have become a priority for many health institutions worldwide. This approach would be the ultimate goal to reach in times and circumstances where health for all is the highest precious value to obtain at global level.

Policies and Procedures for Reviewing Medical Images From Portable Media: Survey of Radiology Departments

PubMed Central

Kalia, Vivek; Carrino, John A.; Macura, Katarzyna J.

2015-01-01

Purpose The purpose of this study was to survey current practices for portable media (CDs and DVDs) use for medical imaging in both academic and nonacademic radiology departments in the United States. Methods This survey was a stratified, nonrandom sample, 22-question electronic survey, using SurveyMonkey, of members of the Association of Administrators in Academic Radiology, the Association for Medical Imaging Management, and the University HealthSystem Consortium, conducted in November 2009. Questions were grouped by media production and media viewing practices. Results One hundred and two individual responses to the survey were received. Ninety-eight percent of respondents said that their institutions produced Digital Imaging and Communications in Medicine (DICOM)-compliant media, with only 2.0% uncertain. Only 22.2% of respondents claimed that their institutions produced Integrating the Healthcare Enterprise (IHE) Portable Data for Imaging (PDI)-compliant media, while 71.6% were uncertain. Rates of DICOM and IHE PDI compliance did not differ between academic and nonacademic centers. As for testing digital media produced at the institutions for DICOM and IHE PDI compliance, only 16.0% of respondents’ institutions routinely did so. Conclusions Three main problem areas regarding portable media became evident from this study: (1) access, (2) importability, and (3) viewing issues, and problems with any of the 3 can delay patient care. Noncompliance and a lack of knowledge about compliance were found to be major issues in the present study, more so for IHE PDI than for DICOM, and there is much room for improvement. Recommendations include that radiology practices should routinely generate only media compliant with DICOM and IHE PDI and should test for compliance. PMID:21211763

Ethics in radiology: wait lists queue jumping.

PubMed

Cunningham, Natalie; Reid, Lynette; MacSwain, Sarah; Clarke, James R

2013-08-01

Education in ethics is a requirement for all Royal College residency training programs as laid out in the General Standards of Accreditation for residency programs in Canada. The ethical challenges that face radiologists in clinical practice are often different from those that face other physicians, because the nature of the physician-patient interaction is unlike that of many other specialties. Ethics education for radiologists and radiology residents will benefit from the development of teaching materials and resources that focus on the issues that are specific to the specialty. This article is intended to serve as an educational resource for radiology training programs to facilitate teaching ethics to residents and also as a continuing medical education resource for practicing radiologists. In an environment of limited health care resources, radiologists are frequently asked to expedite imaging studies for patients and, in some respects, act as gatekeepers for specialty care. The issues of wait lists, queue jumping, and balancing the needs of individuals and society are explored from the perspective of a radiologist. Copyright © 2013 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Five years' experience in a (really) rural teleradiology practice. Was it worth it? The successes and the failures

NASA Astrophysics Data System (ADS)

Telepak, Robert J.; Freede, Emily; Jaramillo, Richard E.; Alverson, Dale C.

1998-07-01

During the past 5 years (1992 - 1997) the Department of Radiology of the University of New Mexico Health Sciences Center has developed an active teleradiology program. Contracts are in place to provide both routine and emergency image interpretations 24 hours per day, every day of the year. Several rural hospitals are served as well as the Navajo Indian Health Service. Areas of success: include significantly improved radiologic service to the rural sites, specialty consultations to general radiologists, successful teaching of teleradiology practice to radiology residents and staff, good diagnostic quality images, a small but real profit, improved quality assurance for the rural sites, and no significant medical-legal problems. Failures include: significant telecommunications problems, lack of acceptance and utilization by some of the rural sites, poor QA compliance by some sites, a long period of disappointing technical support by equipment vendors, and slow acceptance of DICOM by equipment manufacturers. The successes outweigh the failures. We would do it again -- but somewhat differently. We offer advice to institutions developing a new rural teleradiology operation.

Training of interventional cardiologists in radiation protection--the IAEA's initiatives.

PubMed

Rehani, Madan M

2007-01-08

The International Atomic Energy Agency (IAEA) has initiated a major international initiative to train interventional cardiologists in radiation protection as a part of its International Action Plan on the radiological protection of patients. A simple programme of two days' training has been developed, covering possible and observed radiation effects among patients and staff, international standards, dose management techniques, examples of good and bad practice and examples indicating prevention of possible injuries as a result of good practice of radiation protection. The training material is freely available on CD from the IAEA. The IAEA has conducted two events in 2004 and 2005 and number of events are planned in 2006. The survey conducted among the cardiologists participating in these programmes indicates that over 80% of them were attending such a structured programme on radiation protection for the first time. As the magnitude of X-ray usage in cardiology grows to match that in interventional radiology, the standards of training on radiation effects, radiation physics and radiation protection in interventional cardiology should also match those in interventional radiology.

Is current clinical practice modified about intraoperative breast irradiation?

PubMed

Massa, Michela; Franchelli, Simonetta; Panizza, Renzo; Massa, Tiberio

2016-04-01

After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

The polity of academic medicine: a critical analysis of autocratic governance.

PubMed

Willing, Steven J; Gunderman, Richard B; Cochran, Philip L; Saxton, Todd

2004-12-01

How should academic radiology departments be governed? This question has rarely been directly addressed in the radiology literature. The dominant model of administration in present-day academic departments differs from that typically seen in private group practices. Whereas private group practices tend to follow a democratic model whereby key decisions must be supported by a majority of the partners, in academic institutions, medical school deans and department chairs generally possess great latitude in strategic and operational decision making. This article considers arguments for and against "top-down" governance in academia. The rationale supporting this form of governance is weak, and the best evidence from the fields of management and organizational behavior suggests it may in fact be detrimental.

Bits and bytes: the future of radiology lies in informatics and information technology.

PubMed

Brink, James A; Arenson, Ronald L; Grist, Thomas M; Lewin, Jonathan S; Enzmann, Dieter

2017-09-01

Advances in informatics and information technology are sure to alter the practice of medical imaging and image-guided therapies substantially over the next decade. Each element of the imaging continuum will be affected by substantial increases in computing capacity coincident with the seamless integration of digital technology into our society at large. This article focuses primarily on areas where this IT transformation is likely to have a profound effect on the practice of radiology. • Clinical decision support ensures consistent and appropriate resource utilization. • Big data enables correlation of health information across multiple domains. • Data mining advances the quality of medical decision-making. • Business analytics allow radiologists to maximize the benefits of imaging resources.

Radiological health risk evaluation of radium contaminated land: a real life implementation.

PubMed

Paridaens, J

2005-01-01

A plot of land, currently used for dairy farming, has been contaminated over the years with radium due to the operation of one of the world's largest radium production plants. Within the framework of a global remediation approach for the plant surroundings, the land owner needed advice for a future destination of the land. Therefore, the radium contamination was accurately mapped, and on the basis of its severity a practically feasible subdivision of the land into four plots was proposed. For all four plots, the radiological risk was evaluated for the current type of land use and for possible alternative types. Hence a clear and useable advice could be formulated to the authorities reconciling public health, economic and practical issues.

Noncompete clauses: a contract provision that has exhausted its usefulness?

PubMed

Mezrich, Jonathan L; Siegel, Eliot L

2014-02-01

Noncompete clauses (NCs) are common in many physician employment agreements, including those of radiologists. NCs restrict radiologists' ability to perform services for anyone other than their employers, not only during the term of employment but also for a period of time after employment ends. Although courts frown on the post-termination portion as a restraint of trade, in most states, NCs will be enforced if they are deemed reasonable in duration and geography. However the practice of radiology has changed. Teleradiology is common, and improvements in telecommunications and portable devices allow radiologists to perform their services virtually anywhere. In light of these changes, are NCs still necessary for radiologists? Eighty-six University of Maryland radiology residency alumni for whom e-mail information was available were asked to complete an online survey regarding whether they are subject to NCs, the key terms of their NCs, and their views on the continuing usefulness of NCs. A review of all state and federal cases published in the Westlaw law database in which radiologists' NCs were adjudicated was also performed. Twenty-one alumni from our residency program completed the survey, representing a 24.4% response rate; 57.1% of respondents are subject to NCs. Of that group, post-termination restrictions ranged from 1 to 2 years in duration, and geographic limitations ranged from 7 to >50 miles from the employer's practice. Respondents were split as to the impact of teleradiology, with 36.8% feeling that NCs are now more necessary and 26.3% feeling that NCs are less necessary. Searches of Westlaw revealed 7 cases on point, which upheld as reasonable NCs ranging from 1 to 5 years in duration and imposing geographic limitations of 15 to 40 miles from the employer's practice. Although the practice of radiology has undergone significant changes, this survey shows that NCs are still widely used and are still being enforced in many courts. It is unclear whether NCs still make sense in today's practice, but it may be important to modify them to explicitly address the practice of teleradiology. NCs are common and have been upheld in court, although radiologists are split on their usefulness in this era of teleradiology. Contracts should specifically address teleradiology in NC provisions. Copyright © 2014 American College of Radiology. All rights reserved.

PACS for surgery and interventional radiology: features of a Therapy Imaging and Model Management System (TIMMS).

PubMed

Lemke, Heinz U; Berliner, Leonard

2011-05-01

Appropriate use of information and communication technology (ICT) and mechatronic (MT) systems is viewed by many experts as a means to improve workflow and quality of care in the operating room (OR). This will require a suitable information technology (IT) infrastructure, as well as communication and interface standards, such as specialized extensions of DICOM, to allow data interchange between surgical system components in the OR. A design of such an infrastructure, sometimes referred to as surgical PACS, but better defined as a Therapy Imaging and Model Management System (TIMMS), will be introduced in this article. A TIMMS should support the essential functions that enable and advance image guided therapy, and in the future, a more comprehensive form of patient-model guided therapy. Within this concept, the "image-centric world view" of the classical PACS technology is complemented by an IT "model-centric world view". Such a view is founded in the special patient modelling needs of an increasing number of modern surgical interventions as compared to the imaging intensive working mode of diagnostic radiology, for which PACS was originally conceptualised and developed. The modelling aspects refer to both patient information and workflow modelling. Standards for creating and integrating information about patients, equipment, and procedures are vitally needed when planning for an efficient OR. The DICOM Working Group 24 (WG-24) has been established to develop DICOM objects and services related to image and model guided surgery. To determine these standards, it is important to define step-by-step surgical workflow practices and create interventional workflow models per procedures or per variable cases. As the boundaries between radiation therapy, surgery and interventional radiology are becoming less well-defined, precise patient models will become the greatest common denominator for all therapeutic disciplines. In addition to imaging, the focus of WG-24 is to serve the therapeutic disciplines by enabling modelling technology to be based on standards. Copyright © 2011. Published by Elsevier Ireland Ltd.

Improving Radiation Awareness and Feeling of Personal Security of Non-Radiological Medical Staff by Implementing a Traffic Light System in Computed Tomography.

PubMed

Heilmaier, C; Mayor, A; Zuber, N; Fodor, P; Weishaupt, D

2016-03-01

Non-radiological medical professionals often need to remain in the scanning room during computed tomography (CT) examinations to supervise patients in critical condition. Independent of protective devices, their position significantly influences the radiation dose they receive. The purpose of this study was to assess if a traffic light system indicating areas of different radiation exposure improves non-radiological medical staff's radiation awareness and feeling of personal security. Phantom measurements were performed to define areas of different dose rates and colored stickers were applied on the floor according to a traffic light system: green = lowest, orange = intermediate, and red = highest possible radiation exposure. Non-radiological medical professionals with different years of working experience evaluated the system using a structured questionnaire. Kruskal-Wallis and Spearman's correlation test were applied for statistical analysis. Fifty-six subjects (30 physicians, 26 nursing staff) took part in this prospective study. Overall rating of the system was very good, and almost all professionals tried to stand in the green stickers during the scan. The system significantly increased radiation awareness and feeling of personal protection particularly in staff with ≤ 5 years of working experience (p < 0.05). The majority of non-radiological medical professionals stated that staying in the green stickers and patient care would be compatible. Knowledge of radiation protection was poor in all groups, especially among entry-level employees (p < 0.05). A traffic light system in the CT scanning room indicating areas with lowest, intermediate, and highest possible radiation exposure is much appreciated. It increases radiation awareness, improves the sense of personal radiation protection, and may support endeavors to lower occupational radiation exposure, although the best radiation protection always is to re-main outside the CT room during the scan. • A traffic light system indicating areas with different radiation exposure within the computed tomography scanner room is much appreciated by non-radiological medical staff. • The traffic light system increases non-radiological medical staff's radiation awareness and feeling of personal protection. • Knowledge on radiation protection was poor in non-radiological medical staff, especially in those with few working experience. © Georg Thieme Verlag KG Stuttgart · New York.

The 2013 ACR Commission on Human Resources workforce survey.

PubMed

Bluth, Edward I; Truong, Hang; Nsiah, Eugene; Hughes, Danny; Short, Bradley W

2013-10-01

The ACR Commission on Human Resources conducts an annual electronic survey during the first quarter of the year to better understand the present workforce situation for radiologists. We used the Practice of Radiology Environment Database (PRED) to identify 2,067 practice leaders and asked them to complete an electronic survey developed by the Commission on Human Resources. The survey asked group leaders or their designates to report the number of radiologists they currently employ or supervise, the number hired in 2012, and the number they plan to hire in 2013 and 2016. The leaders were also asked to report the subspecialty area that was used as the main reason for hiring that physician. Of the 2,067 practice leaders surveyed, 22% responded, a figure corresponding to 23% of all practicing radiologists in the United States. These results showed that 54% of radiologists are in private practice and 46% are employed by various other entities. The current workforce consists of 21% general radiologists and 79% subspecialists. The largest areas of subspecialty include general interventionalists, neuroradiologists, and body imagers. In 2012, 1,407 radiologists were hired. The greatest number of radiologists hired involved general interventional radiologists, followed by general radiologists, body imagers, and those specializing in musculoskeletal radiology, neuroradiology, and breast imaging. In 2013, 1,526 job opportunities were projected and in 2016, 1,434 job opportunities. In 2013, the most sought-after individuals will be general radiologists, general interventionalists, breast imagers, neuroradiologists, musculoskeletal radiologists, and body imagers. Based on the data collected from the responding practices, the demand for hiring radiologists in 2013 will be similar to 2012. Each of the 1,200 residents who complete their training programs each year should have a position available, but the job may not necessarily be in the subspecialty, geographic area, or type of practice that the individual desires. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Guidelines for the identification of unknown samples for laboratories performing forensic analyses for chemical terrorism.

PubMed

Magnuson, Matthew L; Satzger, R Duane; Alcaraz, Armando; Brewer, Jason; Fetterolf, Dean; Harper, Martin; Hrynchuk, Ronald; McNally, Mary F; Montgomery, Madeline; Nottingham, Eric; Peterson, James; Rickenbach, Michael; Seidel, Jimmy L; Wolnik, Karen

2012-05-01

Since the early 1990s, the FBI Laboratory has sponsored Scientific Working Groups to improve discipline practices and build consensus among the forensic community. The Scientific Working Group on the Forensic Analysis of Chemical, Biological, Radiological and Nuclear Terrorism developed guidance, contained in this document, on issues forensic laboratories encounter when accepting and analyzing unknown samples associated with chemical terrorism, including laboratory capabilities and analytical testing plans. In the context of forensic analysis of chemical terrorism, this guidance defines an unknown sample and addresses what constitutes definitive and tentative identification. Laboratory safety, reporting issues, and postreporting considerations are also discussed. Utilization of these guidelines, as part of planning for forensic analysis related to a chemical terrorism incident, may help avoid unfortunate consequences not only to the public but also to the laboratory personnel. 2011 American Academy of Forensic Sciences. Published 2011. This article is a U.S. Government work and is in the public domain in the U.S.A.

Ethical issues related to professional exposure of pregnant women in the medical field: monitoring and limiting effective dose.

PubMed

Santos, J A M; Nunes, R

2011-03-01

The International Commission on Radiological Protection recommendations for occupational exposed pregnant women do not imply necessarily the complete avoidance of work with radiation or radioactive materials. Instead, a careful review of the exposure conditions, once the pregnancy is declared, as part of the exercise of the ICRP optimisation principle (based in a teleological ethics point of view) is suggested. The dose limitation (following a deontological ethics point of view) of the fetus/embryo is, however, not clearly well established as happens in the case of workers or members of the public. Also, the justification of practices (to continue to work or not with radiation or radioactive materials) is not clearly addressed in most national or international recommendations. An analysis of this justification (bearing in mind both teleological and deontological ethics) is examined in this work having in mind the best interest of the child-to-be as well as other existing social and economical factors.

Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

PubMed

Lääperi, A L

1996-01-01

The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and nonmonetary variables was developed. In it the radiologist, radiographer and examination-specific equipment costs were allocated to the examinations applying estimated cost equivalents. Some minor cost items were replaced by a general cost factor (GCF). The program is suitable for internal cost accounting of radiological departments as well as regional planning. If more accurate cost information is required, cost assignment employing the actual consumption of the resources and applying the principles of activity-based cost accounting is recommended. As an application of the cost accounting formula the average costs of the radiological examinations were calculated. In conventional radiography the average proportion of the cost factors in the total material was: personnel costs 43%, equipment costs 26%, material costs 7%, real estate costs 11%, administration and overheads 14%. The average total costs including radiologist costs in the hospitals were (FIM): conventional roentgen examinations 188, contrast medium examinations 695, ultrasound 296, mammography 315, roentgen examinations with mobile equipment 1578. The average total costs without radiologist costs in the public health centres were (FIM): conventional roentgen examinations 107, contrast medium examinations 988, ultrasound 203, mammography 557. The average currency rate of exchange in 1991 was USD 1 = FIM 4.046. The following formula is proposed for calculating the cost of a radiological examination (or a group of examinations) performed with a certain piece of equipment during a period of time (e.g. 1 year): a2/ sigma ax*ax+ b2/ sigma bx*bx+ d1/d5*dx+ e1 + [(c1+ c2) + d4 + (e2 - e3) + f5 + g1+ g2+ i]/n.

Coding for effective denial management.

PubMed

Miller, Jackie; Lineberry, Joe

2004-01-01

Nearly everyone will agree that accurate and consistent coding of diagnoses and procedures is the cornerstone for operating a compliant practice. The CPT or HCPCS procedure code tells the payor what service was performed and also (in most cases) determines the amount of payment. The ICD-9-CM diagnosis code, on the other hand, tells the payor why the service was performed. If the diagnosis code does not meet the payor's criteria for medical necessity, all payment for the service will be denied. Implementation of an effective denial management program can help "stop the bleeding." Denial management is a comprehensive process that works in two ways. First, it evaluates the cause of denials and takes steps to prevent them. Second, denial management creates specific procedures for refiling or appealing claims that are initially denied. Accurate, consistent and compliant coding is key to both of these functions. The process of proactively managing claim denials also reveals a practice's administrative strengths and weaknesses, enabling radiology business managers to streamline processes, eliminate duplicated efforts and shift a larger proportion of the staff's focus from paperwork to servicing patients--all of which are sure to enhance operations and improve practice management and office morale. Accurate coding requires a program of ongoing training and education in both CPT and ICD-9-CM coding. Radiology business managers must make education a top priority for their coding staff. Front office staff, technologists and radiologists should also be familiar with the types of information needed for accurate coding. A good staff training program will also cover the proper use of Advance Beneficiary Notices (ABNs). Registration and coding staff should understand how to determine whether the patient's clinical history meets criteria for Medicare coverage, and how to administer an ABN if the exam is likely to be denied. Staff should also understand the restrictions on use of ABNs and the compliance risks associated with improper use. Finally, training programs should include routine audits to monitor coders for competence and precision. Constantly changing codes and guidelines mean that a coder's skills can quickly become obsolete if not reinforced by ongoing training and monitoring. Comprehensive reporting and routine analysis of claim denials is without a doubt one of the greatest assets to a practice that is suffering from excessive claim denials and should be considered an investment capable of providing both short and long term ROIs. Some radiologists may lack the funding or human resources needed to implement truly effective coding programs for their staff members. In these circumstances, radiology business managers should consider outsourcing their coding.

Breaking Bad News: A Survey of Radiology Residents' Experiences Communicating Results to Patients.

PubMed

Narayan, Anand; Dromi, Sergio; Meeks, Adam; Gomez, Erin; Lee, Bonmyong

The practice of radiology often includes routine communication of diagnostic test results directly to patients in breast imaging and interventional radiology. There is increasing interest in expanding direct communication throughout radiology. Though these conversations can substantially affect patient well-being, there is limited evidence indicating that radiology residents are specifically taught methods to effectively convey imaging results to patients. Our purpose is to evaluate resident experience communicating imaging results to patients. An IRB-approved study with a total of 11 pilot-tested questions was used. Surveyed programs included radiology residents (PGY2-PGY5) at 2 urban residency programs. Online surveys were administered using SurveyMonkey and e-mailed to residents at both programs (starting November 20, 2015, completed March 31, 2016). Demographics were obtained with survey proportions compared using logistic regression (P < 0.05, statistically significant). A total of 73 residents responded (93.6% response rate) with similar response rates at each institution (P = 0.689). Most were male (71.2%) with 17.8% planning to go into breast imaging (21.9%, interventional radiology (IR)). Furthermore, 83.6% described no training in communicating radiology results to patients; 91.8% of residents communicated results with patients (87.7% diagnostic imaging tests and 57.5% biopsies). Residents most commonly communicated results in person (75.3%) followed by phone (64.4%), and 79.4% agreed or strongly agreed that additional training relaying results would be helpful. A large majority of radiology residents have communicated test results to patients, yet few have received training in how to communicate these results. A large majority of residents expressed interest in obtaining additional communication training. Additional research is required to determine ideal methods to educate residents on communicating test results. Copyright © 2018 Elsevier Inc. All rights reserved.

Implementation of Certified EHR, Patient Portal, and "Direct" Messaging Technology in a Radiology Environment Enhances Communication of Radiology Results to Both Referring Physicians and Patients.

PubMed

Reicher, Joshua Jay; Reicher, Murray Aaron

2016-06-01

Since 2009, the Federal government distributed over $29 billion to providers who were adopting compliant electronic health record (EHR) technology. With a focus on radiology, we explore how EHR technology impacts interoperability with referring clinicians' EHRs and patient engagement. We also discuss the high-level details of contributing supporting frameworks, specifically Direct messaging and health information service provider (HISP) technology. We characterized Direct messaging, a secure e-mail-like protocol built to allow exchange of encrypted health information online, and the new supporting HISP infrastructure. Statistics related to both the testing and active use of this framework were obtained from DirectTrust.org, an organization whose framework supports Direct messaging use by healthcare organizations. To evaluate patient engagement, we obtained usage data from a radiology-centric patient portal between 2014 and 2015, which in some cases included access to radiology reports. Statistics from 2013 to 2015 showed a rise in issued secure Direct addresses from 8724 to 752,496; a rise in the number of participating healthcare organizations from 667 to 39,751; and a rise in the secure messages sent from 122,842 to 27,316,438. Regarding patient engagement, an average of 234,679 patients per month were provided portal access, with 86,400 patients per month given access to radiology reports. Availability of radiology reports online was strongly associated with increased system usage, with a likelihood ratio of 2.63. The use of certified EHR technology and Direct messaging in the practice of radiology allows for the communication of patient information and radiology results with referring clinicians and increases patient use of patient portal technology, supporting bidirectional radiologist-patient communication.

Natural Language Processing Techniques for Extracting and Categorizing Finding Measurements in Narrative Radiology Reports.

PubMed

Sevenster, M; Buurman, J; Liu, P; Peters, J F; Chang, P J

2015-01-01

Accumulating quantitative outcome parameters may contribute to constructing a healthcare organization in which outcomes of clinical procedures are reproducible and predictable. In imaging studies, measurements are the principal category of quantitative para meters. The purpose of this work is to develop and evaluate two natural language processing engines that extract finding and organ measurements from narrative radiology reports and to categorize extracted measurements by their "temporality". The measurement extraction engine is developed as a set of regular expressions. The engine was evaluated against a manually created ground truth. Automated categorization of measurement temporality is defined as a machine learning problem. A ground truth was manually developed based on a corpus of radiology reports. A maximum entropy model was created using features that characterize the measurement itself and its narrative context. The model was evaluated in a ten-fold cross validation protocol. The measurement extraction engine has precision 0.994 and recall 0.991. Accuracy of the measurement classification engine is 0.960. The work contributes to machine understanding of radiology reports and may find application in software applications that process medical data.

Radiology employees' quality of work life.

PubMed

Dargahi, Hussein; Changizi, Vahid; Jazayeri Gharabagh, Elaheh

2012-01-01

Quality of work Life (QWL) originates from interactions between employees' needs and relative organizational resources. QWL is aimed to improve and retain employees' satisfaction, productivity and effectiveness of all organizations. A cross-sectional descriptive study was conducted among 15 Tehran University of Medical Sciences. A Cross-Sectional, descriptive study was conducted among 15 Tehran University of Medical Sciences' Hospitals' Radiology Departments' Employees by QWL questionnaire. Respondents were asked to express their attitudes about a range of key factors as the most important issues impacting their QWL. The data was collected and analyzed by SPSS version 15 software. Most of the respondents indicated that they were unsatisfied and very unsatisfied with key factors of their QWL. Comparison of QWL key factors of TUMS radiology employees with the other countries indicated that most of the employees are unsatisfied with their poor QWL factors. We hope, the implications of these findings deliberate to improve QWL within each of TUMS hospitals radiology departments and also be relevant and value to policymakers of healthcare organizations in Iran. © 2012 Tehran University of Medical Sciences. All rights reserved.

Finding order in complexity: themes from the career of Dr. Robert F. Wagner

NASA Astrophysics Data System (ADS)

Myers, Kyle J.

2009-02-01

Over the course of his long and productive career, Dr. Robert F. Wagner built a framework for the evaluation of imaging systems based on a task-based, decision theoretic approach. His most recent contributions involved the consideration of the random effects associated with multiple readers of medical images and the logical extension of this work to the problem of the evaluation of multiple competing classifiers in statistical pattern recognition. This contemporary work expanded on familiar themes from Bob's many SPIE presentations in earlier years. It was driven by the need for practical solutions to current problems facing FDA'S Center for Devices and Radiological Health and the medical imaging community regarding the assessment of new computer-aided diagnosis tools and Bob's unique ability to unify concepts across a range of disciplines as he gave order to increasingly complex problems in our field.

Spending an Evening in the Dark: The Radiology Medical Student Call Experience.

PubMed

Monks, Dennis; Pagano, Brian; Hartman, Matthew

The level of independent decision-making required of a radiology resident, as well as the acuity of studies populating the worklist, differ between the normal workday and a call shift. However, unlike clerkships where call is standard, medical students in radiology typically only have half of the true resident experience. To expose our rotating medical students to what a future career in radiology might actually look like, we implemented a required call shift as part of our medical student curriculum. All rotating third- and fourth-year medical students were assigned a single 3-hour short call shift alongside a radiology resident during the final week of their rotation. Following this shift, students answered questions via anonymous online survey regarding their perceptions of radiology (primary end point) as well as workload and role of radiology in the clinical care of patients (secondary end points). Following medical student call, 63% of students reported a more positive view of radiology as a career. Additionally, 57% felt that radiology residents work as much or more than other specialties while one call, and several students identified communication issues regarding indications or appropriateness of studies. While we hope that this overwhelmingly positive experience will draw more students into radiology as a career, we also believe that many participating medical students will benefit from a greater understanding of what a radiologist׳s job entails, as well as how this may be affected by communication issues or increased utilization of imaging. Copyright © 2017 Elsevier Inc. All rights reserved.

Bridging the gap between basic and clinical sciences: A description of a radiological anatomy course.

PubMed

Torres, Anna; Staśkiewicz, Grzegorz J; Lisiecka, Justyna; Pietrzyk, Łukasz; Czekajlo, Michael; Arancibia, Carlos U; Maciejewski, Ryszard; Torres, Kamil

2016-05-06

A wide variety of medical imaging techniques pervade modern medicine, and the changing portability and performance of tools like ultrasound imaging have brought these medical imaging techniques into the everyday practice of many specialties outside of radiology. However, proper interpretation of ultrasonographic and computed tomographic images requires the practitioner to not only hone certain technical skills, but to command an excellent knowledge of sectional anatomy and an understanding of the pathophysiology of the examined areas as well. Yet throughout many medical curricula there is often a large gap between traditional anatomy coursework and clinical training in imaging techniques. The authors present a radiological anatomy course developed to teach sectional anatomy with particular emphasis on ultrasonography and computed tomography, while incorporating elements of medical simulation. To assess students' overall opinions about the course and to examine its impact on their self-perceived improvement in their knowledge of radiological anatomy, anonymous evaluation questionnaires were provided to the students. The questionnaires were prepared using standard survey methods. A five-point Likert scale was applied to evaluate agreement with statements regarding the learning experience. The majority of students considered the course very useful and beneficial in terms of improving three-dimensional and cross-sectional knowledge of anatomy, as well as for developing practical skills in ultrasonography and computed tomography. The authors found that a small-group, hands-on teaching model in radiological anatomy was perceived as useful both by the students and the clinical teachers involved in their clinical education. In addition, the model was introduced using relatively few resources and only two faculty members. Anat Sci Educ 9: 295-303. © 2015 American Association of Anatomists. © 2015 American Association of Anatomists.

University of Saskatchewan Radiology Courseware (USRC): an assessment of its utility for teaching diagnostic imaging in the medical school curriculum.

PubMed

Burbridge, Brent; Kalra, Neil; Malin, Greg; Trinder, Krista; Pinelle, David

2015-01-01

We have found it very challenging to integrate images from our radiology digital imaging repository into the curriculum of our local medical school. Thus, it has been difficult to convey important knowledge related to viewing and interpreting diagnostic radiology images. We sought to determine if we could create a solution for this problem and evaluate whether students exposed to this solution were able to learn imaging concepts pertinent to medical practice. We developed University of Saskatchewan Radiology Courseware (USRC), a novel interactive web application that enables preclinical medical students to acquire image interpretation skills fundamental to clinical practice. This web application reformats content stored in Medical Imaging Resource Center teaching cases for BlackBoard Learn™, a popular learning management system. We have deployed this solution for 2 successive years in a 1st-year basic sciences medical school course at the College of Medicine, University of Saskatchewan. The "courseware" content covers both normal anatomy and common clinical pathologies in five distinct modules. We created two cohorts of learners consisting of an intervention cohort of students who had used USRC for their 1st academic year, whereas the nonintervention cohort was students who had not been exposed to this learning opportunity. To assess the learning experience of the users we designed an online questionnaire and image review quiz delivered to both of the student groups. Comparisons between the groups revealed statistically significant differences in both confidence with image interpretation and the ability to answer knowledge-based questions. Students were satisfied with the overall usability, functions, and capabilities of USRC. USRC is an innovative technology that provides integration between Medical Imaging Resource Center, a teaching solution used in radiology, and a Learning Management System.

Patient-centered Radiology: Where Are We, Where Do We Want to Be, and How Do We Get There?

PubMed

Kemp, Jennifer L; Mahoney, Mary C; Mathews, Vincent P; Wintermark, Max; Yee, Judy; Brown, Stephen D

2017-11-01

Purpose The objectives of the Radiological Society of North America (RSNA) Patient-Centered Radiology Steering Committee survey were to (a) assess RSNA members' general attitudes and experiences concerning patient-centered radiology, with specific attention paid to radiologist-to-patient communication; (b) examine the members' barriers to communicating more directly with patients; and (c) explore their perceptions of how such barriers can be overcome. Materials and Methods A total of 5999 radiologists were invited by e-mail to complete an anonymous electronic survey developed by the Steering Committee and the RSNA Department of Research. Participants were asked to identify aspects of patient-centered care important to their practice, report on their interactions with patients, and share their opinions on radiologist-patient communication. Statistical analyses were performed by using the χ 2 test and analysis of variance. Results The response rate was 12% (n = 694, 109 invitations were undeliverable). Most respondents (89%, 611 of 684) agreed that promoting awareness of the role of radiology in patients' overall health care is important to how they practice. The majority (73%, 421 of 575) reported that time or workload frequently prevented them from communicating directly with patients. The majority (74%, 423 of 572) reported that a personal sense of satisfaction was likely to motivate them to communicate more directly with patients, but many commented that changes to reimbursement and compensation would help them communicate with patients more directly. Conclusion Many radiologists support the concept of communicating more directly with patients but report they are constrained by time or workload. Changes to reimbursement schemes may help mitigate these barriers to one crucial aspect of patient-centered care. © RSNA, 2017 Online supplemental material is available for this article.

A Comparative Study Using Numerical Methods for Surface X Ray Doses with Conventional and Digital Radiology Equipment in Pediatric Radiology

NASA Astrophysics Data System (ADS)

Dan, Posa Ioan; Florin, Georgescu Remus; Virgil, Ciobanu; Antonescu, Elisabeta

2011-09-01

The place of the study is a pediatrics clinic which realizes a great variety of emergency, ambulatory ad hospital examinations. The radiology compartment respects work procedures and a system to ensure the quality of X ray examinations. The results show a constant for the programmator of the digital detector machine for the tension applied to the tube. For the screen-film detector machine the applied tension increases proportionally with the physical development of the child considering the trunk thickness.

[Intranet applications in radiology].

PubMed

Knopp, M V; von Hippel, G M; Koch, T; Knopp, M A

2000-01-01

The aim of the paper is to present the conceptual basis and capabilities of intranet applications in radiology. The intranet, which is the local brother of the internet can be readily realized using existing computer components and a network. All current computer operating systems support intranet applications which allow hard and software independent communication of text, images, video and sound with the use of browser software without dedicated programs on the individual personal computers. Radiological applications for text communication e.g. department specific bulletin boards and access to examination protocols; use of image communication for viewing and limited processing and documentation of radiological images can be achieved on decentralized PCs as well as speech communication for dictation, distribution of dictation and speech recognition. The intranet helps to optimize the organizational efficiency and cost effectiveness in the daily work of radiological departments in outpatients and hospital settings. The general interest in internet and intranet technology will guarantee its continuous development.

NegBio: a high-performance tool for negation and uncertainty detection in radiology reports.

PubMed

Peng, Yifan; Wang, Xiaosong; Lu, Le; Bagheri, Mohammadhadi; Summers, Ronald; Lu, Zhiyong

2018-01-01

Negative and uncertain medical findings are frequent in radiology reports, but discriminating them from positive findings remains challenging for information extraction. Here, we propose a new algorithm, NegBio, to detect negative and uncertain findings in radiology reports. Unlike previous rule-based methods, NegBio utilizes patterns on universal dependencies to identify the scope of triggers that are indicative of negation or uncertainty. We evaluated NegBio on four datasets, including two public benchmarking corpora of radiology reports, a new radiology corpus that we annotated for this work, and a public corpus of general clinical texts. Evaluation on these datasets demonstrates that NegBio is highly accurate for detecting negative and uncertain findings and compares favorably to a widely-used state-of-the-art system NegEx (an average of 9.5% improvement in precision and 5.1% in F1-score). https://github.com/ncbi-nlp/NegBio.

Medical errors arising from outsourcing laboratory and radiology services.

PubMed

Chasin, Brian S; Elliott, Sean P; Klotz, Stephen A

2007-09-01

Document errors and the nuisance factor inherent in the informational exchange that occurs with the outsourcing of laboratory and radiology examinations. Three infectious diseases physicians at a tertiary care hospital recorded problems involving data transmitted by telephone or fax from outsource providers for 4 months. This included in- and outpatients, and those in transition from one status to another. Outsourcing laboratory and radiology examinations of insured outpatients is a common practice. Insurance companies determine which healthcare facility performs these tests based on contractual agreements with outsource providers. This leads to confusion and frustration for the doctor and patient alike, and occasionally, to medical error. The exchange of patient data involved in outsourcing is subject to systemic errors that do not allow of easy solution.

Interventional radiology: a half century of innovation.

PubMed

Baum, Richard A; Baum, Stanley

2014-11-01

The evolution of modern interventional radiology began over half century ago with a simple question. Was it possible to use the same diagnostic imaging tools that had revolutionized the practice of medicine to guide the real-time treatment of disease? This disruptive concept led to rapid treatment advances in every organ system of the body. It became clear that by utilizing imaging some patients could undergo targeted procedures, eliminating the need for major surgery, while others could undergo procedures for previously unsolvable problems. The breadth of these changes now encompasses all of medicine and has forever changed the way we think about disease. In this brief review article, major advances in the field, as chronicled in the pages of Radiology, will be described.

Exposure to radiation from the natural radioactivity in Tunisian building materials.

PubMed

Gharbi, F; Oueslati, M; Abdelli, W; Samaali, M; Ben Tekaya, M

2012-12-01

Building materials can expose public and workers to radiation because of their content of radium, thorium and potassium isotopes. This is why it is very important from the radiological point of view to survey the natural radioactivity content of commonly used building materials in any country. This work consists of the measurement of (226)Ra, (232)Th and (40)K activity concentrations in a variety of commonly used building materials in Tunisia and on the estimation of their radiological hazard. The maximum value of radium equivalent for the studied materials was equal to 169 Bq kg(-1) and corresponds to the clay brick, which is lower than the recommended value of 370 Bq kg(-1). In this work, several radiological indexes were calculated and were found to be under their highest permitted limit.

Improved understanding of human anatomy through self-guided radiological anatomy modules.

PubMed

Phillips, Andrew W; Smith, Sandy G; Ross, Callum F; Straus, Christopher M

2012-07-01

To quantifiably measure the impact of self-instructed radiological anatomy modules on anatomy comprehension, demonstrated by radiology, gross, and written exams. Study guides for independent use that emphasized structural relationships were created for use with two online radiology atlases. A guide was created for each module of the first year medical anatomy course and incorporated as an optional course component. A total of 93 of 96 eligible students participated. All exams were normalized to control for variances in exam difficulty and body region tested. An independent t-test was used to compare overall exam scores with respect to guide completion or incompletion. To account for aptitude differences between students, a paired t-test of each student's exam scores with and without completion of the associated guide was performed, thus allowing students to serve as their own controls. Twenty-one students completed no study guides; 22 completed all six guides; and 50 students completed between one and five guides. Aggregate comparisons of all students' exam scores showed significantly improved mean performance when guides were used (radiology, 57.8% [percentile] vs. 45.1%, P < .001; gross, 56.9% vs. 46.5%, P = .001; written, 57.8% vs. 50.2%, P = .011). Paired comparisons among students who completed between one and five guides demonstrated significantly higher mean practical exam scores when guides were used (radiology, 49.3% [percentile] vs. 36.0%, P = .001; gross, 51.5% vs. 40.4%, P = .005), but not higher written scores. Radiological anatomy study guides significantly improved anatomy comprehension on radiology, gross, and written exams. Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

2017 Presidential Address: Staying Ahead of the Curve.

PubMed

Allen, Bibb

2018-05-01

The practice of the radiological sciences has always been dynamic. From economics and payment policy to imaging appropriateness, the ACR has led the way in keeping our specialty ahead of the curve. However, being ahead of the curve is a fragile place, and constant diligence is needed to remain there. There will always be major changes on our horizon, and the ACR will be there to empower us to adapt to change. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Tomography: Three Dimensional Image Construction. Applications of Analysis to Medical Radiology. [and] Genetic Counseling. Applications of Probability to Medicine. [and] The Design of Honeycombs. Applications of Differential Equations to Biology. Modules and Monographs in Undergraduate Mathematics and Its Applications Project. UMAP Units 318, 456, 502.

ERIC Educational Resources Information Center

Solomon, Frederick; And Others.

This document consists of three modules. The first looks at applications of analysis to medical radiology. The goals are to provide: 1) acquaintance with a significant applied mathematics problem utilizing Fourier Transforms; 2) generalization of the Fourier Transforms to two dimensions; 3) practice with Fourier Transforms; and 4) introduction to…

Sedation in a radiology department--do radiologists follow their own guidelines?

PubMed

Eason, D; Chakraverty, S; Wildsmith, J A W

2011-05-01

The Royal College of Radiologists (RCR) published guidelines in 2003 which aimed to standardise and improve the safety of sedation in the modern Radiology department. As sedation requirements increase, we decided to audit our own departments understandings and practice with respect to sedation. A repeat audit cycle was performed following a re-educational lecture, one year later. Three common sedation case scenarios were incorporated into a questionnaire which detailed questioning on requirements for fasting, monitoring and the order and use of sedation drugs alongside analgesics. These were compared to the 2003 RCR guidelines. The audit was recycled at one year. Despite the RCR guidelines, freely available on the RCR website, there was a persisting variation in practice which revealed a lack of awareness of the requirements for adequate fasting and the importance of giving the opiate before the benzodiazepine (sedative) agent in cases where a combination are chosen. The audit did show a trend towards using shorter acting benzodiazepines, which is in keeping with the guidelines. Monitoring of vital signs was generally, well carried out. General awareness of the RCR guidelines for safe sedation in the Radiology department was initially low and practice found to be variable. Re-education saw some improvements but also, some persisting habitual deviations from the guidelines, particularly with respect to the order in which the opiate and sedative benzodiazepine were given.

Data Fusion for a Vision-Radiological System: a Statistical Calibration Algorithm

DOE Office of Scientific and Technical Information (OSTI.GOV)

Enqvist, Andreas; Koppal, Sanjeev; Riley, Phillip

2015-07-01

Presented here is a fusion system based on simple, low-cost computer vision and radiological sensors for tracking of multiple objects and identifying potential radiological materials being transported or shipped. The main focus of this work is the development of calibration algorithms for characterizing the fused sensor system as a single entity. There is an apparent need for correcting for a scene deviation from the basic inverse distance-squared law governing the detection rates even when evaluating system calibration algorithms. In particular, the computer vision system enables a map of distance-dependence of the sources being tracked, to which the time-dependent radiological datamore » can be incorporated by means of data fusion of the two sensors' output data. (authors)« less

Representing complexity well: a story about teamwork, with implications for how we teach collaboration.

PubMed

Lingard, Lorelei; McDougall, Allan; Levstik, Mark; Chandok, Natasha; Spafford, Marlee M; Schryer, Catherine

2012-09-01

In order to be relevant and impactful, our research into health care teamwork needs to better reflect the complexity inherent to this area. This study explored the complexity of collaborative practice on a distributed transplant team. We employed the theoretical lenses of activity theory to better understand the nature of collaborative complexity and its implications for current approaches to interprofessional collaboration (IPC) and interprofessional education (IPE). Over 4 months, two trained observers conducted 162 hours of observation, 30 field interviews and 17 formal interviews with 39 members of a solid organ transplant team in a Canadian teaching hospital. Participants included consultant medical and surgical staff and postgraduate trainees, the team nurse practitioner, social worker, dietician, pharmacist, physical therapist, bedside nurses, organ donor coordinators and organ recipient coordinators. Data collection and inductive analysis for emergent themes proceeded iteratively. Daily collaborative practice involves improvisation in the face of recurring challenges on a distributed team. This paper focuses on the theme of 'interservice' challenges, which represent instances in which the 'core' transplant team (those providing daily care for transplant patients) work to engage the expertise and resources of other services in the hospital, such as those of radiology and pathology departments. We examine a single story of the core team's collaboration with cardiology, anaesthesiology and radiology services to decide whether a patient is appropriate for transplantation and use this story to consider the team's strategies in the face of conflicting expectations and preferences among these services. This story of collaboration in a distributed team calls into question two premises underpinning current models of IPC and IPE: the notion that stable professional roles exist, and the ideal of a unifying objective of 'caring for the patient'. We suggest important elaborations to these premises as they are used to conceptualise and teach IPC in order to better represent the intricacy of everyday collaborative work in health care. © Blackwell Publishing Ltd 2012.

Merit-Based Incentive Payment System Participation: Radiologists Can Run but Cannot Hide.

PubMed

Rosenkrantz, Andrew B; Goldberg, Julia E; Duszak, Richard; Nicola, Gregory N

2018-04-01

To optimize the flexibility and relevancy of its Merit-Based Incentive Payment System (MIPS), CMS exempts selected physicians and groups from participation and grants others relaxed reporting requirements. We assess the practical implications of such special status determinations. For a random sample of 1,000 Medicare-participating radiologists, the CMS MIPS Participation Lookup Tool was manually searched. Individual radiologists' and associated groups' participation requirements and special statuses were assessed. Although only 55% of radiologists were required to participate in MIPS as individuals when considering only one associated taxpayer identification number (TIN), 83% were required to participate as individuals when considering all associated TINs. When using the group reporting option, 97% of radiology groups were required to participate. High participation requirements persisted across generalist and subspecialist radiologists, small and rural, and both academic and nonacademic practices. Non-patient-facing and hospital-based statuses were assigned to high fractions of individual radiologists (91% and 71%, respectively), but much lower fractions of group practices (72% and 25%). Rural and health professional shortage area statuses were assigned to higher percentages of groups (27% and 39%) than individuals (13% and 23%). Small practice status was assigned to 22% of individuals versus 16% of groups. Although not apparent if only considering individual radiologist-TIN combinations, the overwhelming majority of radiologists will be required to participate in MIPS, at the individual or group level. Radiology groups are strongly encouraged to review their physicians' MIPS participation requirements and special statuses to ensure optimal performance scores and payment bonuses. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Chest teleradiology in a teaching hospital emergency practice.

PubMed

Steckel, R J; Batra, P; Johnson, S; Zucker, M; Sayre, J; Goldin, J; Lee, M; Patel, M; Morrison, H

1997-06-01

New standards for hospital accreditation and health care reimbursement may require that faculty subspecialists be more available after regular working hours to supervise residents in academic radiology departments. We designed a receiver operating characteristic study to determine whether a thoracic radiologist who evaluated computed radiography (CR) images of the chest at a home-based teleradiology workstation could add significant value to a junior resident's interpretations of films within the hospital for acutely ill patients. Using a hybrid cassette, we obtained analog chest films and CR images simultaneously for each of 252 acutely ill patients in the emergency department and in an intensive care unit. Interpretations of the analog films by three first-year residents were analyzed for 11 parameters deemed critical for patient management. Likewise, CR images of the same chest studies were viewed on a home teleradiology workstation by a faculty thoracic radiologist who analyzed the images for these 11 interpretive parameters. All interpretations by radiology residents and by the home-based thoracic radiologist were then compared with the interpretations of a consensus panel consisting of another thoracic radiologist and a full-time emergency department radiologist. Analysis of the pooled results from the three junior residents as a group failed to show significant differences between their interpretations of chest films and the interpretations of CR images by a thoracic radiologist at a home workstation. However, we observed significant differences for several image interpretation parameters between individual residents and the home-based radiology subspecialist. The data confirm that significant value can be added to the interpretations of chest films by individual junior residents when a home-based thoracic radiologist uses teleradiology to provide expert interpretations. Accordingly, it is reasonable to infer that on-line supervision by faculty subspecialists via teleradiology could be used to complement the scheduled visits that are being made now by individual faculty members of our institution to interpret films periodically with a radiology resident during overnight and weekend periods.

US hospital-based direct access with radiology referral: an administrative case report.

PubMed

Keil, Aaron; Brown, Suzanne Robben

2015-01-01

Legislative gains in the US allow physical therapists to function in expanded scopes of practice including direct access and referral to specialists. The combination of direct access with privileges to order imaging studies directly offers a desirable practice status for many physical therapists, especially in musculoskeletal focused settings. Although direct access is legal in all US jurisdictions, institutional-based physical therapy settings have not embraced these practices. Barriers cited to implementing direct access with advanced practice are concerns over medical and administrative opposition, institutional policies, provider qualifications and reimbursement. This administrative case report describes the process taken to allow therapists to see patients without a referral and to order diagnostic imaging studies at an academic medical center. Nine-month implementation results show 66 patients seen via direct access with 15% referred for imaging studies. Claims submitted to 20 different insurance providers were reimbursed at 100%. While institutional regulations and reimbursement are reported as barriers to direct access, this report highlights the process one academic medical center used to implement direct access and advanced practice radiology referral by updating policies and procedures, identifying advanced competencies and communicating with necessary stakeholder groups. Favorable reimbursement for services is documented.

The radiologic technologists' health study in South Korea: study design and baseline results.

PubMed

Lee, Won Jin; Ha, Mina; Hwang, Seung-sik; Lee, Kyoung-Mu; Jin, Young-Woo; Jeong, Meeseon; Jun, Jae Kwan; Cha, Eun Shil; Ko, Yousun; Choi, Kyung-Hwa; Lee, Jung-Eun

2015-08-01

To describe the study design, methods, and baseline results of a prospective cohort of radiologic technologists which we have initiated in South Korea. The cohort participants were enrolled through a self-administered questionnaire survey administered from April 2012 to May 2013. Survey data were linked with radiation dosimetry, a cancer registry, and health insurance data by personal identification numbers. A nationwide representative survey was also conducted using a stratified random sampling design with face-to-face interviews. A total of 12,387 radiologic technologists were enrolled, which accounted for approximately 63% of all diagnostic radiologic technologists working in South Korea. For nationwide survey, 585 workers were interviewed using the detailed questionnaire, and buccal cells were also collected by scraping the inside of the cheek. The majority of study subjects were under 50-year-old and male workers. The average annual effective dose of radiation declined both men (from 2.75 to 1.43 mSv) and women (from 1.34 to 0.95 mSv) over the period of 1996-2011. A total of 99 cancers (66 cancers in men and 33 in women) were reported from 1992 to 2010. The standardized incidence ratio of all cancer combined was significantly lower in men (SIR = 0.75, 95% CI 0.58-0.96) than general population, but the ratios for thyroid cancer were significantly higher than expected among both men and women. This cohort provides comprehensive information on work activities and health status of diagnostic radiologic technologists. In addition, the nationwide representative sample provides unique opportunities compared with previous radiologic technologist studies.

Audit of radiology communication systems for critical, urgent, and unexpected significant findings.

PubMed

Duncan, K A; Drinkwater, K J; Dugar, N; Howlett, D C

2016-03-01

To determine the compliance of UK radiology departments and trusts/healthcare organisations with National Patient Safety Agency and Royal College of Radiologist's published guidance on the communication of critical, urgent, and unexpected significant radiological findings. A questionnaire was sent to all UK radiology department audit leads asking for details of their current departmental policy regarding the issuing of alerts; use of automated electronic alert systems; methods of notification of clinicians of critical, urgent, and unexpected significant radiological findings; monitoring of results receipt; and examples of the more common types of serious pathologies for which alerts were issued. One hundred and fifty-four of 229 departments (67%) responded. Eighty-eight percent indicated that they had a policy in place for the communication of critical, urgent, and unexpected significant radiological findings. Only 34% had an automated electronic alert system in place and only 17% had a facility for service-wide electronic tracking of radiology reports. In only 11 departments with an electronic acknowledgement system was someone regularly monitoring the read rate. There is wide variation in practice across the UK with regard to the communication and monitoring of reports with many departments/trusts not fully compliant with published UK guidance. Despite the widespread use of electronic systems, only a minority of departments/trusts have and use electronic tracking to ensure reports have been read and acted upon. Copyright © 2015 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

A Checklist to Improve Patient Safety in Interventional Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Koetser, Inge C. J.; Vries, Eefje N. de; Delden, Otto M. van

2013-04-15

To develop a specific RADiological Patient Safety System (RADPASS) checklist for interventional radiology and to assess the effect of this checklist on health care processes of radiological interventions. On the basis of available literature and expert opinion, a prototype checklist was developed. The checklist was adapted on the basis of observation of daily practice in a tertiary referral centre and evaluation by users. To assess the effect of RADPASS, in a series of radiological interventions, all deviations from optimal care were registered before and after implementation of the checklist. In addition, the checklist and its use were evaluated by interviewingmore » all users. The RADPASS checklist has two parts: A (Planning and Preparation) and B (Procedure). The latter part comprises checks just before starting a procedure (B1) and checks concerning the postprocedural care immediately after completion of the procedure (B2). Two cohorts of, respectively, 94 and 101 radiological interventions were observed; the mean percentage of deviations of the optimal process per intervention decreased from 24 % before implementation to 5 % after implementation (p < 0.001). Postponements and cancellations of interventions decreased from 10 % before implementation to 0 % after implementation. Most users agreed that the checklist was user-friendly and increased patient safety awareness and efficiency. The first validated patient safety checklist for interventional radiology was developed. The use of the RADPASS checklist reduced deviations from the optimal process by three quarters and was associated with less procedure postponements.« less

A model to determine payments associated with radiology procedures.

PubMed

Mabotuwana, Thusitha; Hall, Christopher S; Thomas, Shiby; Wald, Christoph

2017-12-01

Across the United States, there is a growing number of patients in Accountable Care Organizations and under risk contracts with commercial insurance. This is due to proliferation of new value-based payment models and care delivery reform efforts. In this context, the business model of radiology within a hospital or health system context is shifting from a primary profit-center to a cost-center with a goal of cost savings. Radiology departments need to increasingly understand how the transactional nature of the business relates to financial rewards. The main challenge with current reporting systems is that the information is presented only at an aggregated level, and often not broken down further, for instance, by type of exam. As such, the primary objective of this research is to provide better visibility into payments associated with individual radiology procedures in order to better calibrate expense/capital structure of the imaging enterprise to the actual revenue or value-add to the organization it belongs to. We propose a methodology that can be used to determine technical payments at a procedure level. We use a proportion based model to allocate payments to individual radiology procedures based on total charges (which also includes non-radiology related charges). Using a production dataset containing 424,250 radiology exams we calculated the overall average technical charge for Radiology to be $873.08 per procedure and the corresponding average payment to be $326.43 (range: $48.27 for XR and $2750.11 for PET/CT) resulting in an average payment percentage of 37.39% across all exams. We describe how charges associated with a procedure can be used to approximate technical payments at a more granular level with a focus on Radiology. The methodology is generalizable to approximate payment for other services as well. Understanding payments associated with each procedure can be useful during strategic practice planning. Charge-to-total charge ratio can be used to approximate radiology payments at a procedure level. Copyright © 2017 Elsevier B.V. All rights reserved.

Basic concepts in metal work failure after metastatic spine tumour surgery.

PubMed

Kumar, Naresh; Patel, Ravish; Wadhwa, Anshuja Charvi; Kumar, Aravind; Milavec, Helena Maria; Sonawane, Dhiraj; Singh, Gurpal; Benneker, Lorin Michael

2018-04-01

The development of spinal implants marks a watershed in the evolution of metastatic spine tumour surgery (MSTS), which has evolved from standalone decompressive laminectomy to instrumented stabilization and decompression with reconstruction when necessary. Fusion may not be feasible after MSTS due to poor quality of graft host bed along with adjunct chemotherapy and/or radiotherapy postoperatively. With an increase in the survival of patients with spinal tumours, there is a probability of an increase in the rate of implant failure. This review aims to help establish a clear understanding of implants/constructs used in MSTS and to highlight the fundamental biomechanics of implant/construct failures. Published literature on implant failure after spine surgery and MSTS has been reviewed. The evolution of spinal implants and their role in MSTS has been briefly described. The review defines implant/construct failures using radiological parameters that are practical, feasible, and derived from historical descriptions. We have discussed common modes of implant/construct failure after MSTS to allow further understanding, interception, and prevention of catastrophic failure. Implant failure rates in MSTS are in the range of 2-8%. Variability in patterns of failure has been observed based on anatomical region and the type of constructs used. Patients with construct/implant failures may or may not be symptomatic and present either as early (< 3months) or late failures (> 3months). It has been noted that not all the implant failures after MSTS result in revisions. Based on the observed radiological criteria and clinical presentations, we have proposed a clinico-radiological classification for implant/construct failure after MSTS.

Home-based radiology transcription and a productivity pay plan.

PubMed

Kerr, K

1997-01-01

Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet.

NCRP Program Area Committee 3: Nuclear and Radiological Security and Safety [Update on the Ncrp Program Area Committee 3 Activities: Nuclear And Radiological Security and Safety

DOE PAGES

Ansari, Armin; Buddemeier, Brooke

2018-02-01

The National Council on Radiation Protection and Measurements (NCRP) Program Area Committee (PAC) 3 covers the broad subject of nuclear and radiological security and safety and provides guidance and recommendations for response to nuclear and radiological incidents of both an accidental and deliberate nature. In 2017, PAC 3 Scientific Committee 3-1 completed the development of Guidance for Emergency Responder Dosimetry, and began development of a companion commentary on operational aspects of that guidance. PAC 3 members also organized the technical program for the 2017 Annual Meeting of the NCRP on “Assessment of National Efforts in Emergency Preparedness for Nuclear Terrorism:more » Is There a Need for Realignment to Close Remaining Gaps.” Based on discussions and presentations at the annual meeting, PAC 3 is working to develop a commentary on the subject that could serve as a roadmap for focusing our national efforts on the most pressing needs for preparing the nation for nuclear and radiological emergencies. PAC 3 is also engaged in active discussions, exploring the landscape of priority issues for its future activities. Lastly, an important consideration in this discussion is the extent of NCRP’s present and potential future resources to support the work of its scientific committees.« less

NCRP Program Area Committee 3: Nuclear and Radiological Security and Safety [Update on the Ncrp Program Area Committee 3 Activities: Nuclear And Radiological Security and Safety

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ansari, Armin; Buddemeier, Brooke

The National Council on Radiation Protection and Measurements (NCRP) Program Area Committee (PAC) 3 covers the broad subject of nuclear and radiological security and safety and provides guidance and recommendations for response to nuclear and radiological incidents of both an accidental and deliberate nature. In 2017, PAC 3 Scientific Committee 3-1 completed the development of Guidance for Emergency Responder Dosimetry, and began development of a companion commentary on operational aspects of that guidance. PAC 3 members also organized the technical program for the 2017 Annual Meeting of the NCRP on “Assessment of National Efforts in Emergency Preparedness for Nuclear Terrorism:more » Is There a Need for Realignment to Close Remaining Gaps.” Based on discussions and presentations at the annual meeting, PAC 3 is working to develop a commentary on the subject that could serve as a roadmap for focusing our national efforts on the most pressing needs for preparing the nation for nuclear and radiological emergencies. PAC 3 is also engaged in active discussions, exploring the landscape of priority issues for its future activities. Lastly, an important consideration in this discussion is the extent of NCRP’s present and potential future resources to support the work of its scientific committees.« less

IRQN award paper: Operational rounds: a practical administrative process to improve safety and clinical services in radiology.

PubMed

Donnelly, Lane F; Dickerson, Julie M; Lehkamp, Todd W; Gessner, Kevin E; Moskovitz, Jay; Hutchinson, Sally

2008-11-01

As part of a patient safety program in the authors' department of radiology, operational rounds have been instituted. This process consists of radiology leaders' visiting imaging divisions at the site of imaging and discussing frontline employees' concerns about patient safety, the quality of care, and patient and family satisfaction. Operational rounds are executed at a time to optimize the number of attendees. Minutes that describe the issues identified, persons responsible for improvement, and updated improvement plan status are available to employees online. Via this process, multiple patient safety and other issues have been identified and remedied. The authors believe that the process has improved patient safety, the quality of care, and the efficiency of operations. Since the inception of the safety program, the mean number of days between serious safety events involving radiology has doubled. The authors review the background around such walk rounds, describe their particular program, and give multiple illustrative examples of issues identified and improvement plans put in place.

The Importance of Curriculum-Based Training and Assessment in Interventional Radiology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Belli, Anna-Maria, E-mail: anna.belli@stgeorges.nhs.uk; Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl; Lee, Michael, E-mail: mlee@rcsi.ie

Physician performance and outcomes are being scrutinised by health care providers to improve patient safety and cost efficiency. Patients are best served by physicians who have undergone appropriate specialist training and assessment and perform large numbers of cases to maintain their skills. The Cardiovascular and Interventional Radiological Society of Europe has put into place a curriculum for training in interventional radiology (IR) and a syllabus with an examination, the European Board of Interventional Radiology, providing evidence of attainment of an appropriate and satisfactory skill set for the safe practice of IR. This curriculum is appropriate for IR where there ismore » a high volume of image-guided procedures in vascular and nonvascular organ systems with cross-use of minimally invasive techniques in patients with a variety of disease processes. Other specialties may require different, longer, and more focused training if their experience is “diluted” by the need to master a different skill set.« less

Big Data and the Future of Radiology Informatics.

PubMed

Kansagra, Akash P; Yu, John-Paul J; Chatterjee, Arindam R; Lenchik, Leon; Chow, Daniel S; Prater, Adam B; Yeh, Jean; Doshi, Ankur M; Hawkins, C Matthew; Heilbrun, Marta E; Smith, Stacy E; Oselkin, Martin; Gupta, Pushpender; Ali, Sayed

2016-01-01

Rapid growth in the amount of data that is electronically recorded as part of routine clinical operations has generated great interest in the use of Big Data methodologies to address clinical and research questions. These methods can efficiently analyze and deliver insights from high-volume, high-variety, and high-growth rate datasets generated across the continuum of care, thereby forgoing the time, cost, and effort of more focused and controlled hypothesis-driven research. By virtue of an existing robust information technology infrastructure and years of archived digital data, radiology departments are particularly well positioned to take advantage of emerging Big Data techniques. In this review, we describe four areas in which Big Data is poised to have an immediate impact on radiology practice, research, and operations. In addition, we provide an overview of the Big Data adoption cycle and describe how academic radiology departments can promote Big Data development. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Contribution for new genetic markers of rheumatoid arthritis activity and severity: sequencing of the tumor necrosis factor-alpha gene promoter.

PubMed

Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana

2007-01-01

The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-alpha) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-alpha gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-alpha promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD.

Contribution for new genetic markers of rheumatoid arthritis activity and severity: sequencing of the tumor necrosis factor-alpha gene promoter

PubMed Central

Fonseca, João Eurico; Cavaleiro, João; Teles, José; Sousa, Elsa; Andreozzi, Valeska L; Antunes, Marília; Amaral-Turkman, Maria A; Canhão, Helena; Mourão, Ana F; Lopes, Joana; Caetano-Lopes, Joana; Weinmann, Pamela; Sobral, Marta; Nero, Patrícia; Saavedra, Maria J; Malcata, Armando; Cruz, Margarida; Melo, Rui; Braña, Araceli; Miranda, Luis; Patto, José V; Barcelos, Anabela; da Silva, José Canas; Santos, Luís M; Figueiredo, Guilherme; Rodrigues, Mário; Jesus, Herberto; Quintal, Alberto; Carvalho, Teresa; da Silva, José A Pereira; Branco, Jaime; Queiroz, Mário Viana

2007-01-01

The objective of this study was to assess whether clinical measures of rheumatoid arthritis activity and severity were influenced by tumor necrosis factor-alpha (TNF-α) promoter genotype/haplotype markers. Each patient's disease activity was assessed by the disease activity score using 28 joint counts (DAS28) and functional capacity by the Health Assessment Questionnaire (HAQ) score. Systemic manifestations, radiological damage evaluated by the Sharp/van der Heijde (SvdH) score, disease-modifying anti-rheumatic drug use, joint surgeries, and work disability were also assessed. The promoter region of the TNF-α gene, between nucleotides -1,318 and +49, was sequenced using an automated platform. Five hundred fifty-four patients were evaluated and genotyped for 10 single-nucleotide polymorphism (SNP) markers, but 5 of these markers were excluded due to failure to fall within Hardy-Weinberg equilibrium or to monomorphism. Patients with more than 10 years of disease duration (DD) presented significant associations between the -857 SNP and systemic manifestations, as well as joint surgeries. Associations were also found between the -308 SNP and work disability in patients with more than 2 years of DD and radiological damage in patients with less than 10 years of DD. A borderline effect was found between the -238 SNP and HAQ score and radiological damage in patients with 2 to 10 years of DD. An association was also found between haplotypes and the SvdH score for those with more than 10 years of DD. An association was found between some TNF-α promoter SNPs and systemic manifestations, radiological progression, HAQ score, work disability, and joint surgeries, particularly in some classes of DD and between haplotypes and radiological progression for those with more than 10 years of DD. PMID:17408492

Radiology workstation design for the medical intensive care unit.

PubMed

Moise, Adrian; Atkins, Stella M

2002-01-01

The "one-size-fits-all" approach for radiology workstation design is not good enough anymore. While most of the picture archiving and communication system (PACS) vendors are racing to add more features to the radiology workstation, there is little interest in addressing the specific needs of other hospital departments. Significant delays in the availability of radiology reports are often caused by the fact there is not enough Intensive Care Unit (ICU) volume to justify a full time radiologist. Consequently, the radiologist assigned to cover the ICU exams, most likely working from a different building, will read the ICU exams only at certain times, depending on the limitations for remote image availability. This paper addresses the main objectives in designing a digital radiology workstation for use in the medical ICU (MICU), requiring enhancements to current PACS systems. Our suggestions for PACS improvement follow the ICU digital workflow starting with the transfer of the images from the modality, continuing with the presentation of the radiology examination to different types of users (radiologists or ICU staff), up to the creation and distribution of the reports.

Peer support of a faculty "writers' circle" increases confidence and productivity in generating scholarship.

PubMed

Brandon, Catherine; Jamadar, David; Girish, Gandikota; Dong, Qian; Morag, Yoav; Mullan, Patricia

2015-04-01

Publishing is critical for academic medicine career advancement. Rejection of manuscripts can be demoralizing. Obstacles faced by clinical faculty may include lack of time, confidence, and optimal writing practices. This study describes the development and evaluation of a peer-writing group, informed by theory and research on faculty development and writing. Five clinical-track radiology faculty members formed a "Writers' Circle" to promote scholarly productivity and reflection on writing practices. Members decided to work with previously rejected manuscripts. After members' initial meeting, interactions were informal, face to face during clinical work, and online. After the first 6 months, an anonymous survey asked members about the status of articles and evaluations of the writing group. Ten previously rejected articles, at least one from each member, were submitted to the Circle. In 6 months, four manuscripts were accepted for publication, five were in active revision, and one was withdrawn. All participants (100%) characterized the program as worth their time, increasing their motivation to write, their opportunities to support scholarly productivity of colleagues, and their confidence in generating scholarship. Peer-support writing groups can facilitate the pooling of expertise and the exchange of recommended writing practices. Our peer-support group increased scholarly productivity and provided a collegial approach to academic writing. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Problem-based learning for radiological technologists: a comparison of student attitudes toward plain radiography.

PubMed

Terashita, Takayoshi; Tamura, Naomi; Kisa, Kengo; Kawabata, Hidenobu; Ogasawara, Katsuhiko

2016-09-05

Knowledge and skill expected of healthcare providers continues to increase alongside developments in medicine and healthcare. Problem-based learning (PBL) is therefore increasingly necessary in training courses for radiological technologists. However, it is necessary to evaluate the effects of PBL to completely introduce it in our education programs. As a Hypothesis, it seems that a change occurs in the student's attitudes by participating in PBL practical training. There is the Semantic Differential (SeD) technique as a method to identify student's attitudes. We conceived that PBL could be appropriately evaluated by using SeD technique. In this paper, we evaluated PBL for plain radiography practical training using the SeD technique. Thirty-eight third-year students studying radiological technology participated. PBL was introduced to practical training in plain radiography positioning techniques. Five sessions lasting 5 h each were delivered over a 5-week period during November to December 2012. The clinical scenario was an emergency case with multiple trauma requiring plain radiography. Groups comprising approximately eight students created workflows for trauma radiography with consideration of diagnostic accuracy and patient safety. Furthermore, students groups conducted plain radiography on a patient phantom according to created workflows and were then guided by feedback from professional radiologists. All students answered SeD questionnaires to assess views on plain radiography before instruction to provide preliminary practical training reports and after completing practical training. The factors were identified using factor analysis of the questionnaires, which were answered before and after each practical training session. On evaluation of the relationships between factors and question items according to factor loading, we identified "reluctance", "confidence", and "exhaustion" as the predominant attitudes before practical training. Similarly, we identified "expectation", "self-efficacy", and "realness" as the predominant attitudes after practical training. The attitudes toward plain radiography changed before and after PBL practical training. The attitude of self-efficacy was noted after practical training, which incorporated PBL. Student self-efficacy was thought to increase through self-directed learning, which is one of the aims of PBL. Although the influences of other lectures and training, which were performed in parallel with the PBL practice training, were not completely excluded, and although the number of study participants was small, we were able to confirm the effects of PBL.

Educational treasures in radiology: a free online program for Radiology Boards preparation.

PubMed

Talanow, Roland

2011-01-01

An objective tool is desired, which optimally prepares for Radiology boards examination. Such program should prepare examinees with pertinent radiological contents and simulations as expected in the real examination. Many countries require written boards examinations for Radiology certification eligibility. No objective measure exists to tell if the examinee is ready to pass the exam or not. Time pressure and computer environment might be unfamiliar to examinees. Traditional preparation lectures don't simulate the "real" Radiology exam because they don't provide the special environment with multiple choice questions and timing. This online program consists of 4 parts. The entry section allows to create questions with additional fields for comprehensive information. Sections include Pediatrics/Mammography/GI/IR/Nucs/Thoracic/Musculoskeletal/GU/Neuro/Ultrasound/Cardiac/OB/GYN and Miscellaneous. Experienced radiologists and educators evaluate and release/delete these entries in the administrator section. In the exam section users can create (un)timed customized exams for individual needs and learning pace. Exams can either include all sections or only specific sections to gear learning towards areas with weaker performance. Comprehensive statistics unveil the user's strengths and weaknesses to help focussing on "weak" areas. In the search section a comprehensive search and review can be performed by searching the entire database for keywords/topics or only searching within specific sections. www.RadiologyBoards.org is a new working concept of Radiology boards preparation to detect and improve the examinee's weaknesses and finally to increase the examinee's confidence level for the final exam. It is beneficial for Radiology residents and also board certified radiologists to refresh/maintain radiological knowledge.

Coagulation necrosis induced by radiofrequency ablation in the liver: histopathologic and radiologic review of usual to extremely rare changes.

PubMed

Kim, Young-sun; Rhim, Hyunchul; Lim, Hyo Keun; Choi, Dongil; Lee, Min Woo; Park, Min Jung

2011-01-01

As the clinical role of radiofrequency ablation (RFA) of the liver grows, the importance of radiologic imaging after liver RFA to depict the diversity of post-RFA manifestations is also increasing. Because RFA induces coagulation necrosis of the hepatic parenchyma, cross-sectional imaging studies, in principle, demonstrate an area with a defect in contrast enhancement. However, for various reasons, such as the occurrence of a complication, the RFA zone may demonstrate different patterns or be accompanied by other abnormalities. In this investigation, a large number of imaging studies performed after more than 4000 procedures of liver RFA during the past 10-year period were reviewed, and various radiologic manifestations of the RFA zone were compiled. Herein, the basic principles of RFA, as well as the histopathologic features of coagulation necrosis of the liver, are catalogued to provide a more complete understanding of such changes. Through this review, the reader will become more familiar with the usual and unusual radiologic findings of coagulation necrosis induced by RFA in the liver. This increased familiarity will not only facilitate the daily practice of radiology but also deepen understanding of the therapeutic modality of RFA. © RSNA, 2011.

Radiological anatomy - evaluation of integrative education in radiology.

PubMed

Dettmer, S; Schmiedl, A; Meyer, S; Giesemann, A; Pabst, R; Weidemann, J; Wacker, F K; Kirchhoff, T

2013-09-01

Evaluation and analysis of the integrative course "Radiological Anatomy" established since 2007 at the Medical School Hannover (MHH) in comparison with conventional education. Anatomy and radiology are usually taught separately with a considerable time lag. Interdisciplinary teaching of these associated subjects seems logical for several reasons. Therefore, the integrative course "Radiological Anatomy" was established in the second year of medical education, combining these two closely related subjects. This interdisciplinary course was retrospectively evaluated by consideration of a student questionnaire and staff observations. The advantages and disadvantages of integrative teaching in medical education are discussed. The course ratings were excellent (median 1; mean 1.3 on a scale of 1 to 6). This is significantly (p < 0.001) better than the average of all evaluated courses in the respective term (grade 2.8). The course improved the anatomical comprehension (90 %) and the students stated that the topics were relevant for their future medical education (90 %). Furthermore, interest in the subject's anatomy and radiology increased during the course (88 %). According to the students' suggestions the course was enhanced by a visitation in the Department of Radiology and the additional topic central nervous system. Integrative teaching of anatomy and radiology was well received by the students. Both, anatomical and radiological comprehension and the motivation to learn were improved. However, it should be considered, that the amount of work and time required by the teaching staff is considerably increased compared to traditional teaching. © Georg Thieme Verlag KG Stuttgart · New York.

Redefining the Practice of Peer Review Through Intelligent Automation Part 2: Data-Driven Peer Review Selection and Assignment.

PubMed

Reiner, Bruce I

2017-12-01

In conventional radiology peer review practice, a small number of exams (routinely 5% of the total volume) is randomly selected, which may significantly underestimate the true error rate within a given radiology practice. An alternative and preferable approach would be to create a data-driven model which mathematically quantifies a peer review risk score for each individual exam and uses this data to identify high risk exams and readers, and selectively target these exams for peer review. An analogous model can also be created to assist in the assignment of these peer review cases in keeping with specific priorities of the service provider. An additional option to enhance the peer review process would be to assign the peer review cases in a truly blinded fashion. In addition to eliminating traditional peer review bias, this approach has the potential to better define exam-specific standard of care, particularly when multiple readers participate in the peer review process.

American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) Practice Guideline for the Performance of High-Dose-Rate Brachytherapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Erickson, Beth A.; Demanes, D. Jeffrey; Ibbott, Geoffrey S.

2011-03-01

High-Dose-Rate (HDR) brachytherapy is a safe and efficacious treatment option for patients with a variety of different malignancies. Careful adherence to established standards has been shown to improve the likelihood of procedural success and reduce the incidence of treatment-related morbidity. A collaborative effort of the American College of Radiology (ACR) and American Society for Therapeutic Radiation Oncology (ASTRO) has produced a practice guideline for HDR brachytherapy. The guideline defines the qualifications and responsibilities of all the involved personnel, including the radiation oncologist, physicist and dosimetrists. Review of the leading indications for HDR brachytherapy in the management of gynecologic, thoracic, gastrointestinal,more » breast, urologic, head and neck, and soft tissue tumors is presented. Logistics with respect to the brachytherapy implant procedures and attention to radiation safety procedures and documentation are presented. Adherence to these practice guidelines can be part of ensuring quality and safety in a successful HDR brachytherapy program.« less

Pediatric radiology malpractice claims - characteristics and comparison to adult radiology claims.

PubMed

Breen, Micheál A; Dwyer, Kathy; Yu-Moe, Winnie; Taylor, George A

2017-06-01

Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation. We hypothesize that the frequency, character and outcome of malpractice claims made against pediatric radiologists differ from those seen in general radiology practice. We searched the Controlled Risk Insurance Co. (CRICO) Strategies' Comparative Benchmarking System (CBS), a private repository of approximately 350,000 open and closed medical malpractice claims in the United States, for claims related to pediatric radiology. We further queried these cases for the major allegation, the clinical environment in which the claim arose, the clinical severity of the alleged injury, indemnity paid (if payment was made), primary imaging modality involved (if applicable) and primary International Classification of Diseases, 9th revision (ICD-9) diagnosis underlying the claim. There were a total of 27,056 fully coded claims of medical malpractice in the CBS database in the 5-year period between Jan. 1, 2010, and Dec. 31, 2014. Of these, 1,472 cases (5.4%) involved patients younger than 18 years. Radiology was the primary service responsible for 71/1,472 (4.8%) pediatric cases. There were statistically significant differences in average payout for pediatric radiology claims ($314,671) compared to adult radiology claims ($174,033). The allegations were primarily diagnosis-related in 70% of pediatric radiology claims. The most common imaging modality implicated in pediatric radiology claims was radiography. The highest payouts in pediatric radiology pertained to missed congenital and developmental anomalies (average $1,222,932) such as developmental dysplasia of the hip and congenital central nervous system anomalies. More than half of pediatric radiology claims arose in the ambulatory setting. Pediatric radiology is not immune from claims of medical malpractice and these claims result in high monetary payouts, particularly for missed diagnoses of congenital and developmental anomalies. Our data suggest that efforts to reduce diagnostic error in the outpatient radiology setting, in the interpretation of radiographs, and in the improved diagnosis of fractures and congenital and developmental anomalies would be of particular benefit to the pediatric radiology community.

Herbert M. Parker: Publications and contributions to radiological and health physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kathren, R.L.; Baalman, R.W.; Bair, W.J.

For more than a half century, Herbert M. Parker was a leading force in radiological physics. As a scientist, he was codeveloper of a systematic dosimetry scheme for implant therapy and the innovative proposer of radiological units with unambiguous physical and biological bases. He made seminal contributions to the development of scientifically based radiation protection standards and, as an administrator and manager as well as scientist, helped the Hanford Laboratories to achieve preeminance in several areas, including radiation biology, radioactive waste disposal, and environmental radioactivity. This volume brings together, sometimes from obscure sources, his works.

American College of Radiology-American Brachytherapy Society practice parameter for electronically generated low-energy radiation sources.

PubMed

Devlin, Phillip M; Gaspar, Laurie E; Buzurovic, Ivan; Demanes, D Jeffrey; Kasper, Michael E; Nag, Subir; Ouhib, Zoubir; Petit, Joshua H; Rosenthal, Seth A; Small, William; Wallner, Paul E; Hartford, Alan C

This collaborative practice parameter technical standard has been created between the American College of Radiology and American Brachytherapy Society to guide the usage of electronically generated low energy radiation sources (ELSs). It refers to the use of electronic X-ray sources with peak voltages up to 120 kVp to deliver therapeutic radiation therapy. The parameter provides a guideline for utilizing ELS, including patient selection and consent, treatment planning, and delivery processes. The parameter reviews the published clinical data with regard to ELS results in skin, breast, and other cancers. This technical standard recommends appropriate qualifications of the involved personnel. The parameter reviews the technical issues relating to equipment specifications as well as patient and personnel safety. Regarding suggestions for educational programs with regard to this parameter,it is suggested that the training level for clinicians be equivalent to that for other radiation therapies. It also suggests that ELS must be done using the same standards of quality and safety as those in place for other forms of radiation therapy. Copyright © 2017 American Brachytherapy Society and American College of Radiology. Published by Elsevier Inc. All rights reserved.

Intraoperative double-J stent insertion in children with scintigraphic impaired renal function and obstructive urinary tract malformation.

PubMed

Erculiani, E; Zampieri, N; Cecchetto, M; Camoglio, F S; Giacomello, L

2008-03-01

Ureteral double-J (DJ) stents are frequently used in modern urologic practice. At present the role of stents in urological and surgical practice and their efficacy in paediatric age are not yet clear. The aim of this study is to evaluate advantages and efficacy of ureteral stents, correlating clinical and radiological data with the permanence of stent in situ. Between July 1999 and July 2004 surgery with ureteral stenting was performed on 24 consecutive patients aged between 2 and 13.5 months with scintigraphic impaired renal function due to an obstructive urinary tract malformation. During the study the performance and the efficacy of indwelling stent have been evaluated through clinical and radiological variables: pre-, intra-, and post stenting blood tests, ultrasonographic and scintigraphic parameters were also evaluated. The stent insertion was useful to improve renal parenchymal thickness and renal growth. No correlation was found between improved blood tests and scintigraphic values. The improvements of clinical and radiological data were strictly correlated with the time of stenting (>3 months). The insertion of DJ stents as long-term internal urinary diversion is useful and safe. Late complications related to the use of stents are not frequent.

Translating New Lung Cancer Screening Guidelines into Practice: The Experience of One Community Hospital.

PubMed

Ledford, Christy J W; Gawrys, Breanna L; Wall, Jessica L; Saas, Patrick D; Seehusen, Dean A

2016-01-01

In December 2013 the US Preventive Services Task Force issued a recommendation for lung cancer screening with annual low-dose computed tomography (LDCT). As screening guidelines emerge and change, this creates an environment for studying the translation of these guidelines into practice. This study assessed how these guidelines were implemented in a community hospital setting and the resulting radiologic findings. This observational study examined the radiologic outcomes of LDCT lung cancer screening guidelines and the resulting notification. During the first year after publication of the guidelines, 94 screening LDCT scans were ordered. Of these, 21 (22.3%) did not meet the criteria outlined by the US Preventive Services Task Force. Among the 72 cases that did met published criteria, 65.3% of scans detected nodules, and among the remaining 35.6%, half had another clinically significant finding. This study shows that new lung cancer screening guidelines, as implemented at a community hospital, resulted in radiologic findings that required follow-up in more than half of patients. Clinicians must be aware of these potential incidental findings when talking to patients about the decision to order screenings. © Copyright 2016 by the American Board of Family Medicine.

[Development of clinical radiology in the Military field therapy Department of the Military Medical Academy (the 90th anniversary of the birth of G. I. Alekseyev)].

PubMed

Khalimov, Iu Sh; Vlasenko, A N; Matveev, S Iu

2012-08-01

On August 18, 2012, 90 years have passed since the birth of the former head of the Military field therapy Department of The Military-Medical Academy named after S. M. Kirov--the main radiologist of the Ministry of Defence of Russian Federation, the corresponding member of the Soviet Union Academy of Medical Science and the Russian Academy of Medical Science, the major- general of a medical service G. I. Alekseyev, who had been working in the department since its foundation till the last day of his life. Being the head of the department for twelve years, G. I. Alekseyev made a considerable contribution to the formation and development of native military radiology, training of medical and scientific skilled specialists. Professor G. I. Alekseyev's scientific ideas and views in the sphere of radiology were realized and developed in further educational, research and medical work of the department. Nowadays the staff of the Military field therapy Department remembers G. I. Alekseyev with special gratitude and appreciation and successfully realizes his ideas and plans in work.

Multiple cranial neuropathy: a common diagnostic problem.

PubMed

Garg, R K; Karak, B

1999-10-01

Syndrome of multiple cranial palsies is a common clinical problem routinely encountered in neurological practice. Anatomical patterns of cranial nerves involvement help in localizing the lesion. Various infections, malignant neoplasms and autoimmune vasculitis are common disorders leading to various syndromes of multiple cranial nerve palsies. A large number of diffuse neurological disorders (e.g. Gullian-Barre syndrome, myopathies) may also present with syndrome of multiple cranial nerve palsies. Despite extensive biochemical and radiological work-up the accurate diagnosis may not be established. Few such patients represent "idiopathic" variety of multiple cranial nerve involvement and show good response to corticosteroids. Widespread and sequential involvements of cranial nerves frequently suggest possibility of malignant infiltration of meninges, however, confirmation of diagnosis may not be possible before autopsy.

Protection of the public in situations of prolonged radiation exposure. The application of the Commission's system of radiological protection to controllable radiation exposure due to natural sources and long-lived radioactive residues.

PubMed

1999-01-01

This report provides guidance on the application of the ICRP system of radiological protection to prolonged exposure situations affecting members of the public. It addresses the general application of the Commission's system to the control of prolonged exposures resulting from practices and to the undertaking of interventions in prolonged exposure situations. Additionally, it provides recommendations on generic reference levels for such interventions. The report also considers some specific situations and discusses a number of issues that have been of concern, namely: natural radiation sources that may give rise to high doses; the restoration and rehabilitation of sites where human activities involving radioactive substances have been carried out; the return to 'normality' following an accident that has released radioactive substances to the environment; and the global marketing of commodities for public consumption that contain radioactive substances. Annexes provide some examples of prolonged exposure situations and discuss the radiological protection quantities, radiation-induced health effects and aspects of the Commission's system of radiological protection relevant to prolonged exposure. Quantitative recommendations for prolonged exposures are provided in the report. They must be interpreted with extreme caution; Chapters 4 and 5 stress the upper bound nature of the following values: Generic reference levels for intervention, in terms of existing total annual doses, are given as < approximately 100 mSv, above which intervention is almost always justifiable (situations for which the annual dose threshold for deterministic effects in relevant organs is exceeded will almost always require intervention), and < approximately 10 mSv, below which intervention is not likely to be justifiable (and above which it may be necessary). Intervention exemption levels for commodities, especially building materials, are expressed as an additional annual dose of approximately 1 mSv. The dose limit for exposures of the public from practices is expressed as aggregated (prolonged and transitory) additional annual doses from all relevant practices of 1 mSv. Dose constraints for sources within practices are expressed as an additional annual dose lower than 1 mSv (e.g. of approximately 0.3 mSv), which could be approximately 0.1 mSv for the prolonged exposure component. An exemption level for practices is expressed as an additional annual dose of approximately 0.01 mSv.

Factors Influencing the Gender Breakdown of Academic Radiology Residency Programs.

PubMed

Campbell, James C; Yoon, Sora C; Cater, Sarah Wallace; Grimm, Lars J

2017-07-01

To determine the gender distribution of radiology residency programs and identify associations with radiology departmental factors. The residency programs affiliated with the top 50 research medical school from US News and World Report were identified. The gender of all radiology residency graduates from each program from 2011 to 2015 were collected. Radiology departmental factors were collected: gender of chairperson, gender of program director, gender of faculty, geographic location, and city population of the residency program. The median percentage of female radiology faculty and residents were calculated and classified as above or below the median. Comparisons were made between residency programs and departmental factors via a Pearson χ 2 univariate test or logistic regression. There were 618 (27.9%) female and 1,598 (72.1%) male residents in our study, with a median female representation of 26.4% in each program. Programs with a female residency program director were significantly more likely to have an above-median percentage of female residents versus a male program director (68.4% versus 38.7%, P = .04). Programs in the Northeast (70.6%) and West (70.0%) had higher above-median female representation than the South (10.0%) and Midwest (38.5%, P < .01). There was no association with city population size (P = .40), gender of faculty (P = .40), residency size (P = .91), or faculty size (P = .15). Radiology residency programs with a female residency program director and those in the Northeast or West have a greater concentration of female residents. Residency programs that aim to increase female representation should investigate modifiable factors that can improve their recruitment practices. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiology and social media: are private practice radiology groups more social than academic radiology departments?

PubMed

Glover, McKinley; Choy, Garry; Boland, Giles W; Saini, Sanjay; Prabhakar, Anand M

2015-05-01

This study assesses the prevalence of use of the most commonly used social media sites among private radiology groups (PRGs) and academic radiology departments (ARDs). The 50 largest PRGs and the 50 ARDs with the highest level of funding from the National Institutes of Health were assessed for presence of a radiology-specific social media account on Facebook, Twitter, Instagram, Pinterest, YouTube, and LinkedIn. Measures of organizational activity and end-user activity were collected, including the number of posts and followers, as appropriate; between-group comparisons were performed. PRGs adopted Facebook 12 months earlier (P = .02) and Twitter 18 months earlier (P = .02) than did ARDs. A total of 76% of PRGs maintained ≥1 account on the social media sites included in the study, compared with 28% of ARDs (P < .0001). The prevalence of having an account on the social media sites for PRGs was: Facebook, 66%; LinkedIn, 56%; Twitter, 42%; YouTube, 20%; Pinterest, 4%; and Instagram, 2%. The prevalence of radiology-specific social media accounts for ARDs was: Facebook, 18%; LinkedIn, 0%; Twitter, 24%; YouTube, 6%; Pinterest, 0%; and Instagram, 0%. There was no significant difference between ARDs and PRGs in measures of end-user or organizational activity on Facebook or Twitter. Use of social media in health care is emerging as mainstream, with PRGs being early adopters of Facebook and Twitter in comparison with ARDs. Competitive environments and institutional policies may be strong factors that influence how social media is used by radiologists at the group and department levels. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Conversion of Radiology Reporting Templates to the MRRT Standard.

PubMed

Kahn, Charles E; Genereaux, Brad; Langlotz, Curtis P

2015-10-01

In 2013, the Integrating the Healthcare Enterprise (IHE) Radiology workgroup developed the Management of Radiology Report Templates (MRRT) profile, which defines both the format of radiology reporting templates using an extension of Hypertext Markup Language version 5 (HTML5), and the transportation mechanism to query, retrieve, and store these templates. Of 200 English-language report templates published by the Radiological Society of North America (RSNA), initially encoded as text and in an XML schema language, 168 have been converted successfully into MRRT using a combination of automated processes and manual editing; conversion of the remaining 32 templates is in progress. The automated conversion process applied Extensible Stylesheet Language Transformation (XSLT) scripts, an XML parsing engine, and a Java servlet. The templates were validated for proper HTML5 and MRRT syntax using web-based services. The MRRT templates allow radiologists to share best-practice templates across organizations and have been uploaded to the template library to supersede the prior XML-format templates. By using MRRT transactions and MRRT-format templates, radiologists will be able to directly import and apply templates from the RSNA Report Template Library in their own MRRT-compatible vendor systems. The availability of MRRT-format reporting templates will stimulate adoption of the MRRT standard and is expected to advance the sharing and use of templates to improve the quality of radiology reports.

Distributed radiology clerkship for the core clinical year of medical school.

PubMed

Chew, Felix S

2002-11-01

The central role that diagnostic radiology has in the modern practice of medicine has not always been reflected in radiology's place in the curriculum. We developed a new radiology clerkship for undergraduate medical students during their core clinical year that was supported by Web technology. The assumptions underlying the design of the clerkship were that radiology is best learned from radiologists and that students are most receptive to learning radiology when it is related to concurrent patient care experiences. Beginning in May 2000, a required radiology clerkship experience was incorporated into the core clinical year at Wake Forest University School of Medicine. The core clinical year was organized into three 16-week blocks of clerkships. Two or four independent half-day radiology tutorial sessions were included with each clerkship block, and attended by all students in the block (approximately 35 students), regardless of their specific clerkship assignments. There were ten different radiology tutorials, each given three times during the year as students rotated through the clerkship blocks. Thus, each student attended a radiology tutorial session every four to eight weeks during the year. The topics covered during the tutorials were correlated with the content of the clerkship blocks and included adult and pediatric chest radiology, adult and pediatric abdominal radiology, body CT, neuroradiology, obstetric ultrasound, gynecologic ultrasound, osteoporosis, adult and pediatric fractures, mammography, and cervical spine trauma. The tutorials included pre- and post-test, lectures, case presentations, and sometimes tours of the radiology department. The educational emphasis was on pragmatic case-based learning exercises, development of verbal and visual vocabulary, and learning when and where to seek more information. To provide continuity and organization, Web-based curriculum materials were designed and implemented as a component of the clerkship. The home page of the Web site provided the schedule, faculty names, attendance and grading policies, course overview, and links to individual tutorials. The pages for individual tutorials included educational objectives, glossary of radiology terminology relevant to the subject, lecture slides and handouts, and teaching cases. All students had laptop computers and access to the academic network, but did not use them during the actual tutorial sessions. Implementation of the radiology clerkship required extensive negotiation with directors of other clerkships so that students could be released from their other responsibilities in order to attend the radiology tutorials. The radiology clerkship format has proven to be complex in its administration, with faculty and students on different schedules commuting to the radiology lecture hall from various locations. Extensive use of e-mail and communication via the Web site have been instrumental in reminding faculty and students of upcoming sessions. Preliminary evaluations have indicated that students liked the radiology sessions and learned a great deal, but disliked the scheduling and the lack of continuity. An evaluation of the curriculum and its components is ongoing.

Graduates' Transition from Study to Employment of Radiologic Technology Graduates of the Lyceum University of the Philippines--Batangas

ERIC Educational Resources Information Center

Valdez, Anacleta P.

2012-01-01

A ten-year tracer study of Radiologic Technology graduates of Lyceum of the Philippines University SY 1997-2007 using a survey-structured questionnaire was conducted to examine retrospective contribution of their education to their current work. The objectives of the study included the determination of graduates' job-placement profile; how…

Standardization of pediatric uroradiological terms: a multidisciplinary European glossary.

PubMed

Vivier, Pierre-Hugues; Augdal, Thomas A; Avni, Fred E; Bacchetta, Justine; Beetz, Rolf; Bjerre, Anna K; Blickman, Johan; Cochat, Pierre; Coppo, Rosana; Damasio, Beatrice; Darge, Kassa; El-Ghoneimi, Alaa; Hoebeke, Piet; Läckgren, Göran; Leclair, Marc-David; Lobo, Maria-Luisa; Manzoni, Gianantonio; Marks, Stephen D; Mattioli, Girolamo; Mentzel, Hans-Joachim; Mouriquand, Pierre; Nevéus, Tryggve; Ntoulia, Aikaterini; Ording-Muller, Lil-Sofie; Oswald, Josef; Papadopoulou, Frederica; Porcellini, Gabriella; Ring, Ekkehard; Rösch, Wolfgang; Teixeira, Ana F; Riccabona, Michael

2018-02-01

To promote the standardization of nephro-uroradiological terms used in children, the European Society of Paediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication between different clinicians involved in pediatric urology and nephrology.

Building a leadership team that works.

PubMed

Blomenberg, Emily M

2005-01-01

Radiology administrators often are challenged to do more with less. In today's fast-paced work environment, leaders must be creative. They must surround themselves with good people in order to successfully achieve their organizations' goals. Once a radiology administrator is satisfied and comfortable that he or she has, the right staff involved, a leadership team can be formally establislished. Howard Regional Health System established an Imaging Services Leadership Team with a vision to provide leaders for the staff to "follow," just as team members learn from the radiology administrator. In addition, team members are vital in assisting the radiology administrator in managing the department The process of building the team consisted of 3 steps: selecting team members (the most challenging and time-consuming component), formalizing a functional team, and putting the team into action. Finding the right people, holding regular meetings, and making those team meetings meaningful are keys to a successful leadership team. The implementation of the team has had a positive effect on imaging services: the number of procedures has increased, the team is used as a communication tool for front-line staff, front-line staff are becoming more comfortable with making decisions.

Practice Hospital Bed Safety

MedlinePlus

... Administration’s (FDA) Center for Devices and Radiological Health (CDRH). "They are used not only in hospitals, but ... long-term care facilities, and in private homes." CDRH reports that about 2.5 million hospital beds ...

Quality management system in radiotherapy in the light of regulations applicable in Poland

PubMed Central

2012-01-01

The need to establish conditions for safe irradiation was noted in Poland back in 1986 in the Atomic Law, but for over 16 years no regulations regarding this aspect were passed. The radiological incident in Bialystok (Poland) in 2001 undeniably accelerated the implementation of new legal regulations. Nevertheless, in the absence of national guidelines until 2002, most health care institutions resorted to the quality management system (QMS) model proposed by the ISO norm 9001:2000. Eventually, practice proved the theory and the aforementioned model was also implemented into Polish acts of law defining basic requirements for QMS in radiotherapy. The aim of this work is to review current national regulations regarding QMS in radiotherapy, in particular those referring to standard procedures, the establishment of a commission for procedures and performance of external and internal clinical audits in oncological radiotherapy, as well as to present the process of their implementation into the practice of health care institutions. PMID:23788867

Launching a permanent out-of-hour interventional radiology service: single-center experience from a German University Hospital.

PubMed

Goltz, J P; Janssen, H; Petritsch, B; Kickuth, R

2014-02-01

To evaluate the feasibility, frequency of use, types of intervention and labor costs of a formal round-the-clock interventional radiology on-call service. In 11/2011 a formal and permanent out-of-hour interventional radiology rota in addition to the general radiology out-of-hour rota (OOHR) was established. We retrospectively screened the interventional radiology database for procedures completed outside regular working hours, reviewed all interventions and manually selected cases in which the on-call interventionist was called in from home. We determined the type, frequency of use and costs (€/year and procedure) of this service between 1/2012 and 12/2012. The referring physicians' (sub-) specialties were evaluated. During the 12-month period, the on-call interventionists (n = 3) performed 92 procedures OOH. The procedures included angiography and hemorrhage control (n = 36, 39.1 %), angiography and intervention for acute limb ischemia (n = 25, 27.2 %), percutaneous biliary drainage (PTCD) (n = 10, 10.9 %), angiography for non-occlusive ischemia (n = 7, 7.6 %), and other (n = 14, 15.3 %). The total labor costs for the OOHR were € 42,312.21 (€ 32,982.60 lump sum for stand-by, €  9,329.61 for hours spent on procedures). The labor costs per procedure totaled € 459.92. The referring physicians' specialties were general/visceral (n = 25), vascular surgery (n = 24), internal medicine (n = 21), cardiac/thoracic vascular (n = 9), trauma surgery (n = 5), urology (n = 5), and anesthesiology (n = 3). A formal interventional OOHR is practicable in a university hospital setting. Most procedures were requested by general, vascular, and thoracic surgery as well as internal medicine with a focus on hemorrhage control, treatment of acute limb ischemia, and PTCD. The overall labor costs for the OOHR appear moderate. • In a university setting an OOHR for IR is feasible.• Labor costs per procedure appear moderate.• Hemorrhage control and treatment of limb ischemia were the most frequent procedures. Citation Format: • Goltz JP, Janssen H, Petritsch B et al. Launching a Permanent Out-of-Hour Interventional Radiology Service: Single-Center Experience from a German University Hospital. Fortschr Röntgenstr 2014; 186: 136 - 141. © Georg Thieme Verlag KG Stuttgart · New York.

Turbo FRMAC 2011

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fulton, John; Gallagher, Linda K.; Whitener, Dustin

The Turbo FRMAC (TF) software automates the calculations described in volumes 1-3 of "The Federal Manual for Assessing Environmental Data During a Radiological Emergency" (2010 version). This software automates the process of assessing radiological data during a Federal Radiological Emergency. The manual upon which the software is based is unclassified and freely available on the Internet. TF takes values generated by field samples or computer dispersion models and assesses the data in a way which is meaningful to a decision maker at a radiological emergency; such as, do radiation values exceed city, state, or federal limits; should the crops bemore » destroyed or can they be utilized; do residents need to be evacuated, sheltered in place, or should another action taken. The software also uses formulas generated by the EPA, FDA, and other federal agencies to generate field observable values specific to the radiological event that can be used to determine where regulatory limit values are exceeded. In addition to these calculations, TF calculates values which indicate how long an emergency worker can work in the contaminated area during a radiological emergency, the dose received from drinking contaminated water or milk, the dose from eating contaminated food, the does expected down or upwind of a given field sample, along with a significant number of other similar radiological health values.« less

Online social networking for radiology.

PubMed

Auffermann, William F; Chetlen, Alison L; Colucci, Andrew T; DeQuesada, Ivan M; Grajo, Joseph R; Heller, Matthew T; Nowitzki, Kristina M; Sherry, Steven J; Tillack, Allison A

2015-01-01

Online social networking services have changed the way we interact as a society and offer many opportunities to improve the way we practice radiology and medicine in general. This article begins with an introduction to social networking. Next, the latest advances in online social networking are reviewed, and areas where radiologists and clinicians may benefit from these new tools are discussed. This article concludes with several steps that the interested reader can take to become more involved in online social networking. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

Integrating Customer Intimacy Into Radiology to Improve the Patient Perspective: The Case of Breast Cancer Screening.

PubMed

Chhor, Chloe M; Mercado, Cecilia L

2016-02-01

The customer intimacy business model has emerged as a key operational approach for health care organizations as they move toward patient-centered care. The question arises how the customer intimacy approach can be implemented in the clinical setting and whether it can help practitioners address problems and improve quality of care. Breast cancer screening and its emphasis on the patient perspective provides an interesting case study for understanding how the customer intimacy approach can be integrated into radiologic practice to improve the patient experience.

WORKER INHALATION DOSE COEFFICIENTS FOR RADIONUCLIDES NOT PREVIOUSLY IDENTIFIED IN ICRP PUBLICATION 68

DOE Office of Scientific and Technical Information (OSTI.GOV)

McLaughlin, David A; Schwahn, Scott O

2011-01-01

While inhalation dose coefficients are provided for about 800 radionuclides in International Commission on Radiological Protection (ICRP) Publication 68, many radionuclides of practical dosimetric interest for facilities such as high-energy proton accelerators are not specifically addressed, nor are organ-specific dose coefficients tabulated. The ICRP Publication 68 methodology is used, along with updated radiological decay data and metabolic data, to identify committed equivalent dose coefficients [hT(50)] and committed effective dose coefficients [e(50)] for radionuclides produced at the Oak Ridge National Laboratory s Spallation Neutron Source.

The Stability of Factors Influencing the Choice of Medical Specialty Among Medical Students and Postgraduate Radiology Trainees.

PubMed

Yen, Adam J; Webb, Emily M; Jordan, Eric J; Kallianos, Kimberly; Naeger, David M

2018-06-01

To investigate whether general psychological motivating factors that guide career selection of a medical specialty differ over the course of medical school and to compare differences in motivating factors among students choosing "controllable" lifestyle specialties, students choosing "uncontrollable" lifestyle specialties, and a cohort of radiology residents. An anonymous survey was distributed to first- through fourth-year medical students and radiology residents at a single institution. Participants were asked to select their top three of seven factors that most influenced their choice of medical specialty. Fourth-year students were asked to designate the specialty to which they had applied. The survey was distributed to 259 students and 47 radiology residents with a response rate of 93.8% (243 of 259) and 95.7% (45 of 47), respectively. The top three factors indicated by medical students were finding the daily work fulfilling, work-life balance, and interest in the subject. These top three factors were common to all medical student classes and did not differ between students choosing "controllable" versus "uncontrollable" fields. The factors uncommonly selected were similar personality to others in the field, attending income, competitiveness or prestige, and job market conditions. For radiology residents, the top three motivating factors were the same as for medical students. Three out of seven motivating factors were universally important to trainees, regardless of their stage of medical training or their selection of a controllable versus uncontrollable lifestyle specialty. These data suggest the variety of career choices made by students may not derive from differing underlying values. Copyright © 2018 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Supporting Imagers' VOICE: A National Training Program in Comparative Effectiveness Research and Big Data Analytics.

PubMed

Kang, Stella K; Rawson, James V; Recht, Michael P

2017-12-05

Provided methodologic training, more imagers can contribute to the evidence basis on improved health outcomes and value in diagnostic imaging. The Value of Imaging Through Comparative Effectiveness Research Program was developed to provide hands-on, practical training in five core areas for comparative effectiveness and big biomedical data research: decision analysis, cost-effectiveness analysis, evidence synthesis, big data principles, and applications of big data analytics. The program's mixed format consists of web-based modules for asynchronous learning as well as in-person sessions for practical skills and group discussion. Seven diagnostic radiology subspecialties and cardiology are represented in the first group of program participants, showing the collective potential for greater depth of comparative effectiveness research in the imaging community. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Radiation Protection in Pediatric Radiology: Results of a Survey Among Dutch Hospitals.

PubMed

Bijwaard, Harmen; Valk, Doreth; de Waard-Schalkx, Ischa

2016-10-01

A survey about radiation protection in pediatric radiology was conducted among 22 general and seven children's hospitals in the Netherlands. Questions concerned, for example, child protocols used for CT, fluoroscopy and x-ray imaging, number of images and scans made, radiation doses and measures taken to reduce these, special tools used for children, and quality assurance issues. The answers received from 27 hospitals indicate that radiation protection practices differ considerably between general and children's hospitals but also between the respective general and children's hospitals. It is recommended that hospitals consult each other to come up with more uniform best practices. Few hospitals were able to supply doses that can be compared to the national Diagnostic Reference Levels (DRLs). The ones that could be compared exceeded the DRLs in one in five cases, which is more than was expected beforehand.

Community archiving of imaging studies

NASA Astrophysics Data System (ADS)

Fritz, Steven L.; Roys, Steven R.; Munjal, Sunita

1996-05-01

The quantity of image data created in a large radiology practice has long been a challenge for available archiving technology. Traditional methods ofarchiving the large quantity of films generated in radiology have relied on warehousing in remote sites, with courier delivery of film files for historical comparisons. A digital community archive, accessible via a wide area network, represents a feasible solution to the problem of archiving digital images from a busy practice. In addition, it affords a physician caring for a patient access to imaging studies performed at a variety ofhealthcare institutions without the need to repeat studies. Security problems include both network security issues in the WAN environment and access control for patient, physician and imaging center. The key obstacle to developing a community archive is currently political. Reluctance to participate in a community archive can be reduced by appropriate design of the access mechanisms.

Breast cancer mammographic diagnosis performance in a public health institution: a retrospective cohort study.

PubMed

Mello, Juliana M R B; Bittelbrunn, Fernando P; Rockenbach, Marcio A B C; May, Guilherme G; Vedolin, Leonardo M; Kruger, Marilia S; Soldatelli, Matheus D; Zwetsch, Guilherme; de Miranda, Gabriel T F; Teixeira, Saone I P; Arruda, Bruna S

2017-12-01

To evaluate the quality assurance of mammography results at a reference institution for the diagnosis and treatment of breast cancer in southern Brazil, based on the BIRADS (Breast Imaging Reporting and Data System) 5th edition recommendations for auditing purposes. Retrospective cohort and cross-sectional study with 4502 patients (9668 mammographies)) who underwent at least one or both breast mammographies throughout 2013 at a regional public hospital, linked to a federal public university. The results were followed until 31 December 2014, including true positives (TPs), true negatives (TNs), false positives (FPs), false negatives (FNs), positive predictive values (PPVs), negative predictive value (NPV), sensitivity and specificity, with a confidence interval of 95%. The study showed high quality assurance, particularly regarding sensitivity (90.22%) and specificity (92.31%). The overall positive predictive value (PPV) was 65.35%, and the negative predictive value (NPV) was 98.32%. The abnormal interpretation rate (recall rate) was 12.26%. The results are appropriate when compared to the values proposed by the BIRADS 5th edition. Additionally, the study provided self-reflection considering our radiological practice, which is essential for improvements and collaboration regarding breast cancer detection. It may stimulate better radiological practice performance and continuing education, despite possible infrastructure and facility limitations. • Accurate quality performance rates are possible despite financial and governmental limitations. • Low-income institutions should develop standardised teamwork to improve radiological practice. • Regular mammography audits may help to increase the quality of public health systems.

Efficacy of radiation safety glasses in interventional radiology.

PubMed

van Rooijen, Bart D; de Haan, Michiel W; Das, Marco; Arnoldussen, Carsten W K P; de Graaf, R; van Zwam, Wim H; Backes, Walter H; Jeukens, Cécile R L P N

2014-10-01

This study was designed to evaluate the reduction of the eye lens dose when wearing protective eyewear in interventional radiology and to identify conditions that optimize the efficacy of radiation safety glasses. The dose reduction provided by different models of radiation safety glasses was measured on an anthropomorphic phantom head. The influence of the orientation of the phantom head on the dose reduction was studied in detail. The dose reduction in interventional radiological practice was assessed by dose measurements on radiologists wearing either leaded or no glasses or using a ceiling suspended screen. The different models of radiation safety glasses provided a dose reduction in the range of a factor of 7.9-10.0 for frontal exposure of the phantom. The dose reduction was strongly reduced when the head is turned to the side relative to the irradiated volume. The eye closest to the tube was better protected due to side shielding and eyewear curvature. In clinical practice, the mean dose reduction was a factor of 2.1. Using a ceiling suspended lead glass shield resulted in a mean dose reduction of a factor of 5.7. The efficacy of radiation protection glasses depends on the orientation of the operator's head relative to the irradiated volume. Glasses can offer good protection to the eye under clinically relevant conditions. However, the performance in clinical practice in our study was lower than expected. This is likely related to nonoptimized room geometry and training of the staff as well as measurement methodology.

SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, J; Williams, D; DiSantis, D

Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a fullmore » week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use the medical physics in practice.« less

External Factors That Influence the Practice of Radiology: Proceedings of the International Society for Strategic Studies in Radiology Meeting.

PubMed

Rubin, Geoffrey D; McNeil, Barbara J; Palkó, András; Thrall, James H; Krestin, Gabriel P; Muellner, Ada; Kressel, Herbert Y

2017-06-01

In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries. On the basis of material presented at the 2015 meeting of the International Society for Strategic Studies in Radiology, this report outlines the effects of reforms aimed at (a) controlling imaging use, (b) controlling payer expense through changes in benefit design, and (c) controlling both costs and quality through "value-based" payment schemes. Reasons are considered for radiology practices on both sides of the Atlantic about why the emphasis needs to shift from providing a large volume of imaging services to increasing the value of imaging as manifested in clinical outcomes, patient satisfaction, and overall system savings. Options for facilitating the shift from volume to value are discussed, from the use of advanced management strategies that improve workflow to the creation of programs for patient engagement, the development of new clinical decision-making support tools, and the validation of clinically relevant imaging biomarkers. Radiologists in collaboration with industry must enhance their efforts to expand the performance of comparative effectiveness research to establish the value of these initiatives, while being mindful of the importance of minimizing conflicts of interest. © RSNA, 2017.

Occupational musculoskeletal pain in cardiac sonographers compared to peer employees: a multisite cross-sectional study.

PubMed

Orme, Nicholas M; Geske, Jeffrey B; Pislaru, Sorin V; Askew, John Wells; Lennon, Ryan J; Lewis, Bradley R; Rihal, Charanjit S; Pellikka, Patricia A; Singh, Mandeep

2016-11-01

The purpose of this study was to compare the prevalence and impact of work-related musculoskeletal pain in cardiac sonographers to a large control group of peer employees with similar demographics. Cardiac sonographers are known to have high levels of occupational musculoskeletal pain. Comparative studies with other employees within cardiology/radiology departments have never been performed. An electronic survey was administered to Mayo Clinic employees at six major patient care facilities in four different states. There were 2682 employees within the departments of cardiology and radiology who were contacted, and 1532 (57%) completed the survey. After excluding those who wore protective lead aprons, 517 employees comprised the control group and 66 cardiac sonographers made up the study group. Cardiac sonographers reported work-related musculoskeletal pain more frequently than the control group (88% vs 40%; P<.001). This association persisted after multivariable adjustment for age, sex, body mass index, length of current employment, and history of preexisting musculoskeletal pain (OR 11.6; [95% CI 5.32, 25.5]; P<.001). Cardiac sonographers sought medical care for their work-related pain more often (55% vs 21%; P<.001) and missed more work due to pain (35% vs 12%, P<.001). In a secondary analysis, cardiac sonographers also experienced more work-related musculoskeletal pain than nurses, technicians, and physicians working in the interventional laboratory who regularly wear a protective lead apron (P<.001). In this multisite cross-sectional study, cardiac sonographers experienced significantly more work-related pain and missed more work due to pain than peer employees within cardiology/radiology departments. © 2016, Wiley Periodicals, Inc.

TRENCADIS--a WSRF grid MiddleWare for managing DICOM structured reporting objects.

PubMed

Blanquer, Ignacio; Hernandez, Vicente; Segrelles, Damià

2006-01-01

The adoption of the digital processing of medical data, especially on radiology, has leaded to the availability of millions of records (images and reports). However, this information is mainly used at patient level, being the extraction of information, organised according to administrative criteria, which make the extraction of knowledge difficult. Moreover, legal constraints make the direct integration of information systems complex or even impossible. On the other side, the widespread of the DICOM format has leaded to the inclusion of other information different from just radiological images. The possibility of coding radiology reports in a structured form, adding semantic information about the data contained in the DICOM objects, eases the process of structuring images according to content. DICOM Structured Reporting (DICOM-SR) is a specification of tags and sections to code and integrate radiology reports, with seamless references to findings and regions of interests of the associated images, movies, waveforms, signals, etc. The work presented in this paper aims at developing of a framework to efficiently and securely share medical images and radiology reports, as well as to provide high throughput processing services. This system is based on a previously developed architecture in the framework of the TRENCADIS project, and uses other components such as the security system and the Grid processing service developed in previous activities. The work presented here introduces a semantic structuring and an ontology framework, to organise medical images considering standard terminology and disease coding formats (SNOMED, ICD9, LOINC..).

Architecture of next-generation information management systems for digital radiology enterprises

NASA Astrophysics Data System (ADS)

Wong, Stephen T. C.; Wang, Huili; Shen, Weimin; Schmidt, Joachim; Chen, George; Dolan, Tom

2000-05-01

Few information systems today offer a clear and flexible means to define and manage the automated part of radiology processes. None of them provide a coherent and scalable architecture that can easily cope with heterogeneity and inevitable local adaptation of applications. Most importantly, they often lack a model that can integrate clinical and administrative information to aid better decisions in managing resources, optimizing operations, and improving productivity. Digital radiology enterprises require cost-effective solutions to deliver information to the right person in the right place and at the right time. We propose a new architecture of image information management systems for digital radiology enterprises. Such a system is based on the emerging technologies in workflow management, distributed object computing, and Java and Web techniques, as well as Philips' domain knowledge in radiology operations. Our design adapts the approach of '4+1' architectural view. In this new architecture, PACS and RIS will become one while the user interaction can be automated by customized workflow process. Clinical service applications are implemented as active components. They can be reasonably substituted by applications of local adaptations and can be multiplied for fault tolerance and load balancing. Furthermore, it will provide powerful query and statistical functions for managing resources and improving productivity in real time. This work will lead to a new direction of image information management in the next millennium. We will illustrate the innovative design with implemented examples of a working prototype.

How often do neuroradiologists perform sonography of the carotid arteries? A survey of academic and nonacademic radiology practices, with implications for fellowship training.

PubMed

Friedman, David P; Maitino, Andrea J

2003-08-01

Debate in the neuroradiology community surrounds the amount of formal training in sonography of the carotid arteries that should be provided to fellows. This study was designed to assess current practice patterns at both academic and nonacademic practices regarding the performance of carotid sonography. A neurovascular radiology survey was sent to all 102 program directors of neuroradiology fellowships in the United States and Canada (academic practices). The survey was also sent to 146 randomly selected senior members of the ASNR (three per state, except one each for Alaska and Vermont) who were not affiliated with fellowship programs (nonacademic practices). Fifty-seven surveys from academic practices and 70 surveys from nonacademic practices were returned. Radiologists at academic practices performed approximately 42% of studies (general radiologists or sonography specialists, 36%; neuroradiologists, 5%; cardiovascular radiologists, 1%). Nonradiologists performed approximately 58% of studies (vascular surgeons, 47%; neurologists, 10%; cardiologists, 1%; neurosurgeons, <1%). Neuroradiologists performed carotid sonography at 11% (6/57) of academic practices. On average, radiologists at nonacademic practices performed approximately 62% of studies (general radiologists or sonography specialists, 38%; neuroradiologists, 15%; cardiovascular radiologists, 9%). Nonradiologists performed approximately 38% of studies (vascular surgeons, 25%; neurologists, 6%; cardiologists or internists, 6%). Neuroradiologists performed carotid sonography at 53% (37/70) of nonacademic practices. At most academic practices, neuroradiologists do not perform sonography of the carotid arteries. This may explain the reluctance of some fellowships to provide formal training in this technique. In contrast, although neuroradiologists perform carotid sonography at a majority of the nonacademic practices, the percentage of studies that they perform is small; moreover, neuroradiologists perform far fewer studies than do general radiologists or sonography specialists.

Image Sharing in Radiology-A Primer.

PubMed

Chatterjee, Arindam R; Stalcup, Seth; Sharma, Arjun; Sato, T Shawn; Gupta, Pushpender; Lee, Yueh Z; Malone, Christopher; McBee, Morgan; Hotaling, Elise L; Kansagra, Akash P

2017-03-01

By virtue of its information technology-oriented infrastructure, the specialty of radiology is uniquely positioned to be at the forefront of efforts to promote data sharing across the healthcare enterprise, including particularly image sharing. The potential benefits of image sharing for clinical, research, and educational applications in radiology are immense. In this work, our group-the Association of University Radiologists (AUR) Radiology Research Alliance Task Force on Image Sharing-reviews the benefits of implementing image sharing capability, introduces current image sharing platforms and details their unique requirements, and presents emerging platforms that may see greater adoption in the future. By understanding this complex ecosystem of image sharing solutions, radiologists can become important advocates for the successful implementation of these powerful image sharing resources. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Standardization of pediatric uroradiological terms: A multidisciplinary European glossary.

PubMed

Vivier, Pierre-Hugues; Augdal, Thomas A; Avni, Fred E; Bacchetta, Justine; Beetz, Rolf; Bjerre, Anna K; Blickman, Johan; Cochat, Pierre; Coppo, Rosana; Damasio, Beatrice; Darge, Kassa; El-Ghoneimi, Alaa; Hoebeke, Piet; Läckgren, Göran; Leclair, Marc-David; Lobo, Maria-Luisa; Manzoni, Gianantonio; Marks, Stephen D; Mattioli, Girolamo; Mentzel, Hans-Joachim; Mouriquand, Pierre; Nevéus, Tryggve; Ntoulia, Aikaterini; Ording-Muller, Lil-Sofie; Oswald, Josef; Papadopoulou, Frederica; Porcellini, Gabriella; Ring, Ekkehard; Rösch, Wolfgang; Teixeira, Ana F; Riccabona, Michael

2017-12-01

To promote the standardization of nephro-uroradiological terms used in children, the European Society of Pediatric Radiology uroradiology taskforce wrote a detailed glossary. This work has been subsequently submitted to European experts in pediatric urology and nephrology for discussion and acceptance to improve the quality of radiological reports and communication among different clinicians involved in pediatric urology and nephrology. Copyright © 2017. Published by Elsevier Ltd.

Novel Application of FTIR Spectroscopy for the Passive Standoff Detection of Radiological Materials

DTIC Science & Technology

2006-08-01

possibility of applying the long-wave passive standoff detection technique to the identification of radiological materials. This work is based on...infrared (FTIR) radiometry is a well-known technique for detecting and identifying chemical warfare agents. In addition to these potential threats...necessary tools and techniques available for detecting and identifying radioactive products. At present, the main detection techniques depend on methods

Preventing tuberculosis in healthcare workers of the radiology department: a Malaysian perspective.

PubMed

Tan, Lh; Kamarulzaman, A

2006-01-01

Tuberculosis (TB) is a well recognised occupational hazard for healthcare workers (HCWs). Concerns on the safety of healthcare settings in Malaysia was raised following a report of 25 HCWs working in 11 general hospitals in Malaysia who were infected with TB in 2004 being publicised in the media recently. As the disease burden in general is high in Malaysia, due attention should be given to this disease in our healthcare facilities including the radiology department, an often neglected area in TB infection control programmes. This article focuses on the key control measures that can be implemented in radiology departments in a developing country with limited resources.

My road on interventional radiology

PubMed Central

Li, Yan-Hao

2010-01-01

The author tells a story of how he has become an expert of interventional radiotherapy from a graduate of middle school. In his childhood, he wanted to become an astronomer. However, he was forced to go to the countryside as a school graduate. In 1974, he was enrolled as a “worker-peasant-soldier” student in Henan Medical College. After graduated from the college, he was assigned to the Radiology Department of the First Affiliated Hospital of Henan Medical College where he worked hard as an assistant doctor. Then, he was transferred to Nanfang Hospital (Guangzhou, China) where he achieved great successes and thus has become an expert of interventional radiology. PMID:21161028

The imaging 3.0 informatics scorecard.

PubMed

Kohli, Marc; Dreyer, Keith J; Geis, J Raymond

2015-04-01

Imaging 3.0 is a radiology community initiative to empower radiologists to create and demonstrate value for their patients, referring physicians, and health systems. In image-guided health care, radiologists contribute to the entire health care process, well before and after the actual examination, and out to the point at which they guide clinical decisions and affect patient outcome. Because imaging is so pervasive, radiologists who adopt Imaging 3.0 concepts in their practice can help their health care systems provide consistently high-quality care at reduced cost. By doing this, radiologists become more valuable in the new health care setting. The authors describe how informatics is critical to embracing Imaging 3.0 and present a scorecard that can be used to gauge a radiology group's informatics resources and capabilities. Copyright © 2015 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Academic Radiology in the New Healthcare Delivery Environment

PubMed Central

Qayyum, Aliya; Yu, John-Paul J.; Kansagra, Akash P.; von Fischer, Nathaniel; Costa, Daniel; Heller, Matthew; Kantartzis, Stamatis; Plowman, R. Scooter; Itri, Jason

2014-01-01

Ongoing concerns over the rising cost of health care are driving large-scale changes in the way that health care is practiced and reimbursed in the United States. To effectively implement and thrive within this new health care delivery environment, academic medical institutions will need to modify financial and business models and adapt institutional cultures. In this paper, we review the expected features of the new health care environment from the perspective of academic radiology departments. Our review will include background on Accountable Care Organizations, identify challenges associated with the new managed care model, and outline key strategies—including expanding the use of existing information technology infrastructure, promoting continued medical innovation, balancing academic research with clinical care, and exploring new roles for radiologists in efficient patient management—that will ensure continued success for academic radiology. PMID:24200477

History and Evolution of the Barium Swallow for Evaluation of the Pharynx and Esophagus.

PubMed

Levine, Marc S; Rubesin, Stephen E

2017-02-01

This article reviews the history of the barium swallow from its early role in radiology to its current status as an important diagnostic test in modern radiology practice. Though a variety of diagnostic procedures can be performed to evaluate patients with dysphagia or other pharyngeal or esophageal symptoms, the barium study has evolved into a readily available, non-invasive, and cost-effective technique that can facilitate the selection of additional diagnostic tests and guide decisions about medical, endoscopic, or surgical management. This article focuses on the evolution of fluoroscopic equipment, radiography, and contrast media for evaluating the pharynx and esophagus, the importance of understanding pharyngoesophageal relationships, and major advances that have occurred in the radiologic diagnosis of select esophageal diseases, including gastroesophageal reflux disease, infectious esophagitis, eosinophilic esophagitis, esophageal carcinoma, and esophageal motility disorders.