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Clinical Imaging 2019"Curbside consults" are informal opinions provided by one physician to another. In radiology, it often refers to opinions rendered on imaging performed at outside...
OBJECTIVE
"Curbside consults" are informal opinions provided by one physician to another. In radiology, it often refers to opinions rendered on imaging performed at outside facilities and has evolved from being a targeted response to a discrete clinical question to a complete over-read in recent years. Given that the consults are usually sought for patients with complex conditions, the potential for error increases with informal reads, often due to the time constraint and lack of adequate information. Misinterpretations and inaccurate documentation by the referring clinician are also more likely. This study assesses the policies and views on curbside consults at academic centers in the United States.
MATERIALS AND METHODS
An online survey (via SurveyMonkey.com) was circulated to the 319 active radiologist members of the Association of Program Directors. There were 80 responses, representing a 25% response rate.
RESULTS
While most facilities provided second reads (92%), only a few (23%) provided written reports and read the case entirely. The majority (77%) tailored their read to answer specific clinical questions. Approximately two-thirds did not require the outside radiologist's report to be available before their interpretation. Seventy-nine percent were at least mildly concerned about liability. Up to 45% billed for the study; 39% were not aware of the billing practice.
CONCLUSION
Curbside consults are widely provided at U.S. academic institutions with only a minority documenting their opinions. The majority are concerned about the legal implications and this paper puts forth recommendations to minimize the potential for errors in patient care and decrease liability.
Topics: Documentation; Hospitals, Teaching; Humans; Liability, Legal; Practice Patterns, Physicians'; Radiology; Referral and Consultation; United States
PubMed: 31163294
DOI: 10.1016/j.clinimag.2019.05.009 -
Studies in Health Technology and... 2014The Radiology Gamuts Ontology (RGO) is a knowledge model of diseases, interventions, and imaging manifestations. RGO incorporates 16,822 terms with their synonyms and...
The Radiology Gamuts Ontology (RGO) is a knowledge model of diseases, interventions, and imaging manifestations. RGO incorporates 16,822 terms with their synonyms and abbreviations and 55,393 relationships between terms. Subsumption defines the relationship between more general and more specific terms; causality relates disorders and their imaging manifestations. We explored the application of the RGO to build an interactive decision support system for radiological diagnosis. The Gamuts DDx system was created to apply the RGO's knowledge: it identifies a list of potential diagnoses in response to one or more user-specified imaging observations. The system also identifies a set of observations that allow one to narrow the diagnosis, and dynamically narrows or expands the list of diagnoses as imaging findings are selected or deselected. The functionality has been implemented as a web-based user interface and as a web service. The current work demonstrates the feasibility of exploiting the RGO's causal knowledge to provide interactive decision support for diagnosis of imaging findings. Ongoing efforts include the further development of the system's knowledge base and evaluation of the system in clinical use.
Topics: Biological Ontologies; Decision Support Systems, Clinical; Image Interpretation, Computer-Assisted; Natural Language Processing; Radiology; Radiology Information Systems; Terminology as Topic; User-Computer Interface
PubMed: 25160149
DOI: No ID Found -
Studies in Health Technology and... May 2022The present study shows first attempts to automatically classify oncology treatment responses on the basis of the textual conclusion sections of radiology reports...
The present study shows first attempts to automatically classify oncology treatment responses on the basis of the textual conclusion sections of radiology reports according to the RECIST classification. After a robust and extended manual annotation of 543 conclusion sections (5-to-50-word long), and after the training of several machine learning techniques (from traditional machine learning to deep learning), the best results show an accuracy score of 0.90 for a two-class classification (non-progressive vs. progressive disease) and of 0.82 for a four-class classification (complete response, partial response, stable disease, progressive disease) both with Logistic Regression approach. Some innovative solutions are further suggested to improve these scores in the future.
Topics: Machine Learning; Natural Language Processing; Radiography; Radiology; Research Report; Supervised Machine Learning
PubMed: 35612224
DOI: 10.3233/SHTI220605 -
Journal of the American College of... Jan 2014In October 2010, a white paper was published in this journal that represented a consensus of the ACR Incidental Findings Committee, including guidance for...
PURPOSE
In October 2010, a white paper was published in this journal that represented a consensus of the ACR Incidental Findings Committee, including guidance for characterizing, reporting, and managing incidental findings in the liver, kidneys, adrenal glands, and pancreas. A survey was conducted of the ACR membership to determine how widely this paper had been read, how the information is being used, and how management of incidental findings may be improved.
METHODS
A survey consisting of 14 multiple-choice and 5 free-text responses was distributed by e-mail to 14,336 ACR physician members. The survey was open during June and July 2012 using SurveyMonkey. Topics included how the paper's recommendations had affected practice and the frequency of recommendations for additional imaging, how incidental findings are reported, the content and the form of the white paper, and the possible effects of tort reform.
RESULTS
Of the 14,336 radiologists contacted, 2,892 (20%) returned the survey; of these, 1,099 (38%) indicated that they had read the paper. Of the 1,099 radiologists who read the paper, 978 (89%) responded that the content was used in clinical practice. The white paper led 560 radiologists (51%) to recommend additional imaging less often and 33 radiologists (3%) to recommend imaging more often. Tort reform was cited by 835 radiologists (76%) as a means to decrease the likelihood of their recommending additional imaging.
CONCLUSIONS
The 2010 JACR white paper on incidental abdominal CT findings has been read by a substantial number of radiologists, and among those who read it, the recommendations are being largely followed and are leading to a reduction in imaging recommendations. Future similar consensus-based white papers could lead to more consistent and effective management of incidental imaging findings and likely reduce the overall number of patients for whom additional imaging is recommended.
Topics: Data Collection; Guideline Adherence; Incidental Findings; Journal Impact Factor; Periodicals as Topic; Practice Patterns, Physicians'; Radiography, Abdominal; Radiology; Societies, Medical; Tomography, X-Ray Computed; United States
PubMed: 24139322
DOI: 10.1016/j.jacr.2013.06.002 -
Academic Radiology Sep 2004To describe the development of and assess student satisfaction with a blended learning method for teaching radiologic anatomy that integrates web-based instruction with... (Comparative Study)
Comparative Study
RATIONALE AND OBJECTIVES
To describe the development of and assess student satisfaction with a blended learning method for teaching radiologic anatomy that integrates web-based instruction with small group and didactic teaching.
MATERIALS AND METHODS
In 2002 the teaching of radiologic anatomy to first-year medical students was changed from group learning (20-30 students with a preceptor and films at a viewbox) to a blended learning model that included a brief didactic introduction followed by small group (7-8 students) web-based structured learning modules with rotating lab instructors. In 2003 the modules were changed to include self-study cases prior to the lab, follow-up cases, and twice-weekly optional review sessions. Students and lab instructors were surveyed for their response to the content and design of the sessions.
RESULTS
Course surveys in 2001, with a response rate of 84%, showed 58 negative comments regarding inconsistency between various instructors. Individual response rates for 2002 for radiologic anatomy teaching sessions (RadLab) surveys ranged from 56%-81%, dropping as the course progressed. All RadLabs were rated "very useful" or "useful," except the cardiovascular lab, which was not designed as an interactive module. In 2003, after redesign of the cardiovascular lab in the same format as the other labs, all RadLabs were rated 2.4 or better (useful).
CONCLUSION
An integration of computers with small and large group didactic instruction allow optimal use of faculty, conform to accepted theories of adult learning, and are well-accepted by students.
Topics: Adult; Anatomy; Computer-Assisted Instruction; Education, Medical, Undergraduate; Faculty, Medical; Follow-Up Studies; Humans; Internet; Learning; Personal Satisfaction; Program Evaluation; Radiology; Students, Medical; Surveys and Questionnaires; Systems Integration; User-Computer Interface
PubMed: 15350588
DOI: 10.1016/j.acra.2004.05.018 -
Academic Radiology Dec 2021To describe and analyze the pediatric neuroradiology implicit curriculum for general-pediatric and neuro-pediatric radiology fellowship training in order to define...
RATIONALE AND OBJECTIVES
To describe and analyze the pediatric neuroradiology implicit curriculum for general-pediatric and neuro-pediatric radiology fellowship training in order to define specific trainee needs and inform an explicit pediatric neuroradiology curriculum.
MATERIALS AND METHODS
A focus group of pediatric radiologists, pediatric neuroradiologists and fellows was conducted to create a needs assessment questionnaire that focused on training experience, current job, and a list of essential competency items. The questionnaire was distributed to 175 members of the Society for Pediatric Radiology. Data were derived from categorical and continuous survey variables. Using an inductive approach, we analyzed and systematically inspected the data to derive themes regarding trainee needs and how they might inform an explicit curriculum.
RESULTS
Fifty-seven pediatric radiologists (response rate of 33%) responded to the survey. Sixty-three percent of respondents were fellowship trained in general pediatric radiology, 21% in pediatric neuroradiology, and 16% in both. In their current jobs, 75% of respondents were responsible for interpreting some pediatric neuroradiology. 50% or greater reported limited or no fellowship instruction in five areas of imaging interpretation: fetal neuroimaging; ear and/or nose and/or throat imaging; head and neck imaging; neuroembryology; neuro-spectroscopy and four areas of technical skills and/or image quality: reducing imaging time; choice of contrast agents; sedation; understanding clinical management pathways.
CONCLUSION
Trainees endorse inadequate training in certain aspects of imaging interpretation and technical skills which are known to remain a significant and vital aspect of pediatric neuroradiology practice, revealing an opportunity to emphasize these aspects in an explicit curriculum and dedicate educational resources towards this cause.
Topics: Child; Curriculum; Education, Medical, Graduate; Fellowships and Scholarships; Humans; Needs Assessment; Radiology; Surveys and Questionnaires
PubMed: 33618941
DOI: 10.1016/j.acra.2020.08.025 -
Radiation Protection Dosimetry May 2023In this paper, two decision support systems have been used to re-analyze the Fukushima accident emissions: the European Realtime Online Decision Support System for...
In this paper, two decision support systems have been used to re-analyze the Fukushima accident emissions: the European Realtime Online Decision Support System for Nuclear Emergency Management (RODOS, version JRodos 2019)-providing a set of modules for the dispersion of nuclides following atmospheric and aquatic releases, dosimetry modules for dose estimation to individuals and communities for all exposure pathways with application of countermeasures, and modules for time estimation of the radiological situation in inhabited and agricultural areas-and CBRNE Platform, developed by IFIN-HH within a research project on anticipative and prognostic evaluation of chemical, biological, radiological, nuclear and explosive events (CBRNE), which is a tool for effect diagnosis functions, response measures and consecutive recommendation for a large variety of scenarios. We have reproduced the event on both systems, using accident time weather data and updated source terms. Current and initial results were cross-compared and evaluated.
Topics: Humans; Fukushima Nuclear Accident; Radiology; Agriculture; Online Systems; Radioactivity
PubMed: 37225233
DOI: 10.1093/rpd/ncad088 -
Physica Medica : PM : An International... Oct 2017Medical physicists represent a valuable asset at the disposal of a structured and planned response to nuclear or radiological emergencies (NREs), especially in the...
Medical physicists represent a valuable asset at the disposal of a structured and planned response to nuclear or radiological emergencies (NREs), especially in the hospital environment. The recognition of this fact led the International Atomic Energy Agency (IAEA) and the International Organization for Medical Physics (IOMP) to start a fruitful collaboration aiming to improve education and training of medical physicists so that they may support response efforts in case of NREs. Existing shortcomings in specific technical areas were identified through international consultations supported by the IAEA and led to the development of a project aiming at preparing a specific and standardized training package for medical physicists in support to NREs. The Project was funded through extra-budgetary contribution from Japan within the IAEA Nuclear Safety Action Plan. This paper presents the work accomplished through that project and describes the current steps and future direction for enabling medical physicists to better support response to NREs.
Topics: Capacity Building; Curriculum; Education, Distance; Emergencies; Environmental Pollution; Health Physics; Humans; Nuclear Energy; Publications; Radiation Protection; Radioactive Hazard Release; Radiology
PubMed: 29173925
DOI: 10.1016/j.ejmp.2017.09.117 -
Surgical and Radiologic Anatomy : SRA Jan 2022Anatomy pedagogy and radiologists involvement in teaching undergraduate anatomy varies widely. We surveyed radiologists practising in Australia and New Zealand to...
INTRODUCTION
Anatomy pedagogy and radiologists involvement in teaching undergraduate anatomy varies widely. We surveyed radiologists practising in Australia and New Zealand to establish their opinions on their own experience of undergraduate anatomy and their view on the role of radiology in anatomy teaching. We also sought their views on the role of radiologists in anatomy teaching.
METHODS
A short survey was designed on the Survey Monkey platform using the website surveymonkey.com. The survey was distributed to members of the Royal Australian and New Zealand College of Radiologists (RANCZR) as a link attached to a monthly e-newsletter with a short paragraph outlining its aim.
RESULTS
Sixty-seven responses were eligible for analysis. 33% (22/67) were dissatisfied with their own anatomy training and 55% (38/67) felt that current graduates had an inadequate level of anatomy. 55% (38/67) indicated that radiology had not been a major part of their own undergraduate anatomy training. 58% (39/67) of respondents felt that non-radiology medical and para-medical professionals were not suitably qualified to teach radiologic anatomy. 75% (42/67) were of the opinion that radiology with 3-D support platforms may replace cadaveric dissection in the future, yet most were not familiar with 3-D platforms in current usage.
Topics: Anatomy; Australia; Curriculum; Dissection; Education, Medical, Undergraduate; Humans; New Zealand; Radiography; Radiology; Surveys and Questionnaires; Teaching
PubMed: 34378106
DOI: 10.1007/s00276-021-02811-9 -
European Radiology Jun 2022To explore radiographers' actions toward inappropriate referrals and hindrances to assessing referrals.
OBJECTIVES
To explore radiographers' actions toward inappropriate referrals and hindrances to assessing referrals.
METHODS
An online survey was distributed to radiographers via the International Society of Radiographers and Radiological Technologists (ISRRT) networks. The questionnaire consisted of 5-point Likert scale questions on radiographers' actions to supplement referral information, actions for unjustified referrals and hindrances to referral assessment. The questionnaire was validated using a test-retest reliability analysis. Kappa values ≥ 0.6 were accepted. SPSS software was used for data analysis and chi-square tests to compare subgroups.
RESULTS
Total responses received were 279. The most reported actions to supplement missing referral information were to ask the patient or relative, examine the body region of concern and check medical records (73%, 70%, 67%, responded often/always, respectively). The actions when confronted with unjustified referrals were reported equally to consult the radiologist, referring clinician and radiographer (69-68% often/always responses). The hindering factors ranked high (agreed/strongly agreed responses) pertained to inadequate information in referral forms (83%), ineffective communication among healthcare professionals (79%), lack of training (70%) and allocated time (61%). Statistically significant associations were observed for a few actions and hindrances with education level, modality of practice and responsibility to screen imaging referrals.
CONCLUSION
Radiographers consult colleagues about suspected unjustified referrals. Effective communication pathways, training and time allocation to improve radiographers' skills to assess referrals may enhance appropriate imaging and delivery of quality patient care.
KEY POINTS
• Radiographers' actions of supplementing missing information in radiology referrals facilitate provision of high-quality health services. • Radiographers' strategy when confronted with inappropriate referrals is to consult radiologists and referring clinicians. • Better inter-professional communication and organisation of tasks can facilitate radiographers' participation in referral assessment to ensure appropriate imaging.
Topics: Humans; Radiography; Radiologists; Radiology; Referral and Consultation; Reproducibility of Results
PubMed: 34989841
DOI: 10.1007/s00330-021-08470-z