Journal of the American College of Radiology最新文献

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Staging and Post-Therapy Assessment of Head and Neck Cancer","authors":"Corey Feuer , Sharon L. D’Souza MD, MPH","doi":"10.1016/j.jacr.2024.06.017","DOIUrl":"10.1016/j.jacr.2024.06.017","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Page 617"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Female Breast Cancer Screening: 2024 Update","authors":"Aatiqah Aziz , Sonya Bhole MD","doi":"10.1016/j.jacr.2024.09.017","DOIUrl":"10.1016/j.jacr.2024.09.017","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Page 615"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142634240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State-Level Medicaid Reimbursement and Imaging Utilization by Medicaid and Children’s Health Insurance Program Patients","authors":"Eric W. Christensen PhD ,&nbsp;Alexandra R. Drake MPH ,&nbsp;Neil C. Davey MD ,&nbsp;Elizabeth Y. Rula PhD","doi":"10.1016/j.jacr.2024.10.009","DOIUrl":"10.1016/j.jacr.2024.10.009","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine if relative Medicaid-to-Medicare reimbursement rates are associated with patient imaging utilization.</div></div><div><h3>Methods</h3><div>This cross-sectional study estimated the association of diagnostic imaging utilization with the state-level Medicaid-to-Medicare reimbursement ratio (MMRR) of professional payments. State-specific reimbursement ratios were computed for each imaging modality. Logistic regression was used to estimate the likelihood of having imaging, and gamma regression was used to estimate the average number of imaging studies for those with imaging. These models were performed for each gender-modality combination controlling for patient characteristics.</div></div><div><h3>Results</h3><div>Among 48,835,765 Medicaid patients, 54.3% were women. The median MMRR was 0.82 (interquartile range [IQR]: 0.73-0.94) for CT, 0.87 (IQR: 0.76-1.01) for MR, 0.76 (IQR: 0.69-0.99) for nuclear medicine (NM), 0.85 (IQR: 0.73-1.09) for ultrasound, and 0.82 (IQR: 0.74-0.97) for radiography or fluoroscopy (XR). The probability of having imaging was 25.9% for CT, 25.9% for MR, 21.4% for ultrasound, and 31.8% for XR higher at 75th percentile of the MMRR distribution compared with the 25th percentile (<em>P</em> &lt; .001). For those with imaging, the mean number of imaging studies received was associated with 5.7% fewer studies for NM at the 75th percentile compared with the 25th percentile (<em>P</em> &lt; .001), although there was no difference for other modalities.</div></div><div><h3>Conclusions</h3><div>Medicaid payments are related to imaging utilization. A higher MMRR is associated with a substantially increased likelihood of Medicaid patients receiving CT, MR, ultrasound, and XR imaging but no difference in the amount of imaging studies received for those with imaging for these modalities.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Pages 530-538"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has Anyone Seen Our Chief?","authors":"Jennifer Nathan MD ,&nbsp;Frank J. Lexa MD, MBA ,&nbsp;Kenneth Hite MD ,&nbsp;Candice Johnstone MD, MPH ,&nbsp;Serena Liebengood MD, MHSA","doi":"10.1016/j.jacr.2024.12.013","DOIUrl":"10.1016/j.jacr.2024.12.013","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Page 606"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Discrimination and Pandemic Attitudes on Cancer Screening Behaviors Among Asian American Women: A Sequential Explanatory Mixed-Methods Study","authors":"Chau D. Vo MD ,&nbsp;Bingjing Mao PhD ,&nbsp;Alexander W. Burns BS ,&nbsp;Jordan Neil PhD ,&nbsp;Nathaniel Mercaldo PhD ,&nbsp;Qi Yan MPH ,&nbsp;Yasmine Nousari BA ,&nbsp;Lauren Ballini MPH ,&nbsp;Nikki López-Suárez MD ,&nbsp;Aayan V. Khasgiwala ,&nbsp;Arlin Arias Castro MEd ,&nbsp;Kelly Irwin MD ,&nbsp;Elyse R. Park PhD, MPH ,&nbsp;Ruth C. Carlos MD, MS ,&nbsp;Efrén J. Flores MD","doi":"10.1016/j.jacr.2024.11.032","DOIUrl":"10.1016/j.jacr.2024.11.032","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to assess how pandemic-related health concerns and discrimination affected cancer screenings among Asian American women (AAW).</div></div><div><h3>Methods</h3><div>A two-phase explanatory mixed-methods study was conducted. In phase 1, a survey was distributed among AAW eligible for lung, breast, or colorectal cancer screening to assess delays during the pandemic, concerns about contracting coronavirus disease 2019 (COVID-19), barriers to care, and experiences of discrimination. In phase 2, four qualitative focus group discussions, stratified by generational status and history of delayed cancer screening, were conducted to explore a priori domains of interest on cancer screening during the pandemic and perceived discrimination. Logistic regression analyses were performed to identify factors associated with delays, followed by deductive thematic qualitative analysis.</div></div><div><h3>Results</h3><div>In phase 1, of 225 participants recruited, 166 met the inclusion criteria (74%). Most participants were first-generation Americans (67%), were employed (65%), and had higher education (67% with a master’s degree or higher). Forty percent reported delays in cancer screening. Factors associated with delays included worry about contracting COVID-19 (adjusted odds ratio, 2.57; 95% confidence interval, 1.05-6.28; <em>P</em> = .038) and spreading it to family or friends (adjusted odds ratio, 5.78; 95% confidence interval, 1.50-22.3; <em>P</em> = .011). No association between discrimination and delayed cancer screening was found. In phase 2, focus group discussions (n = 19) revealed that first-generation women who delayed screening faced barriers due to a fear of infection and perceived discrimination. Perceived discrimination affected daily behaviors and sense of safety, though less so in medical settings.</div></div><div><h3>Conclusions</h3><div>Delays in cancer screening among AAW were associated with patients’ concerns about contracting and spreading COVID-19. Radiology practices can lead collaborative efforts on cancer screening campaigns that emphasize early detection and promote psychological safety.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Pages 539-549"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Road Map for ACR Practice Accreditation for Radiology Artificial Intelligence","authors":"David B. Larson MD, MBA ,&nbsp;Mythreyi Bhargavan-Chatfield PhD ,&nbsp;Michael Tilkin MS ,&nbsp;Laura Coombs PhD ,&nbsp;Christoph Wald MD, PhD, MBA","doi":"10.1016/j.jacr.2025.02.008","DOIUrl":"10.1016/j.jacr.2025.02.008","url":null,"abstract":"<div><div>As the use of artificial intelligence (AI) continues to grow in radiology, it has become clear that its real-world performance often differs from that demonstrated in premarket testing, underscoring the need for robust quality management (QM) programs at local institutions. For decades, a key mechanism to ensure QM in radiology practices has been ACR accreditation. However, no such program currently exists for AI in radiology. As leaders of the ACR Commissions on Quality and Safety and Informatics, we are dedicated to establishing ACR accreditation for radiology AI. In this article, we outline our plan for this effort. ACR accreditation is a peer-reviewed process that evaluates radiology practices according to ACR Practice Parameters and Technical Standards, which are consensus-based guidelines aimed at improving care quality and reducing variability. ACR Practice Parameters focus on clinical aspects like patient management, and Technical Standards address the performance of imaging and treatment equipment. To support the development of this accreditation program, the ACR Recognized Center for Healthcare-AI (ARCH-AI) program has been established as a precursor to formal accreditation. ARCH-AI participants attest to meeting minimum criteria in areas such as governance, model selection, acceptance testing, monitoring, and management of locally developed models. Insights gained from ARCH-AI will inform the development of the formal accreditation program, which will culminate in ACR Council approval, currently anticipated in spring 2027. The College remains committed to fostering dialogue among members and stakeholders to ensure AI fulfills its promise of enhancing patient care safely and effectively.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Pages 586-592"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Female Representation in Integrated Interventional Radiology Residency: Trends, Underrepresentation, and Modest Growth Over Five Years","authors":"Emily R. Hunt BS ,&nbsp;Sophie Vo BS ,&nbsp;Andrea Benson BS ,&nbsp;Sherron Thomas BS ,&nbsp;Harika Dabbara BS ,&nbsp;Rebecca T. Le MD","doi":"10.1016/j.jacr.2024.12.008","DOIUrl":"10.1016/j.jacr.2024.12.008","url":null,"abstract":"<div><h3>Objective</h3><div>Women remain a minority of trainees in interventional radiology (IR) since the residency’s inception in 2014. Similar phenomena have been observed in other surgical specialties. Our study aims to quantify changes in female trainee representation in integrated IR over a 5-year period from the 2018-2019 to 2022-2023 academic years and to compare with trends in other specialties.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of survey data collected from the National Graduate Medical Education database. The eight selected specialties, including IR, were chosen due to qualitative similarities with IR training or due to less than 30% female trainee representation in 2018-2019. In these data, gender was categorized as male or female. Percentage of female trainees in each specialty was collected in the study period. Analysis was conducted using analysis of variance, linear regression, and Tukey honest significant difference (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>In the 5-year study period, female representation in integrated IR residency grew by 16.6% at a mean relative growth rate of 4.0% annually. By 2022-2023, integrated vascular surgery residency had the highest female trainee representation (38.4%), whereas integrated IR had the second lowest (22.4%), ahead of orthopedic surgery (20.4%).</div></div><div><h3>Discussion</h3><div>Despite observed growth, female trainee representation in integrated IR lags behind other procedural and radiology specialties. Our analysis emphasizes the need for continued recruitment of female applicants to bolster gender parity. Supporting known ongoing initiatives like female mentorship programs and developing new strategies to support female interest in IR should be a priority for the field.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Pages 593-599"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Parathyroid Adenoma","authors":"Christian P. Haskett PhD, AEMT ,&nbsp;Gregory J. Czuczman MD","doi":"10.1016/j.jacr.2024.06.016","DOIUrl":"10.1016/j.jacr.2024.06.016","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Page 618"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141499752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization and Targeting of the Main Drivers of Elective Imaging Utilization: A Cross-Sectional Study Applying Conjoint Analysis","authors":"Cindy Yuan MD, PhD ,&nbsp;Hongxian Huang MA ,&nbsp;Douglas Dirschl MD ,&nbsp;Pradeep Chintagunta PhD ,&nbsp;David Paushter MD","doi":"10.1016/j.jacr.2025.01.009","DOIUrl":"10.1016/j.jacr.2025.01.009","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize patient and referring physician preferences when selecting where to have elective imaging performed.</div></div><div><h3>Methods</h3><div>In this institutional research board–approved survey-based study, online surveys were completed by 393 patients who had recently had a noncontrast MRI of the shoulder, lumbar spine, or knee within the past 2 years and 168 physicians who had ordered at least 12 such MRIs in the past year. The survey data included explicit questions about preferences as well as a set of conjoint choice screens. Conjoint analysis used a logistic model estimated using maximum likelihood estimation. Additionally, latent class analysis was performed to evaluate segmentation of the market.</div></div><div><h3>Results</h3><div>Both patients and referring physicians placed most value on copay and cost, with both groups containing a large segment that places almost all value on low costs. Patients also valued the recommendation of their referring physician and convenient appointment time and location. Overall, physicians also valued image quality and a trusted radiologist, with one physician segment placing more value on these traits than cost. As expected, there was some variation between the relative importance of traits depending on whether respondents were ranking, rating, or implicitly valuing characteristics.</div></div><div><h3>Discussion</h3><div>Overall, both patients and referring physicians place greatest importance on copay and cost but other nonmonetary characteristics have significant utility values, which could be leveraged to help radiology practices offer better services for their patients and referring physicians.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Pages 521-529"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Supplemental Breast Cancer Screening Based on Breast Density: 2024 Update","authors":"Avani Shinde ,&nbsp;Samantha L. Heller MD, PhD","doi":"10.1016/j.jacr.2025.01.005","DOIUrl":"10.1016/j.jacr.2025.01.005","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"22 5","pages":"Page 614"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}