Journal of the American College of Radiology最新文献

{"title":"Understanding Provider Cost of MRI for Appendicitis in Children: A Time-Driven Activity-Based Costing Analysis","authors":"","doi":"10.1016/j.jacr.2024.05.008","DOIUrl":"10.1016/j.jacr.2024.05.008","url":null,"abstract":"<div><h3>Objective</h3><div>To use time driven activity-based costing to characterize the provider cost of rapid MRI for appendicitis compared to other MRI examinations billed with the same Current Procedural Terminology codes commonly used for MRI appendicitis examinations.</div></div><div><h3>Methods</h3><div>Rapid MRI appendicitis examination was compared with MRI pelvis without intravenous contrast, MRI abdomen/pelvis without intravenous contrast, and MRI abdomen/pelvis with intravenous contrast. Process maps for each examination were created through direct shadowing of patient procedures (n = 20) and feedback from relevant health care professionals. Additional data were collected from the electronic medical record for 327 MRI examinations. Practical capacity cost rates were calculated for personnel, equipment, and facilities. The cost of each step was calculated by multiplying the capacity cost rate with the mean duration of each step. Stepwise costs were summed to generate a total cost for each MRI examination.</div></div><div><h3>Results</h3><div>The mean duration and costs for MRI examination type were as follows: MRI appendicitis: 11 (range: 6-25) min, $20.03 (7.80-44.24); MRI pelvis without intravenous contrast: 55 (29-205) min, $105.99 (64.18-285.13); MRI abdomen/pelvis without intravenous contrast: 65 (26-173) min, $144.83 (61.16-196.50); MRI abdomen/pelvis with intravenous contrast: 128 (39-303) min, $236.99 (102.62-556.54).</div></div><div><h3>Conclusion</h3><div>The estimated cost of providing a rapid appendicitis MRI examination is significantly less than other MRI examinations billed using Current Procedural Terminology codes typically used for appendicitis MRI. Mechanisms to appropriately bill rapid MRI examinations with limited sequences are needed to improve cost efficiency for the patient and to enable wider use of limited MRI examinations in the pediatric population.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 10","pages":"Pages 1668-1676"},"PeriodicalIF":4.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332689","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®: Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix","authors":"","doi":"10.1016/j.jacr.2024.04.017","DOIUrl":"10.1016/j.jacr.2024.04.017","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Page e85"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004307/pdfft?md5=c11a4bf4f9d4cd6b222af6d9770e6409&pid=1-s2.0-S1546144024004307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Diversity and Representation of Artificial Intelligence–Generated Images of Radiologists: An Observational Study","authors":"","doi":"10.1016/j.jacr.2024.05.004","DOIUrl":"10.1016/j.jacr.2024.05.004","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1497-1500"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004551/pdfft?md5=248a2977b25044c160baf188281fcec2&pid=1-s2.0-S1546144024004551-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finding Common Ground: The Intersection of Science, Creativity, and the Human Connection","authors":"","doi":"10.1016/j.jacr.2023.08.033","DOIUrl":"10.1016/j.jacr.2023.08.033","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1542-1543"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170752","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 Role of Allies in Successful Change Management","authors":"","doi":"10.1016/j.jacr.2024.03.008","DOIUrl":"10.1016/j.jacr.2024.03.008","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1537-1538"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308140","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®: Acute Pelvic Pain in the Reproductive Age Group","authors":"","doi":"10.1016/j.jacr.2024.04.019","DOIUrl":"10.1016/j.jacr.2024.04.019","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Page e89"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004320/pdfft?md5=4f6765cb5c715004f1812907f0c408f8&pid=1-s2.0-S1546144024004320-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140917636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical Insights From Integrating Financial Hardship Screening at a Comprehensive Cancer Center","authors":"Samilia Obeng-Gyasi MD, MPH ,&nbsp;Yevgeniya Gokun MS ,&nbsp;Carolyn J. Presley MD, MHS ,&nbsp;Ashley Rosko ,&nbsp;Jesse Plascak PhD ,&nbsp;Electra D. Paskett PhD","doi":"10.1016/j.jacr.2024.08.001","DOIUrl":"10.1016/j.jacr.2024.08.001","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1398-1401"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S154614402400677X/pdfft?md5=6e5c005e5a0005a887a911a2841febc0&pid=1-s2.0-S154614402400677X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Timing, and Long-Term Outcomes of COVID-19 Vaccine-Related Lymphadenopathy on Screening Mammography","authors":"","doi":"10.1016/j.jacr.2024.02.032","DOIUrl":"10.1016/j.jacr.2024.02.032","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the incidence, timing, and long-term outcomes of unilateral axillary lymphadenopathy ipsilateral to vaccine site (UIAL) on screening mammography after COVID-19 vaccination.</p></div><div><h3>Methods</h3><p>This retrospective, multisite study included consecutive patients undergoing screening mammography February 8, 2021, to January 31, 2022, with at least 1 year of follow-up. UIAL was typically considered benign (BI-RADS 1 or 2) in the setting of recent (≤6 weeks) vaccination or BI-RADS 0 (ultrasound recommended) when accompanied by a breast finding or identified &gt;6 weeks postvaccination. Vaccination status and manufacturer were obtained from regional registries. Lymphadenopathy rates in vaccinated patients with and without UIAL were compared using Pearson’s χ² test.</p></div><div><h3>Results</h3><p>There were 44,473 female patients (mean age 60.4 ± 11.4 years) who underwent screening mammography at five sites, and 40,029 (90.0%) received at least one vaccine dose. Ninety-four (0.2%) presented with UIAL, 1 to 191 days postvaccination (median 13.5 [interquartile range: 5.0-31.0]). Incidence declined from 2.1% to 0.9% to ≤0.5% after 1, 2, and 3 weeks and persisted up to 36 weeks (<em>P</em> &lt; .001). UIAL did not vary across manufacturer (<em>P</em> = .15)<em>.</em> Of 94, 77 (81.9%) were BI-RADS 1 or 2 at screening. None were diagnosed with malignancy at 1-year follow-up. Seventeen (18.1%) were BI-RADS 0 at screening. At diagnostic workup, 13 (76.5%) were BI-RADS 1 or 2, 2 (11.8%) were BI-RADS 3, and 2 (11.8%) were BI-RADS 4. Both BI-RADS 4 patients had malignant status and ipsilateral breast malignancies. Of BI-RADS 3 patients, at follow-up, one was biopsied yielding benign etiology, and one was downgraded to BI-RADS 2.</p></div><div><h3>Discussion</h3><p>Isolated UIAL on screening mammography performed within 6 months of COVID-19 vaccination can be safely assessed as benign.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1477-1488"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S154614402400276X/pdfft?md5=956782ac48d7fc738b21f7bb44f7f772&pid=1-s2.0-S154614402400276X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Management of Blunt Splenic Trauma in Adults: An Analysis of the Trauma Quality Improvement Program Registry","authors":"","doi":"10.1016/j.jacr.2024.03.007","DOIUrl":"10.1016/j.jacr.2024.03.007","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to evaluate the effectiveness of management strategies for blunt splenic injuries in adult patients.</p></div><div><h3>Methods</h3><p>Patients 18 years and older with blunt splenic injuries registered via the Trauma Quality Improvement Program (2013-2019) were identified. Management strategies initiated within 24 hours of hospital presentation were classified as watchful waiting, embolization<span>, surgery, or combination therapy. Patients were stratified by injury grade. Linear models estimated each strategy’s effect on hospital length of stay (LOS), intensive care unit (ICU) LOS, and mortality.</span></p></div><div><h3>Results</h3><p>Of 81,033 included patients, 86.3%, 10.9%, 2.5%, and 0.3% of patients received watchful waiting, surgery, embolization, and combination therapy, respectively. Among patients with low-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (9.4 days, <em>Q</em> &lt; .001, Cohen’s <em>d</em> = .30) and ICU LOS (5.0 days, <em>Q</em> &lt; .001, Cohen’s <em>d</em> = .44). Among patients with high-grade injuries and compared with surgery, embolization was associated with shorter hospital LOS (8.7 days, <em>Q</em> &lt; .001, Cohen’s <em>d</em> = .12) and ICU LOS (4.5 days, <em>Q</em> &lt; .001, Cohen’s <em>d</em> = .23). Among patients with low- and high-grade injuries, the odds ratios for in-hospital mortality associated with surgery compared with embolization were 4.02 (<em>Q</em> &lt; .001) and 4.38 (<em>Q</em> &lt; .001), respectively.</p></div><div><h3>Conclusions</h3><p>Among patients presenting with blunt splenic injuries and compared with surgery, embolization was associated with shorter hospital LOS, shorter ICU LOS, and lower risk for mortality.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1453-1463"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141194","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":"Cost-Effectiveness of Artificial Intelligence–Based Opportunistic Compression Fracture Screening of Existing Radiographs","authors":"","doi":"10.1016/j.jacr.2023.11.029","DOIUrl":"10.1016/j.jacr.2023.11.029","url":null,"abstract":"<div><h3>Purpose</h3><p>Osteoporotic vertebral compression fractures (OVCFs) are a highly prevalent source of morbidity and mortality, and preventive treatment has been demonstrated to be both effective and cost effective. To take advantage of the information available on existing chest and abdominal radiographs, the authors’ study group has developed software to access these radiographs for OVCFs with high sensitivity and specificity using an established artificial intelligence deep learning algorithm. The aim of this analysis was to assess the potential cost-effectiveness of implementing this software.</p></div><div><h3>Methods</h3><p>A deterministic expected-value cost-utility model was created, combining a tree model and a Markov model, to compare the strategies of opportunistic screening for OVCFs against usual care. Total costs and total quality-adjusted life-years were calculated for each strategy. Screening and treatment costs were considered from a limited societal perspective, at 2022 prices.</p></div><div><h3>Results</h3><p><span>In the base case, assuming a cost of software implantation of $10 per patient screened, the screening strategy dominated the nonscreening strategy: it resulted in lower cost and increased quality-adjusted life-years. The lower cost was due primarily to the decreased costs associated with </span>fracture treatment and decreased probability of requiring long-term care in patients who received preventive treatment. The screening strategy was dominant up to a cost of $46 per patient screened.</p></div><div><h3>Conclusions</h3><p>Artificial intelligence–based opportunistic screening for OVCFs on existing radiographs can be cost effective from a societal perspective.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 9","pages":"Pages 1489-1496"},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289841","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}