Journal of the American College of Radiology最新文献

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Global Health Collaboration: Unlocking a Healthier World, One Saturday at a Time 全球卫生合作:一个星期六,一次开启一个更健康的世界。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-10-01 DOI: 10.1016/j.jacr.2024.09.001
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引用次数: 0
Socio-Economic Factors and Clinical Context Can Predict Adherence to Incidental Pulmonary Nodule Follow-up via Machine Learning Models 社会经济因素和临床环境可通过机器学习模型预测偶然肺结节随访的依从性。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-10-01 DOI: 10.1016/j.jacr.2024.02.031
{"title":"Socio-Economic Factors and Clinical Context Can Predict Adherence to Incidental Pulmonary Nodule Follow-up via Machine Learning Models","authors":"","doi":"10.1016/j.jacr.2024.02.031","DOIUrl":"10.1016/j.jacr.2024.02.031","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify the relative importance of demographic, contextual, socio-economic, and nodule-related factors that influence patient adherence to incidental pulmonary nodule (IPN) follow-up visits and evaluate the predictive performance of machine learning models utilizing these features.</div></div><div><h3>Methods</h3><div><span>We curated a 1,610-subject patient data set from electronic medical records consisting of 13 clinical and socio-economic predictors and IPN follow-up adherence status (timely, delayed, or never) as the outcome. </span>Univariate analysis<span> and multivariate logistic regression were performed to quantify the predictors’ contributions to follow-up adherence. Three additional machine learning models (random forests, neural network, and support vector machine) were fitted and cross-validated to examine prediction performance across different model architectures and evaluate intermodel concordance.</span></div></div><div><h3>Results</h3><div>On univariate basis, all 13 predictors except comorbidity were found to have a significant association with follow-up. In multiple logistic regression, inpatient or emergency clinical context (odds ratio favoring never following up: 7.28 and 8.56 versus outpatient, respectively) and high nodule risk (odds ratio: 0.25 versus low risk) are the most significant predictors of follow-up, and sex, race, and marital status become additionally significant if clinical context is removed from the model. Clinical context itself is associated with sex, race, insurance, employment, marriage, income, nodule risk, and smoking status, suggesting its role in mediating socio-economic inequities. On cross-validation, all four machine learning models demonstrated comparable and good predictive performances, with mean area under the curve ranging from 0.759 to 0.802, with sensitivity 0.641 to 0.660 and specificity 0.768 to 0.840.</div></div><div><h3>Conclusion</h3><div>Socio-economic factors and clinical context are predictive of IPN follow-up adherence, with clinical context being the most significant contributor and likely representing uncaptured socio-economic determinants.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140095303","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}
引用次数: 0
Understanding Provider Cost of MRI for Appendicitis in Children: A Time-Driven Activity-Based Costing Analysis 了解儿童阑尾炎核磁共振成像的供应商成本:基于时间驱动活动的成本核算分析。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-10-01 DOI: 10.1016/j.jacr.2024.05.008
{"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":null,"pages":null},"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}
引用次数: 0
Patient-Friendly Summary of the ACR Appropriateness Criteria®: Pretreatment Evaluation and Follow-up of Invasive Cancer of the Cervix ACR 适宜性标准®患者友好型摘要:宫颈浸润癌的治疗前评估和随访。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.04.017
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引用次数: 0
Evaluating the Diversity and Representation of Artificial Intelligence–Generated Images of Radiologists: An Observational Study 评估人工智能生成的放射科医生图像的多样性和代表性:一项观察研究
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.05.004
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引用次数: 0
Finding Common Ground: The Intersection of Science, Creativity, and the Human Connection 寻找共同点:科学、创造力和人际关系的交汇点。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2023.08.033
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引用次数: 0
Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Pelvic Pain in the Reproductive Age Group ACR 适宜性标准®患者友好型摘要:生殖年龄组急性盆腔疼痛。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.04.019
{"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":null,"pages":null},"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}
引用次数: 0
The Role of Allies in Successful Change Management 盟友在成功变革管理中的作用。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.03.008
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引用次数: 0
Practical Insights From Integrating Financial Hardship Screening at a Comprehensive Cancer Center 综合癌症中心整合经济困难筛查的实用见解。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.08.001
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引用次数: 0
Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Respiratory Illness in Immunocompromised Patients ACR 适宜性标准®患者友好摘要:免疫力低下患者的急性呼吸道疾病。
IF 4 3区 医学
Journal of the American College of Radiology Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.04.014
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Acute Respiratory Illness in Immunocompromised Patients","authors":"","doi":"10.1016/j.jacr.2024.04.014","DOIUrl":"10.1016/j.jacr.2024.04.014","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004277/pdfft?md5=7e7f0cb8a84ed275de97710a191d66fd&pid=1-s2.0-S1546144024004277-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140893047","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}
引用次数: 0
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