Journal of the American College of Radiology : JACR最新文献

{"title":"Outcomes of Implementation of a Same-Day Breast Biopsy Program in a Safety-Net Public Hospital.","authors":"Nhat-Tuan Tran, Ivy Ewald, Grayson L Baird, Antonio Escamilla Guevarra, Christopher Doyle, Randy C Miles","doi":"10.1016/j.jacr.2025.04.024","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.024","url":null,"abstract":"<p><strong>Purpose: </strong>Safety-net hospitals play an important role in providing care to patients from historically underserved groups, representing a natural target for initiatives to reduce health disparities. This study evaluates the implementation of a same day biopsy (SDB) program on time to breast biopsy in the safety-net setting.</p><p><strong>Materials & methods: </strong>This study utilized an interrupted time series design with pre- and post- analysis. After IRB approval, all diagnostic and ultrasound (US) examinations leading to US-guided biopsy during the phase-in period (May 2021-February 2022), official implementation period (March 2022-April 2023), and follow-up period (May 2023-December 2023) were identified. Demographic characteristics of the groups using Wilcoxon rank-sum tests for continuous variables in chi square tests of independence for categorical variables were evaluated. Spline modeling with generalized linear models was used to assess differences in days from biopsy recommendation to biopsy and rates of having a SDB in pre- and post-implementation groups.</p><p><strong>Results: </strong>A total of 677 patients received recommended US-guided breast biopsies during the study period, with 233 patients in the phase-in group, 306 patients in the official implementation group, and 138 patients in the follow-up group. For all patients, the SDB program reduced the median time from biopsy recommendation to biopsy from 13.0-3.5 (IQR: 6.0-12.0) days (P < 0.0001). There was no statistically significant decrease in time from biopsy recommendation to initial surgical (19.0-15.0 days; P=0.29) or oncologic (26.0-21.0 days; P=0.19) appointment.</p><p><strong>Conclusion: </strong>Implementation of a SDB program is effective in reducing overall diagnostic delays following a breast biopsy recommendation for patients seen in safety net institutions. Additional administrative and ancillary support may be required however to aid surgical and oncologic services to further improve overall time to treatment in these settings.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using EPIC Campaigns® to Increase Breast Cancer Screening Completion of Government-Insured and Uninsured Women in a Community Setting.","authors":"Glen Ellen Whitfield, Brenda L Rooney, Barbara A Bennie, Mary C Oldenburg, Taj M Kattapuram","doi":"10.1016/j.jacr.2025.04.036","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.036","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate EPIC Campaigns® as a quality improvement initiative to reach our community's uninsured and Medicaid-enrolled patients overdue for screening mammography, describing effectiveness in outreach and factors associated with screening mammography completion.</p><p><strong>Methods: </strong>In March of 2024 screening completion percentages for the Emplify Health by Gundersen patient population were 63.7% for Medicaid patients and 61% for uninsured patients. Using the tool Epic Campaigns®, uninsured or Medicaid-enrolled women aged 40 to 74 years who were overdue for a screening mammogram were identified. Eligible patients were notified of their overdue status via their preferred contact method (patient portal message, text, or postal service) and provided instruction on how to schedule a screening mammogram. Rate of screening completion within 6 months of contact was the central outcome. Rates were analyzed by patient demographics as well as community residence type and social determinants of health (SDOH) using univariate tests-Pearson χ² or Fisher exact-and multiple regression modeling.</p><p><strong>Results: </strong>We contacted 5336 women who were overdue for breast cancer screening as of March 2024. Of those, 701 (13%) completed screening mammography within 6 months of our initial contact. The screening completion rate was significantly higher for women on Medicaid versus those who were uninsured (15% vs 6.4%, respectively; P < .001). Screening completion rates were significantly different between community residence types (P = .031). Sixty-eight percent of the study population lived in Rural Underserved, Rural, or Rural Advantaged communities, the screening completion rates of which were 11% vs 15% vs 14%, respectively. SDOH had varying effects on screening completion rates.</p><p><strong>Conclusion: </strong>For practices using the EPIC electronic health record, Epic Campaigns® is an outreach option that can be tailored by various parameters to achieve goals such as increasing breast cancer screening completion. Thirteen percent of Medicaid-enrolled and uninsured women who were overdue for breast cancer screening completed breast cancer screening within 6 months of initial contact, with a higher completion rate in Medicaid-enrolled women. Various SDOH affected screening completion.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A reality check on the GPT revolution.","authors":"Mohamed W Waked A, Ana M Rendón-Garavito, Laura Manuela Olarte Bermúdez, Hernan Dario Paez Rueda","doi":"10.1016/j.jacr.2025.04.025","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.025","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of exam and non-exam factors with ultrasound positivity for deep vein thrombosis.","authors":"Eric Pepin, Jacob Player, Yin Xi, David Fetzer, Travis Browning","doi":"10.1016/j.jacr.2025.04.029","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.029","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>First-line imaging for diagnosis of deep vein thrombosis (DVT) is ultrasound (US). Although Well's criteria and laboratory testing help inform best ordering practices, this investigation evaluates the influence of various patient and non-patient factors on exam results.</p><p><strong>Materials and methods: </strong>This study analyzed structured reports from all inpatient and emergency department (ED) ultrasound exams across two institutions from 2015-2022. Examination, provider, and patient factors were compared to exam result for effect on exam result and inter-group variance.</p><p><strong>Results: </strong>The overall rate of acute/new non-calf DVT was 10.4%. Rates of acute/new non-calf DVT were found to be higher in Inpatients (vs ED patients), upper extremities (vs. lower), patients with lower BMIs, Physicians (vs Advanced Practice Providers), and when ordered by providers with fewer overall DVT US exams ordered. Mixed results were observed for number of limbs examined and provider supervision status. Exam day of week and time of day were not significant.</p><p><strong>Conclusions: </strong>DVT US results varied based on exam, facility, patient, and provider level factors, which can inform institutional quality monitoring programs, resource utilization, and future investigations into factors that may influence diagnostic testing results.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Respiratory Illness in Immunocompetent Patients: 2025 Update.","authors":"Avani Shinde, Sherry S Wang","doi":"10.1016/j.jacr.2025.04.032","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.032","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary ACR Appropriateness Criteria®: Dementia: 2025 Update.","authors":"Abby Newman, Vincent M Timpone","doi":"10.1016/j.jacr.2025.04.033","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.033","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Friendly Summary of the American College of Radiology Appropriateness Criteria®: Lung Cancer-Surveillance After Therapy.","authors":"Elizabeth McGuire, Saadiya Sehareen","doi":"10.1016/j.jacr.2025.04.035","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.035","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","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 Hip Pain: 2025 Update.","authors":"Jonathan Burns, Shari T Jawetz","doi":"10.1016/j.jacr.2025.04.034","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.034","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JACR Cybersecurity Expert Panels: Cybersecurity Imperatives in Radiology Practices.","authors":"Sanaz Vahdati, Shawn Clark, Gal Gnainsky, Devang Gor, Chris Joerg, Po-Hao Chen","doi":"10.1016/j.jacr.2025.04.031","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.031","url":null,"abstract":"<p><p>Today's radiology systems rely heavily on interconnected electronic systems in order to deliver high-quality patient care. Security risks that interfere with access or jeopardize the integrity of any networked component can negatively impact patient care. Radiology practice is a susceptible target for cybersecurity incidents, and achieving optimal cybersecurity in this era of artificial intelligence requires strong collaboration between radiology practice and vendors. In this JACR Cybersecurity Expert Panel article, four cybersecurity experts across clinical radiology practice and industry share comments and deliver insights on critical steps required to be taken from both radiology practice and vendors' perspectives toward secure device procurement and mitigating vulnerability to cyberattacks.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Lenses on Breast Imaging in Diverse Settings: Implications for Practice, Policy, and Research.","authors":"Amy K Patel, Toma Omafoye, Randy C Miles","doi":"10.1016/j.jacr.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.027","url":null,"abstract":"<p><p>Breast cancer is the leading cause of death from cancer worldwide and is the most common cancer. According to The World Health Organization, \"health equity is defined as the absence of unfair and avoidable or remediable differences in health among population groups defined socially, economically, demographically, or geographically.\"Achieving health equity can address disparities in all arenas of medicine, including access to breast imaging and improving breast cancer outcomes. Thus, it is important to recognize the unique challenges of diverse practice types, including in the safety net, community, and global setting when it comes to breast health and imaging inequities, and also to formulate strategies to bridge the gap, from a practice, policy, and research perspective.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}