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

{"title":"Whole-Body Overdiagnosis: Perils of Whole-Body MRI.","authors":"Saurabh Jha","doi":"10.1016/j.jacr.2024.08.024","DOIUrl":"10.1016/j.jacr.2024.08.024","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156795","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":"Screening for Financial Toxicity Among Patients With Cancer: A Systematic Review.","authors":"Nadia L Samaha, Leila J Mady, Maria Armache, Madison Hearn, Rachel Stemme, Reshma Jagsi, Laila A Gharzai","doi":"10.1016/j.jacr.2024.04.024","DOIUrl":"10.1016/j.jacr.2024.04.024","url":null,"abstract":"<p><strong>Objective: </strong>Despite the pervasiveness and adverse impacts of financial toxicity (FT) in cancer care, there are no definitive measures for FT screening that have been widely integrated into clinical practice. The aim of this review is to evaluate current methods of assessing FT among patients with cancer and confirm factors associated with higher risk of FT.</p><p><strong>Methods: </strong>A systematic review was performed according to PRISMA guidelines. We included peer-reviewed studies that cross-sectionally, longitudinally, or prospectively measured the self-reported financial impact of patients undergoing cancer care in the United States.</p><p><strong>Results: </strong>Out of 1,085 identified studies, 51 met final inclusion criteria. Outcomes evaluated included FT measures or tools, time and setting of screening, FT prevalence, and sociodemographic or clinical patient-level associated factors. Our findings demonstrate that there is wide variability in FT screening practices including in the timing (diagnosis versus treatment versus survivorship), setting (clinic-based, online, telephone or mail), tools used (21 unique tools, 7 previously validated), and interpretations of screening results (varying FT score cutoffs defining high versus low FT). Younger age, lower income, lower education, non-White race, employment status change, advanced cancer stage, and systemic or radiation therapy were among factors associated with worse FT across the studies.</p><p><strong>Discussion: </strong>FT screening remains heterogenous within the United States. With the ever-escalating cost of cancer care, and the strong association between FT and poor patient outcomes, universal and routine FT screening is imperative in cancer care. Further research and multifaceted interventions identifying best practices for FT screening are needed.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961031","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":"Preference Signaling in the Radiology Residency Match: National Survey of Applicants.","authors":"Dhairya A Lakhani, Mahla Radmard, Armin Tafazolimoghadam, Sahil Patel, Arun Murugesan, Hammad Malik, Jeffery P Hogg, Ziling Shen, David M Yousem, Francis Deng","doi":"10.1016/j.jacr.2024.08.009","DOIUrl":"10.1016/j.jacr.2024.08.009","url":null,"abstract":"<p><strong>Objective: </strong>Two-tiered preference signaling has been implemented in the radiology residency application system to reduce congestion in the setting of high-volume applications. Signals are an indicator of strong interest that an applicant can transmit to a limited number of programs. This study assessed the impact of program signaling on interview invitations, how applicants strategically used signals based on their application's competitiveness, and applicants' attitudes toward the current signaling system.</p><p><strong>Methods: </strong>A survey was sent to radiology residency applicants registered with TheRadRoom during the 2024 application cycle. We queried the applicants' background, applications, signal distribution, and interview outcome depending on the type of signal sent. We also asked whether respondents received an interview invitation from a hypothetical \"comparator nonsignaled program\" if they had one additional signal to use. Group differences were assessed using nonparametric Wilcoxon signed rank test.</p><p><strong>Results: </strong>A total of 202 applicants completed the survey (28% response rate). Most applied to diagnostic radiology (81%). Nearly all respondents used all six gold (98%) and six silver (96.5%) signals. Interview invitation rates were significantly higher for signaled programs (59.8% ± 27.4%) than nonsignaled (8.5% ± 8.5%); the invitation rate at the comparator nonsignaled programs was 37%. Gold-signaled programs had significantly higher interview rates (67.8% ± 29.3) than silver (51.8% ± 31.3%). Respondents used 49.2% (±21.7%) of their signals for \"likely to match\" programs, 33.1% (±20.9%) for \"aspirational\" programs, and 17.6% (±15.8%) for \"safety\" programs. Most respondents (146; 76%) supported continuing the signaling system for future cycles.</p><p><strong>Conclusion: </strong>Signaling programs significantly enhanced interview invitation rates, with gold signals being more effective than silver. The applicants used about six total signals for \"likely-to-match\" programs, two for \"aspirational\" programs, and about four for \"safety\" programs.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115723","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":"PRO-READ IR: Enhanced PROcedural Information READability for Patient-Centered Care in Interventional Radiology With Large Language Models.","authors":"Tarig Elhakim, Allison R Brea, Wilton Fidelis, Sriram S Paravastu, Mira Malavia, Mustafa Omer, Ana Mort, Shakthi Kumaran Ramasamy, Satvik Tripathi, Michael Dezube, Sara Smolinski-Zhao, Dania Daye","doi":"10.1016/j.jacr.2024.08.010","DOIUrl":"10.1016/j.jacr.2024.08.010","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the extent to which Generative Pre-trained Transformer 4 (GPT-4) can educate patients by generating easily understandable information about the most common interventional radiology (IR) procedures.</p><p><strong>Materials and methods: </strong>We reviewed 10 IR procedures and prepared prompts for GPT-4 to provide patient educational instructions about each procedure in layman's terms. The instructions were then evaluated by four clinical physicians and nine nonclinical assessors to determine their clinical appropriateness, understandability, and clarity using a survey. A grade-level readability assessment was performed using validated metrics to evaluate accessibility to a wide patient population. The same procedures were also evaluated from the patient instructions available at radiologyinfo.org and compared with GPT-generated instructions utilizing a paired t test.</p><p><strong>Results: </strong>Evaluation by four clinical physicians shows that nine GPT-generated instructions were fully appropriate, whereas arterial embolization instructions was somewhat appropriate. Evaluation by nine nonclinical assessors shows that paracentesis, dialysis catheter placement, thrombectomy, ultrasound-guided biopsy, and nephrostomy-tube instructions were rated excellent by 57% and good by 43%. The arterial embolization and biliary-drain instructions were rated excellent by 28.6% and good by 71.4%. In contrast, thoracentesis, port placement, and CT-guided biopsy instructions received 43% excellent, 43% good, and 14% fair. The readability assessment across all procedural instructions showed a better Flesch-Kincaid mean grade of GPT-4 instructions compared with radiologyinfo.org (7.8 ± 0.87 versus 9.6 ± 0.83; P = .007) indicating excellent readability at 7th- to 8th-grade level compared with 9th to 10th grade. Additionally there was a lower Gunning Fog mean index (10.4 ± 1.2 versus 12.7 ± 0.93; P = .006), and higher Flesch Reading Ease mean score (69.4 ± 4.8 versus 51.3±3.9; P = .0001) indicating better readability.</p><p><strong>Conclusion: </strong>IR procedural instructions generated by GPT-4 can aid in improving health literacy and patient-centered care in IR by generating easily understandable explanations.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115724","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":"Status of LGBTQ+ Inclusion: Multi-Institution Assessment of US Radiology Residencies.","authors":"Jordan D Perchik, Charles Maxfield, Megan Mills, Atul Agarwal, Nate C Hull, Anne Darrow, Morlie Wang, Erin Cooke, Jayne Seekins, Mary Marx, Heidi Wassef, Jennifer Gould, Lars Grimm","doi":"10.1016/j.jacr.2024.08.008","DOIUrl":"10.1016/j.jacr.2024.08.008","url":null,"abstract":"<p><strong>Introduction: </strong>An inclusive residency program is crucial to the recruitment and retention of competitive and diverse applicants. The radiology lesbian, gay, bisexual, transgender, queer or questioning, or another diverse gender identity (LGBTQ+) inclusion audit was published in 2022, which provided a road map for assessing the inclusivity of a program's policies, facilities, culture, and engagement. In this multi-institutional trial, we detail the results of the LGBTQ+ inclusion audit for nine US radiology residency programs.</p><p><strong>Methods: </strong>A volunteer cohort of academic radiology programs was recruited through the Radiology Residency Education Research Alliance. The LGBTQ+ inclusion audit was modified to apply to a multi-institutional study. Participating programs performed the audit from December 2023 to February 2024. Pre- and postaudit surveys were distributed to capture participants subjective assessment of inclusivity at their programs.</p><p><strong>Results: </strong>Nine US radiology residency programs completed the audit. Audit scores ranged from 6 out of 10 to 9 out of 10; no program received a perfect 10 out of 10 score. Inclusive facilities and institutional culture scored highly, with eight of nine programs reporting all milestones met in these areas. The lowest-performing areas were department culture and community engagement with only three of nine and four of nine programs reporting \"all milestones met.\" After the audit, programs overall reported improved self-perceived inclusivity, with postaudit survey scores increasing in areas related to department policy, inclusive facilities, and LGBTQ+ community outreach.</p><p><strong>Discussion: </strong>Participating radiology residency programs demonstrated an overall high level of LGBTQ+ inclusivity; however, all programs identified inclusion shortcomings in department policy and practice. Intentional review of a department can be a helpful tool to promote a welcoming and healthy environment for a diverse radiology practice.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115725","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":"Diversity, Equity, Inclusion in US Radiology: Current Status and Legislative Trends.","authors":"Florence X Doo, Jordan D Perchik, Nicole M Hindman, Judy Yee, Efren J Flores, Marques L Bradshaw, Elizabeth G McFarland","doi":"10.1016/j.jacr.2024.07.028","DOIUrl":"10.1016/j.jacr.2024.07.028","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142094272","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, Referring Physician, and Radiologist Opinions Over Time on Providing Patients Access to Radiology Reports: A Systematic Review.","authors":"Mohammad Alarifi, M Courtney Hughes, Abdulrahman M Jabour, Yazeed Alashban, Erin Vernon","doi":"10.1016/j.jacr.2024.08.006","DOIUrl":"10.1016/j.jacr.2024.08.006","url":null,"abstract":"<p><strong>Objective: </strong>Patients increasingly have access to their radiology reports. This systematic review examined the opinions of patients, referring physicians, and radiologists over time on providing patients full access to their radiology reports.</p><p><strong>Methods: </strong>A systematic review examining quantitative, qualitative, and mixed methods research using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO CRD42023466502). Our search was conducted through September 30, 2023, and spanned five databases (CINAHL Plus, Web of Science, ProQuest, PubMed, and Scopus). The studies included were peer-reviewed journal articles about the opinions of patients, referring physicians, or radiologists regarding giving patients unrestricted access to their radiology reports.</p><p><strong>Results: </strong>After screening 4,520 articles, the full texts of 439 studies were assessed for eligibility. Thirty-three studies met the inclusion criteria. The studies showed that, over time, patients have consistently expressed a strong desire to access radiology reports, and referring physicians and radiologists have varied opinions about patient access to radiology reports. The main advantages of patient access found in the studies were enhanced understanding and empowerment and increased patient-physician engagement and communication. The main disadvantages were difficulties in patients understanding reports and patient anxiety from accessing reports. Referring physicians' opinions and radiologists' opinions were found in less than 20% (six studies) and 10% (three studies), respectively.</p><p><strong>Discussion: </strong>The studies show patients have desired access to radiology reports over time. Future research should elicit the opinions of referring physicians and radiologists to enable a more informed design of patient access to radiology reports.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001513","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":"Reinvesting in the Next Generation of Physician Scientists and Educators in Radiology.","authors":"Priscilla J Slanetz, Steven J Cajamarca, Ana P Lourenco, Neil M Rofsky","doi":"10.1016/j.jacr.2024.08.004","DOIUrl":"10.1016/j.jacr.2024.08.004","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001514","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":"Life: Distributed and Open Source.","authors":"Matthew Mullenweg, Elliot K Fishman, Linda C Chu, Steven P Rowe, Ryan C Rizk","doi":"10.1016/j.jacr.2024.08.005","DOIUrl":"10.1016/j.jacr.2024.08.005","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001512","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":"Diagnostic Accuracy of Cone-Beam CT for Acute Intracranial Hemorrhage: A Systematic Review and Meta-Analysis.","authors":"Nicholas G Ferrone, Maria X Sanmartin, Joseph O'Hara, Jean Jimenez, Sophia R Ferrone, Zachary Lodato, Gregory Lacher, Sanjana Bandi, Alicia Convey, Mehrad Bastani, Un Jung Lee, Jaclyn Morales Vialet, Timothy White, Jason J Wang, Jeffrey M Katz, Pina C Sanelli","doi":"10.1016/j.jacr.2024.07.026","DOIUrl":"10.1016/j.jacr.2024.07.026","url":null,"abstract":"<p><strong>Objective: </strong>Our purpose was to synthesize evidence in the literature to determine the diagnostic accuracy of cone-beam CT (CBCT) for the detection of intracranial hemorrhage (ICH) and hemorrhage types, including intraparenchymal hemorrhage (IPH), subarachnoid hemorrhage (SAH), and intraventricular hemorrhage (IVH).</p><p><strong>Methods: </strong>We performed a meta-analysis following the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Our protocol was registered with International Prospective Register of Systematic Reviews (PROSPERO-CRD42021261915). Systematic searches were last performed on April 30, 2024, in EMBASE, PubMed, Web-of-Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature databases. Inclusion criteria were (1) studies reporting diagnostic metrics of CBCT for ICH and (2) studies using a reference standard to determine ICH. Exclusion criteria were (1) case reports, abstracts, reviews and (2) studies without patient-level data. Pooled estimates and 95% confidence intervals (CIs) were calculated for diagnostic odds ratios (DORs), sensitivity, and specificity using random-effects and common-effects models. Mixed methods appraisal tool was used to evaluate risk of bias.</p><p><strong>Results: </strong>Seven studies were included in the meta-analysis yielding 466 patients. Mean or median age ranged from 54 to 75 years. Female patients represented 51.4% (222 of 432) in reported studies. Multidetector CT was the reference standard in all studies. DOR, pooled sensitivity, and pooled specificity for ICH were 5.28 (95% CI: 4.11-6.46), 0.88 (95% CI: 0.79-0.97), and 0.99 (95% CI: 0.98-1.0). Pooled sensitivity for IPH, SAH, and IVH was 0.98 (95% CI: 0.95-1.0), 0.82 (95% CI: 0.57-1.0), and 0.78 (95% CI: 0.55-1.0). Pooled specificity for IPH, SAH, and IVH was 0.99 (95% CI: 0.98-1.0), 0.99 (95% CI: 0.97-1.0), and 1.0 (95% CI: 0.98-1.0).</p><p><strong>Discussion: </strong>CBCT had moderate DOR and high pooled specificity for ICH and hemorrhage types. However, pooled sensitivity varied by hemorrhage type, with the highest sensitivity for IPH, followed by SAH and IVH.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989666","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}