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

{"title":"Quality Measures for Medical Imaging: Current Status, Gaps and Solutions.","authors":"Ehsan Samei, Donald Frush, M Mahesh","doi":"10.1016/j.jacr.2024.08.002","DOIUrl":"10.1016/j.jacr.2024.08.002","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141984122","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":"Reducing Intravenous Contrast Utilization for CT: A Health System-Wide Intervention With Sustained Impact.","authors":"Mark Isabelle, Ronilda Lacson, Heather Johnston, Oleg Pianykh, Amita Sharma, Debra A Gervais, Sanjay Saini, Ramin Khorasani, Daniel I Glazer","doi":"10.1016/j.jacr.2024.07.025","DOIUrl":"10.1016/j.jacr.2024.07.025","url":null,"abstract":"<p><strong>Objective: </strong>To determine the volume of intravenous iodinated contrast media used for CT before, during, and after the global iohexol shortage over a total of 17 months at a multisite health system.</p><p><strong>Methods: </strong>This retrospective study included all patients who underwent CT at a large health system with 12 sites. Standardized contrast doses for 13 CT examinations were implemented May 23, 2022. Mean contrast utilization per CT encounter was compared between three periods (preintervention: January 1, 2022, to May 22, 2022; intervention: May 23, 2022, to September 11, 2022; postintervention: September 12, 2022, to June 30, 2023). Contrast doses and CT encounter data were extracted from the enterprise data warehouse. Categorical variables were compared with a χ² test, and continuous variables were compared with a two-tailed t test. Multivariable linear regression assessed significance, with coefficients noted to determine magnitude and direction of effect.</p><p><strong>Results: </strong>Preintervention, there were 152,009 examinations (87,722 with contrast [57.7%]); during the intervention, there were 120,031 examinations (63,217 with contrast [52.7%]); and during the postintervention, there were 341,862 examinations (194,231 with contrast [56.8%]). Preintervention, mean contrast dose was 89.3 mL per examination, which decreased to 78.0 mL after standardization (Δ of -12.7%) (P < .001). This decrease continued throughout the intervention and persisted in the postintervention period (80.4 mL; Δ -10.0%, P < .001). On multivariable analysis, patient weight, sex, and performing site were all associated with variations in contrast dose. Most but not all sites (9 of 12) sustained the decreased contrast media dose in the postintervention period.</p><p><strong>Discussion: </strong>Implementing standardized contrast media dosing for commonly performed CT examinations led to a rapid decrease in contrast media utilization, which persisted over 1 year.</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":"141984123","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":"Assessing the Impact of Patient-Friendly Radiology Reports on Patient-Centered Outcomes Using Artificial Intelligence Sentiment Analysis.","authors":"Ali Khader, Nicholas Befera, Ryan Short, Jalil Afnan, Christoph Wald","doi":"10.1016/j.jacr.2024.07.022","DOIUrl":"10.1016/j.jacr.2024.07.022","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972416","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":"CT Pulmonary Angiogram Clinical Pretest Probability Tool: Impact on Emergency Department Utilization.","authors":"Rachel P Rosovsky, Mark Isabelle, Nooshin Abbasi, Nicole Vetrano, Sanjay Saini, Sayon Dutta, David Lucier, Amita Sharma, Andetta Hunsaker, Stanley Hochberg, Ali S Raja, Ramin Khorasani, Ronilda Lacson","doi":"10.1016/j.jacr.2024.07.024","DOIUrl":"https://doi.org/10.1016/j.jacr.2024.07.024","url":null,"abstract":"<p><strong>Objective: </strong>Currently, computed tomographic pulmonary angiogram (CTPA) for evaluating acute pulmonary embolism (PE) in Emergency Departments (EDs) is overused and with low yields. The goal of this study is to assess the impact of an evidence-based clinical decision support (CDS) tool, aimed at optimizing appropriate use of CTPA for evaluating PE.</p><p><strong>Methods: </strong>The study was performed at EDs in a large healthcare system and included 9 academic and community hospitals. The primary outcome was the percent difference in utilization (number of CTPA performed/number of ED visits) and secondary outcome was yield (percentage of CTPA positive for acute PE), comparing 12 months before (6/1/2021-5/31/2022) vs. 12 months after (6/1/2022-5/31/2023) a system-wide implementation of the CDS. Univariate and multivariable analyses using logistic regression were performed to assess factors associated with diagnosis of acute PE. Statistical process control (SPC) charts were used to assess monthly trends in utilization and yield.</p><p><strong>Results: </strong>Among 931,677 visits to Emergency Departments, 28,101 CTPAs were performed on 24,675 patients. 14,825 CTPAs were performed among 455,038 visits (3.26%) pre-intervention; 13,276 among 476,639 visits (2.79%) post-intervention, a 14.51% relative decrease in CTPA utilization (chi-square, p<0.001). CTPA yield remained unchanged (1371/14825=9.25% pre- vs. 1184/13276=8.92% post-intervention; chi-square, p=0.34). Patients with COVID diagnosis prior to CTPA had higher probability of acute PE. SPC charts demonstrated seasonal variation in utilization (Friedman test, p=0.047).</p><p><strong>Discussion: </strong>Implementing a CDS based on validated decision rules was associated with a significant reduction in CTPA utilization. The change was immediate and sustained for 12 months post-intervention.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972417","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":"Take Your Leave: Our Recommendation for an Inclusive and Equitable Parental Leave Policy in Diagnostic and Interventional Radiology Residency.","authors":"Avani Pathak, Arif Musa, Samuel C Johnson, Brigitte Berryhill, Lisa Dillon, Jarrett J Weinberger, Ali Harb, Monte Harvill, Gulcin Altinok","doi":"10.1016/j.jacr.2024.07.023","DOIUrl":"10.1016/j.jacr.2024.07.023","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972418","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":"The Downsides of Efficiency.","authors":"Ali Rastegarpour","doi":"10.1016/j.jacr.2024.07.020","DOIUrl":"10.1016/j.jacr.2024.07.020","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914749","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":"Utilization of Hip or Knee MRI in Patients 50 Years and Older With Atraumatic Pain: An Analysis of the National Ambulatory Medical Care Survey.","authors":"Erin F Alaia, Andrew B Ross, Bangyan Chen, Soterios Gyftopoulos","doi":"10.1016/j.jacr.2024.07.021","DOIUrl":"10.1016/j.jacr.2024.07.021","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to use the National Ambulatory Medical Care Survey database to assess MRI utilization in patients 50 years and older with atraumatic hip or knee pain.</p><p><strong>Methods: </strong>National Ambulatory Medical Care Survey weighted survey data (2007-2019) were obtained for ambulatory visits in patients 50 years and older with atraumatic hip or knee pain. The outcome variable was MRI ordering status, and analyzed characteristics included patient age, race/ethnicity, payer, physician specialty, metropolitan statistical area, and a coexistent radiography order. Multivariable logistic regressions were conducted to assess the association between MRI ordering status and the analyzed patient characteristics. All tests were two sided, and P values ≤.05 were considered to indicate statistical significance.</p><p><strong>Results: </strong>In total, 88,978,804 knee pain and 28,675,725 hip pain patient visits (survey weighted) were analyzed, with 4,690,943 (5.3%) and 2,023,226 (7.1%) having knee or hip MRI orders, respectively. Overall, 2,454,433 knee pain visits (2.8%) and 575,155 hip pain visits (2.0%) had orders for both MRI and radiographs. Black patients (P = .03) and patients 80 years and older (P = .04) were less likely to have knee MRI ordered, whereas uninsured patients were less likely to have hip MRI ordered (P = .01). Patients with hip pain were more likely to have hip MRI ordered if seen by a surgical subspecialist (P = .01).</p><p><strong>Conclusions: </strong>A low proportion of MRI examinations were ordered for visits in patients 50 years and older with atraumatic hip or knee pain. Groups with lower health care access were less likely to have an MRI order, highlighting known disparities in health care equity.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914750","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":"Virtual Multidisciplinary Team Meetings: A Tool to Increase Radiology Access in Global Health Settings.","authors":"Benjamin Brown, William Pryor, Bip Nandi, Amarylis Mapurisa, Casey L McAtee, Nmazuo Ozuah, Suzgo Mzumara, Katrina McGinty","doi":"10.1016/j.jacr.2024.07.018","DOIUrl":"10.1016/j.jacr.2024.07.018","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908579","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":"The Scents, Sense, and Cents in Jeni's Splendid Ice Creams: Implications for Radiology.","authors":"Jeni Britton, Elliot K Fishman, Steven P Rowe, Linda C Chu, Ryan C Rizk","doi":"10.1016/j.jacr.2024.07.017","DOIUrl":"10.1016/j.jacr.2024.07.017","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908578","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®: Palpable Abdominal Mass-Suspected Neoplasm.","authors":"Elizabeth M McGuire, Luke Ledbetter","doi":"10.1016/j.jacr.2024.07.014","DOIUrl":"10.1016/j.jacr.2024.07.014","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908576","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}