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

{"title":"National Utilization Trends of Inpatient Procedures for Symptomatic Uterine Fibroids and Adenomyosis: A 10-year Analysis.","authors":"Matthew A Patetta, Kira N Griffith, Joshua A Walker, Maureen P Kohi, Sarah J Nyante, Gloria Salazar, Nicole A Keefe","doi":"10.1016/j.jacr.2024.11.031","DOIUrl":"https://doi.org/10.1016/j.jacr.2024.11.031","url":null,"abstract":"<p><strong>Objective: </strong>To determine the changes in procedural utilization for symptomatic uterine fibroids and adenomyosis over the past decade.</p><p><strong>Methods: </strong>An IRB-exempt retrospective study of the National Inpatient Sample database from 2011-2020 was performed utilizing ICD-9 and 10 diagnosis and procedural codes for uterine fibroids, adenomyosis, hysterectomy, myomectomy, UAE, and endometrial ablation. Patients with endometriosis, uterine cancer, placenta accreta spectrum, pelvic inflammatory disease, and uterine prolapse were excluded. Data was analyzed through statistical process control (SPC) and chi square testing.</p><p><strong>Results: </strong>A total of 247,476 inpatient procedures were identified in women with fibroids and/or adenomyosis. Of those patients with only uterine fibroids (n=212,532), 77.9% underwent hysterectomy, 18.9% underwent myomectomy, and 2.8% underwent UAE. The utilization of UAE remained stable over the decade, while an increased prevalence of myomectomy was offset by a decrease in hysterectomy (2011: hysterectomy- 81.4%, myomectomy- 15.4%, UAE- 2.9%; versus 2020: 73.7%, 24.0%, and 2.0%, respectively). Regarding adenomyosis only (n= 16,073), more women underwent hysterectomy (98.1%) when compared to or UAE (1.1%), with minimal change in these procedures across the decade. For combined fibroids and adenomyosis (n=18,871), hysterectomy was the most utilized procedure, with its utilization declining from 92.0% to 85.2% during the time period.</p><p><strong>Discussion: </strong>The utilization of hysterectomy remains the dominant inpatient procedural intervention for the treatment of uterine fibroids and adenomyosis, however the proportion of myomectomy in the setting of fibroids is increasing. Utilization of UAE has not changed over the past decade and remains relatively underutilized despite initiatives to increase utilization.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815155","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":"Building and Scaling a Platform Business in Health Care.","authors":"Anurati Mathur, Elliot K Fishman, Steven P Rowe, Linda C Chu, Ryan C Rizk","doi":"10.1016/j.jacr.2024.11.033","DOIUrl":"10.1016/j.jacr.2024.11.033","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815131","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":"Impact of a Clinical Decision Support System on CT Pulmonary Angiography Yield and Utilization in Hospitalized Patients.","authors":"Amita Sharma, Mark Isabelle, Andetta Hunsaker, Sayon Dutta, David Lucier, Rachel P Rosovsky, Sanjay Saini, Adam Landman, Ali S Raja, Ramin Khorasani, Ronilda Lacson","doi":"10.1016/j.jacr.2024.11.030","DOIUrl":"10.1016/j.jacr.2024.11.030","url":null,"abstract":"<p><strong>Purpose: </strong>The aims of this study were to determine whether point-of-order clinical decision support (CDS) based on the Wells criteria improves CT pulmonary angiography (CTPA) yield and utilization in hospitalized patients in an enterprise-wide health system and to identify yield-related factors.</p><p><strong>Methods: </strong>This retrospective, institutional review board-approved, cross-sectional study in an urban, multi-institution health system included hospitalized patients undergoing CTPA 12 months before and after CDS implementation (entire cohort). The χ² test was used to compare pulmonary embolism (PE) yield in patients in whom providers overrode versus followed CDS alerts after CDS implementation. It was also used to compare utilization and yield before- versus after the intervention. Univariate and multivariable regression analyses were performed on patient factors and post-CDS Wells scores to evaluate yield-related factors.</p><p><strong>Results: </strong>For 2,429 inpatient CT pulmonary angiographic examinations after the intervention, CTPA yield was significantly higher when CDS recommendations were followed (18.3% [250 of 1,365]) compared with those overridden (14.2% [151 of 1,064]) (P < .01). For 5,372 CT pulmonary angiographic examinations in the entire cohort, there was no difference in PE yield before (448 of 2,943 [15.2%]) versus after (401 of 2,429 [16.5%]) CDS implementation (P = .20). However, in 340,146 admissions over the study period, a 7.4% relative decrease in CTPA utilization (from 17.5 to 16.2 CT pulmonary angiographic examinations per 1,000 admissions before and after CDS, respectively, P = .003) was observed.</p><p><strong>Conclusions: </strong>When CDS recommendations were followed, the yield of CTPA was significantly higher than when clinicians overrode CDS alerts. In addition, point-of-order CDS to reduce unnecessary CTPA in hospitalized patients resulted in a significant decrease in CTPA utilization after CDS implementation, with a modest although nonsignificant increase in CTPA yield.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815140","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":"Recognition and Accountability Strategies to Preserve Radiology's Academic Mission.","authors":"Priscilla J Slanetz, Catherine H Phillips, Jessica B Robbins, Christopher P Hess","doi":"10.1016/j.jacr.2024.11.023","DOIUrl":"10.1016/j.jacr.2024.11.023","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755748","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":"Team Building and Employee Satisfaction-How We Do It.","authors":"Trina Spear, Linda C Chu, Elliot K Fishman, Steven P Rowe","doi":"10.1016/j.jacr.2024.11.021","DOIUrl":"10.1016/j.jacr.2024.11.021","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755796","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":"How to Create Creativity.","authors":"Ed Catmull, Elliot K Fishman, Linda C Chu, Steven P Rowe, Charles K Crawford, Jen-Hsun Huang","doi":"10.1016/j.jacr.2024.11.025","DOIUrl":"10.1016/j.jacr.2024.11.025","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142756038","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":"Making the Most of the Golden Years-Transitions and Opportunities.","authors":"Priscilla J Slanetz, Donna Magid, Catherine J Everett, Lori A Deitte","doi":"10.1016/j.jacr.2024.11.022","DOIUrl":"10.1016/j.jacr.2024.11.022","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755371","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":"Promises and Perils-The Debate Over Competency-Based Education in Radiology.","authors":"Priscilla J Slanetz, Ryan Cummings, Erin Gomez, J Mark McKinney","doi":"10.1016/j.jacr.2024.11.026","DOIUrl":"10.1016/j.jacr.2024.11.026","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755833","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®: Imaging of the Axilla.","authors":"Christian P Haskett, Sonya Bhole","doi":"10.1016/j.jacr.2024.11.018","DOIUrl":"10.1016/j.jacr.2024.11.018","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752472","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®: Altered Mental Status, Coma, Delirium, and Psychosis: 2024 Update.","authors":"Giorgia Villa, Orit Ariel Glenn","doi":"10.1016/j.jacr.2024.11.019","DOIUrl":"10.1016/j.jacr.2024.11.019","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752515","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}