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

{"title":"Application of the Socio-Ecological Model to Address Recruitment, Promotion, and Leadership Development of Women in Radiology.","authors":"Shiva D Yagobian, Franklin Iheanacho, Amy Patel, Efren J Flores, Toma S Omofoye, Megha Garg, Randy C Miles","doi":"10.1016/j.jacr.2025.04.011","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.011","url":null,"abstract":"<p><p>Women, who represent nearly 50% of medical school graduates, consistently comprise approximately 25% of radiology residency spots. Recruitment, promotion, and leadership development of radiologists from diverse backgrounds is important for continued growth of the field. Despite major radiological societies and journals championing this cause across all practice levels, efforts to improve diversity in the field have been limited. The socio-ecological model has been used to address challenges in health care by evaluating the interplay between individuals and their environment. In this article, we build on prior literature describing challenges faced by women in recruitment, promotion, and leadership development by applying the socio-ecological model to systematically understand and address barriers to the advancement of qualified women in radiology. We evaluate challenges women face in terms of recruitment, promotion, and leadership development at each level of the socio-ecological model and propose evidence-based solutions aimed at addressing barriers to the advancement of women in the field.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060060","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":"Enhancing Emergency Communication in Radiology: The Role of Real-Time Dashboards.","authors":"Aura Maria Ramírez, Laura Manuela Olarte Bermúdez, David Fernando Torres Cortes","doi":"10.1016/j.jacr.2025.03.007","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.03.007","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055531","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 Value of Radiology Consultation: Effort Allocation, Clinical Impact, and Untapped Opportunities.","authors":"Samra Iftikhar, Saeed Rahmani, Omar A Zaree, Ahmed Kertam, Thomas Farquhar, Long H Tu","doi":"10.1016/j.jacr.2025.04.006","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.006","url":null,"abstract":"<p><p>A substantial proportion of work in radiology involves activities beyond the primary interpretation of imaging. In this review, the authors discuss the current state of consultative work in radiology and evaluate potential strategies for more equitable reimbursement of these activities. \"Noninterpretive\" or \"consultative\" activities may constitute 35% to 60% of work hours. These activities routinely impact patient care; for example, changes in management are seen with 3-9% of radiologist-protocoled exams, 8-37% of secondary interpretations, 12-55% of ad-hoc (\"curbside\") consultations, and 8-58% of multidisciplinary conferences. Currently, ad hoc and multidisciplinary consultations are not associated with formal mechanisms for documentation or billing, despite together constituting 10% to 15% of radiologists' work hours. Existing and future mechanisms, however, could help bridge this gap. Practice in radiology might benefit from dedicated consultation Current Procedural Terminology billing codes, similar to those already in place for consultations in pathology. Existing non-face-to-face (electronic) consultation codes represent a potential stopgap solution. Practices may alternatively negotiate compensation for noninterpretive tasks as part of a value-based reimbursement model. Any viable solution would need to account for the opportunity cost of time spent on nonbillable activities (usually >5 work relative value units/hour). Consultation is likely to play an increasingly important role in the future of radiology with advances in imaging and artificial intelligence-based technologies. Individual radiologists and group practices would benefit from recognizing and leveraging the value of their consultative work.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030640","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":"Not All That Glitters Is Gold, nor All Artificial Intelligence a Large Language Soul.","authors":"Teodoro Martín-Noguerol, Pilar López-Úbeda, Antonio Luna","doi":"10.1016/j.jacr.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.010","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044173","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":"Peer Learning and Artificial Intelligence in Radiology: Partners in Progress or Rivals in the Race for Accuracy?","authors":"Mara M Kunst, Richard E Sharpe, Christoph Wald, Jennifer C Broder","doi":"10.1016/j.jacr.2025.04.009","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.009","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993877","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":"Radiology Resident Perspectives on and Experiences With Labor Union Participation.","authors":"Erica Kinne, Charles Maxfield, Elliot Varney, Charlotte S Taylor, Sara Janos, Jennifer Gould, Lars J Grimm","doi":"10.1016/j.jacr.2025.04.005","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.005","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to understand the perceptions of radiology residents regarding labor unions and the differences between unionized and nonunionized residents in perceived versus actual benefits of unionization.</p><p><strong>Methods: </strong>This cross-sectional survey, focused on residents' experiences with and perceptions of unions, was sent to radiology residency program directors within the 50-member Radiology Residency Education Research Alliance, who subsequently forwarded it to 756 residents across 24 programs. Bivariable analyses were conducted to evaluate differences in opinions between unionized and nonunionized residents regarding benefits and drawbacks of union membership. Additional subgroup analyses were performed for current union members.</p><p><strong>Results: </strong>A total of 249 responses were received, with 20 excluded because of incomplete data (n = 229, a 30.3% response rate). The majority of residents were very supportive (n = 126 [55.0%]) or somewhat supportive (n = 47, 20.5%) of unions, believing that unions had a positive impact on time off (n = 151 [65.9%]), duty hours (n = 147 [64.2%]), the ability of residents to make their voices heard (n = 156 [68.1%]), resident salaries (n = 183 [79.9%]), resident benefits (n = 190 [83.0%]), and resident wellness (n = 137 [59.8%]). Unionized residents reported more vacation time (20 or more days: 90.4% vs 70.3%; P < .001), more subsidized housing (53.8% vs 5.7%, P < .001), and more technology and education stipends (90.4% vs 81.7%, P = .025) compared with nonunionized counterparts. Nonunionized respondents were significantly more likely to report that unionization positively affected duty hours (70.9% vs 53.9%, P = .026). Additionally, nonunionized residents were more likely to view disciplinary action as a drawback of union membership (14.6% vs 1.9%, P = .011). Although the majority of radiology respondents felt that unionization had neither a positive nor a negative impact on fostering resident-faculty relationships, those from nonunionized programs were significantly more likely than their unionized peers to perceive these relationships as both positively (22.2% vs 9.6%, P = .034) and negatively (33.5% vs 19.2%, P = .044) affected by union membership.</p><p><strong>Conclusions: </strong>The majority of radiology residents surveyed were supportive of resident unions, believing that unions positively affected time off, duty hours, ability of residents to make their voices heard, salaries, benefits, and wellness.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045824","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":"Causes of Moral Distress in Academic Radiologists: Variation Among Institutions.","authors":"Priya Dave, Olga R Brook, Alexander Brook, Andrew W Bowman, Luke Yoon, Robert W Morris, Jonathan A Flug, Ethan A Smith, Bettina Siewert","doi":"10.1016/j.jacr.2025.04.001","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.001","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether causes of moral distress vary by academic institution. Moral distress is experienced when health care providers are unable to provide the right care to patients because of institutional or resource constraints.</p><p><strong>Materials and methods: </strong>A survey was performed based on Moral Distress Scale-Revised for Health Care Professionals for 16 clinical scenarios assessing frequency and severity of moral distress among academic radiologists. The survey was sent to members of the RSNA Quality Improvement Committee for distribution to their department. Measure of Moral Distress for Health Care Professionals (MMD-HP) was calculated for individuals and moral distress index for clinical scenarios. MMD-HP were compared by sex, ethnicity, age, years of practice, weekly work hours, practice setting or type, and consideration of leaving the workplace. Statistical analysis was performed using Kruskal-Wallis test and Kendall ordinal correlation.</p><p><strong>Results: </strong>In all, 126 respondents from five institutions from five different states were included in the analysis. MMD-HP ranged from 24 to 66 (maximum 266). Median MMD-HP was higher in radiologists working >60 hours per week (59 versus 32.5, P = .048). Radiologists across institutions consistently reported four main sources of moral distress: pressure to perform unsafe numbers of studies (108 of 126, 85%), high workloads impeding resident teaching (102 of 126, 81%), lack of administrative support for patient care issues (102 of 126, 81%), and pressure to conduct unnecessary imaging (111 of 126, 88%). Higher MMD-HPs correlated significantly with job turnover intentions or past job changes (P < .001). The average percentage of radiologists with an intention to leave or having left as position was 44% with a range of 26% to 84%.</p><p><strong>Conclusion: </strong>Moral distress is pervasive in radiology, with four primary causes consistently identified across academic institutions. Strong association between higher moral distress levels and job turnover intentions highlights its impact on workforce retention.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054839","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":"Trends in Academic Radiology Faculty Promotion in US Medical Schools.","authors":"Ajay Malhotra, Dheeman Futela, Seyedmehdi Payabvash, Max Wintermark, Dheeraj Gandhi, Richard Duszak","doi":"10.1016/j.jacr.2025.04.003","DOIUrl":"https://doi.org/10.1016/j.jacr.2025.04.003","url":null,"abstract":"<p><strong>Background: </strong>Faculty promotion is important for retention in academic medicine and has implications for diversity.</p><p><strong>Purpose: </strong>We aimed to assess faculty promotion trends in academic radiology in US medical schools over time and assess variations based on gender and race or ethnicity.</p><p><strong>Materials and methods: </strong>Using the Association of American Medical Colleges faculty roster, full-time faculty appointed between January 1, 2020, and December 31, 2009 (primary cohort), were followed for 14 years till January 1, 2024. Promotion rates and average time to promotion were compared by faculty track, gender, and race or ethnicity using bivariate analyses. Recent trends in promotions were assessed by comparing 7-year promotion end points between the primary cohort and a secondary cohort appointed between January 1, 2010, and December 31, 2016.</p><p><strong>Results: </strong>The primary cohort included 2,497 faculty (182 instructors, 1,589 assistant professors, and 726 associate professors) from academic radiology departments, appointed between January 1, 2020, and December 31, 2009. Clinical educator-track faculty had a marginally higher promotion rate (39.6% versus 36.4%, P = .116) but a significantly longer time to promotion (8.25 versus 7.4 years, P < .0001) versus those on traditional track. For clinical educator-track faculty, promotion rates over 14 years tended to be greater for women (42.3%) than men (38.3%, P = .12) across all ranks. The average time to promotion was significantly greater for women (8.9 years) assistant professors compared with men (8.2 years) (mean difference of 0.65 years, P = .013). For the more recent faculty cohort, rates of promotion over a 7-year period were higher (26% versus 15% for assistant professors, P < .001), and average time to promotion was shorter (5.7 versus 6.0 years for assistant professors, P = .002) across all ranks and for both men and women.</p><p><strong>Conclusion: </strong>Over time, promotion rates in US academic radiology departments have gone up and time to promotion has declined. Promotion rates for men and women are similar.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029971","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 State of Paid Family and Medical Leave Policies: An ACR, AAWR, SWRO Member Survey.","authors":"Kirti Magudia, Rachel S Lee, Elizabeth H Dibble, Dominick Parris, Claire C Baniel, Sara Beltran Ponce, Olga Laur, Susan Hamman, Elizabeth Kagan Arleo, Candice Johnstone, Johnson Lightfoote, Eric Rubin, Lori Deitte, Reshma Jagsi, Amy L Kotsenas, Thomas S C Ng","doi":"10.1016/j.jacr.2025.03.006","DOIUrl":"10.1016/j.jacr.2025.03.006","url":null,"abstract":"","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774727","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":"Excess Greenhouse Gas Emissions Associated With Inappropriate Medical Imaging in the US Medicare Part B Population From 2017 to 2021.","authors":"Gregory Cavanagh, Julia Hyde Schoen, Kate Hanneman, Elizabeth Y Rula, Michael K Atalay","doi":"10.1016/j.jacr.2025.02.043","DOIUrl":"10.1016/j.jacr.2025.02.043","url":null,"abstract":"<p><strong>Introduction: </strong>Medical imaging is a source of greenhouse gas emissions, and inappropriate use results in low-value, excess imaging. The environmental impact of low-value imaging has not been quantified.</p><p><strong>Objective: </strong>This study seeks to estimate excess greenhouse gas (GHG) emissions associated with inappropriate imaging in metric kilotons (kT) of carbon dioxide equivalents (CO2e) from the Medicare Part B population from 2017 to 2021.</p><p><strong>Materials and methods: </strong>Using the Harvey L. Neiman Health Policy Institute 2017 to 2021 data on trends in imaging utilization for Medicare Fee-for-Service Beneficiaries and the 2014 RAND Corporation report on Medicare Imaging Demonstration, low-end and high-end estimates of average yearly GHG emissions from inappropriate examinations in Medicare Part B population were modeled for the four most-common imaging modalities (MRI, CT, radiography, and ultrasound) from the estimated number of inappropriate examinations per year and GHG emissions per modality.</p><p><strong>Results: </strong>Of all imaging, 4% to 26% is estimated as inappropriate. Total inappropriate Medicare imaging examinations were estimated to have produced an average of 3.55 to 129.2 kT CO2e per year during the entire 5-year period, with MRI and CT accounting for the greatest proportion (0.621-33.8 kT and 1.24-64.8 kT, respectively); 3.55 to 129.2 kT CO2e approximates to the GHG produced by the yearly electricity of a town of 2,000 to 72,000 people, respectively.</p><p><strong>Conclusion: </strong>Our results demonstrate that substantial excess GHG emissions arise from inappropriate imaging, particularly MRI and CT. These data support the need to reduce low-value imaging and adherence to appropriate use criteria.</p>","PeriodicalId":73968,"journal":{"name":"Journal of the American College of Radiology : JACR","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733438","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}