Current problems in diagnostic radiology最新文献

{"title":"Assessment of radiology residents' diagnostic accuracy in thoracic emergencies using the WIDI SIM platform.","authors":"Michael Mathelier, Abheek Raviprasad, Kevin Pierre, Persis Desai, Olivia Scheuermann, Christopher Sistrom, Roberta Slater, Otgonbayar Batmunh, Linda Lanier, Anthony Mancuso, Dhanashree Rajderkar, Priya Sharma","doi":"10.1067/j.cpradiol.2025.02.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.02.001","url":null,"abstract":"<p><strong>Purpose: </strong>To assess radiology residents' diagnostic accuracy in interpreting thoracic emergency cases using the Wisdom in Diagnostic Imaging Simulation (WIDI SIM) platform and identify potential areas for educational improvement.</p><p><strong>Methods: </strong>In this retrospective study, 761 radiology residents were assessed on five thoracic emergency cases using WIDI SIM over four years. Cases included bronchial disruption, septic emboli, ventricular perforation, pulmonary embolism, and a negative pulmonary CTA. Residents provided free-text interpretations, which were scored by faculty using a standardized point system. Scores and errors were analyzed using descriptive statistics and the Kruskal-Wallis test.</p><p><strong>Results: </strong>Residents' performance varied across the five cases, with the highest average score on the negative pulmonary CTA (9.59) and the lowest on bronchial disruption (6.59). Observational errors were more common than interpretive errors. The Kruskal-Wallis test revealed significant differences in median scores across the cases (p < 0.0001), with pairwise comparisons showing significant differences in all but two comparisons.</p><p><strong>Conclusion: </strong>This study reveals significant variability in radiology residents' diagnostic accuracy in interpreting thoracic emergency cases, with a high prevalence of observational errors. Our observations emphasize the need for targeted educational strategies to address specific areas of weakness and improve diagnostic accuracy in this critical area of radiology practice.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477002","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 competency in diagnosing non-traumatic musculoskeletal conditions: A simulation-based assessment using WIDI SIM.","authors":"Isabella E Amador, Abheek G Raviprasad, Kevin Pierre, Nicholas Rodriguez-Zingg, Kerolus Anis, Roberta M Slater, Christopher L Sistrom, Ivan Davis, Anthony A Mancuso, Dhanashree Rajderkar","doi":"10.1067/j.cpradiol.2025.01.014","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.014","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate radiology resident performance in diagnosing four non-traumatic musculoskeletal (MSK) pathologies that have historically yielded low scores on the Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM).</p><p><strong>Materials and methods: </strong>This multi-institutional, retrospective study analyzed WIDI SIM data collected from 2015 to 2021. A total of 351 radiology residents (R1-R4) interpreted 65 de-identified imaging cases, four of which focused on septic arthritis/osteomyelitis of the shoulder, septic arthritis/osteomyelitis of the hip, acetabular neoplasm, and Legg-Calve-Perthes disease. Each case was scored using a standardized 10-point rubric (0-2 = critical error, 3-6 = problematic omissions, 7-10 = effective report). Scores were further categorized into observational (missed findings) and interpretive (incorrect conclusion despite correct identification) errors. The Kruskal-Wallis test with Dunn's multiple comparisons was used to assess performance differences across postgraduate years.</p><p><strong>Results: </strong>Among these four MSK pathologies, only hip osteomyelitis demonstrated a statistically significant difference across training levels (p = 0.0063), although no specific pairwise comparisons were significant. Average scores remained relatively low across all cases, with observational errors surpassing interpretive errors in frequency.</p><p><strong>Conclusion: </strong>Radiology residents struggled to accurately diagnose non-traumatic MSK pathologies in a simulated on-call setting, predominantly due to missed imaging findings. Implementation of enhanced training strategies, such as targeted case review, high-yield simulations, and systematic visual search protocols, may improve MSK diagnostic competency and reduce the risk of clinically significant oversights.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191543","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":"Mismatch in productivity calculated from wRVU metric and the actual number of images in musculoskeletal radiographic studies.","authors":"Oganes Ashikyan, Alex Zhu, Travis Browning, Cecilia Brewington, Avneesh Chhabra","doi":"10.1067/j.cpradiol.2025.01.001","DOIUrl":"https://doi.org/10.1067/j.cpradiol.2025.01.001","url":null,"abstract":"<p><p>The work relative value unit (wRVU) measures the physician's work involved in performing a service and is commonly used to quantify physician productivity. A critical component factored in wRVUs is the time required to perform a service. In musculoskeletal radiology, this time correlates directly with the number of images produced per radiograph. The purpose of this project was to evaluate whether the actual number of acquired images matches the number of views indicated in musculoskeletal radiographs CPT code descriptions. A query of our internal database returned 76,204 musculoskeletal radiograph reports. 440 random radiographs were reviewed to evaluate variability in the number of images obtained. This sample consisted of ten studies from each of the forty-four musculoskeletal codes. We recorded the number of actual images obtained. 242 studies from the safety net health care system and 198 studies from the university associated hospitals and clinics were evaluated. Seventy-five studies (31 %) were found to have mismatched number of images among the 242 studies from the safety net health care system. Sixty-six studies (33 %) were found to have mismatched number of images among the 198 studies sample from university associated tertiary care system. There was significant difference between the extra images obtained at two different health care systems (p < 0.001). There were more studies with extra images in the safety net system compared to the university hospital. The commonly used wRVU metric has broad variability in the assessment of work productivity for musculoskeletal radiographs given the variance in the number of images obtained.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018438","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 quick cash? Kickbacks, compliance, and consequences.","authors":"Robert Optican, Richard Duszak","doi":"10.1067/j.cpradiol.2024.05.020","DOIUrl":"10.1067/j.cpradiol.2024.05.020","url":null,"abstract":"<p><p>The Anti-Kickback Statute was passed by Congress in the 1970s to reduce the overuse of government-reimbursed medical services. It attempts to eliminate fraud, abuse, and waste of medical services by outlawing the incentive of personal gain when referring patients for government-funded services. Although safe harbors were written into the law to maintain transactions beneficial to society, they require strict adherence. Anti-Kickback Statute violations are subject to the whistleblower provision of the False Claims Act, and violations can yield significant civil and criminal penalties.</p>","PeriodicalId":93969,"journal":{"name":"Current problems in diagnostic radiology","volume":" ","pages":"677-678"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961173","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}