Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.08.012
Expert Panel on Musculoskeletal Imaging, Karen C. Chen MD , Alice S. Ha MD, MS , Roger J. Bartolotta MD , Ryan Avery MD , Matthew D. Bucknor MD , Jonathan Flug MD, MBA , Christian S. Geannette MD , Alexander David Grushky MD , Michal Hose MD , Olga Laur MD , Noah M. Raizman MD , Eric Y. Chang MD
Acute elbow pain can be the result of traumatic and atraumatic processes. Pathologic processes include osseous, ligamentous, and tendinous etiologies.
The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
{"title":"ACR Appropriateness Criteria® Acute Elbow and Forearm Pain","authors":"Expert Panel on Musculoskeletal Imaging, Karen C. Chen MD , Alice S. Ha MD, MS , Roger J. Bartolotta MD , Ryan Avery MD , Matthew D. Bucknor MD , Jonathan Flug MD, MBA , Christian S. Geannette MD , Alexander David Grushky MD , Michal Hose MD , Olga Laur MD , Noah M. Raizman MD , Eric Y. Chang MD","doi":"10.1016/j.jacr.2024.08.012","DOIUrl":"10.1016/j.jacr.2024.08.012","url":null,"abstract":"<div><div>Acute elbow pain can be the result of traumatic and atraumatic processes. Pathologic processes include osseous, ligamentous, and tendinous etiologies.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages S355-S363"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.07.014
Elizabeth M. McGuire MBA, MSc, BS , Luke Ledbetter MD
{"title":"Patient-Friendly Summary of the ACR Appropriateness Criteria®: Palpable Abdominal Mass-Suspected Neoplasm","authors":"Elizabeth M. McGuire MBA, MSc, BS , Luke Ledbetter MD","doi":"10.1016/j.jacr.2024.07.014","DOIUrl":"10.1016/j.jacr.2024.07.014","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Page e93"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.05.012
Aric Lee MBBS, FRCR (UK), MMed (Diagnostic Radiology) , Eunice Lee MBBS, MMed (Anaesthesia) , Shalini Nair Masters in Magnetic Resonance Technology (M.MRT) , Chi Yao Wang BSc , Jennifer Chong BSc , James Thomas Patrick Decourcy Hallinan MBChB (Hons), BSc (Hons), FRCR , Sophia Ang MBBS, MMed (Anaesthesia)
Objective
Develop structured, quality improvement interventions to achieve a 15%-point reduction in MRIs performed under sedation or general anesthesia (GA) delayed more than 15 min within a 6-month period.
Methods
A prospective audit of MRIs under sedation or GA from January 2022 to June 2023 was conducted. A multidisciplinary team performed process mapping and root cause analysis for delays. Interventions were developed and implemented over four Plan, Do, Study, Act (PDSA) cycles, targeting workflow standardization, preadmission patient counseling, reinforcing adherence to scheduled scan times and written consent respectively. Delay times (compared with Kruskal-Wallis and Dunn’s tests), delays more than 15 min and delays of 60 min or more at baseline and after each PDSA cycle were recorded.
Results
In all, 627 MRIs under sedation or GA were analyzed, comprising 443 at baseline and 184 postimplementation. Of the 627, 556 (88.7%) scans were performed under sedation, 22 (3.5%) under monitored anesthesia care, and 49 (7.8%) under GA. At baseline, 71.6% (317 of 443) scans were delayed over 15 min and 28.2% (125 of 443) scans by 60 min or more, with a median delay of 30 min. Postimplementation, there was a 34.7%-point reduction in scans delayed more than 15 min, a 17.5%-point reduction in scans delayed by 60 min or more, and a reduction in median delay time by 15 min (P < .001).
Discussion
Structured interventions significantly reduced delays in MRIs under sedation and GA, potentially improving outcomes for both patients and providers. Key factors included a diversity of perspectives in the study team, continued stakeholder engagement and structured quality improvement tools including PDSA cycles.
{"title":"Reducing Delays in MRIs Under Sedation and General Anesthesia Using Quality Improvement Tools","authors":"Aric Lee MBBS, FRCR (UK), MMed (Diagnostic Radiology) , Eunice Lee MBBS, MMed (Anaesthesia) , Shalini Nair Masters in Magnetic Resonance Technology (M.MRT) , Chi Yao Wang BSc , Jennifer Chong BSc , James Thomas Patrick Decourcy Hallinan MBChB (Hons), BSc (Hons), FRCR , Sophia Ang MBBS, MMed (Anaesthesia)","doi":"10.1016/j.jacr.2024.05.012","DOIUrl":"10.1016/j.jacr.2024.05.012","url":null,"abstract":"<div><h3>Objective</h3><div>Develop structured, quality improvement interventions to achieve a 15%-point reduction in MRIs performed under sedation or general anesthesia (GA) delayed more than 15 min within a 6-month period.</div></div><div><h3>Methods</h3><div>A prospective audit of MRIs under sedation or GA from January 2022 to June 2023 was conducted. A multidisciplinary team performed process mapping and root cause analysis for delays. Interventions were developed and implemented over four Plan, Do, Study, Act (PDSA) cycles, targeting workflow standardization, preadmission patient counseling, reinforcing adherence to scheduled scan times and written consent respectively. Delay times (compared with Kruskal-Wallis and Dunn’s tests), delays more than 15 min and delays of 60 min or more at baseline and after each PDSA cycle were recorded.</div></div><div><h3>Results</h3><div>In all, 627 MRIs under sedation or GA were analyzed, comprising 443 at baseline and 184 postimplementation. Of the 627, 556 (88.7%) scans were performed under sedation, 22 (3.5%) under monitored anesthesia care, and 49 (7.8%) under GA. At baseline, 71.6% (317 of 443) scans were delayed over 15 min and 28.2% (125 of 443) scans by 60 min or more, with a median delay of 30 min. Postimplementation, there was a 34.7%-point reduction in scans delayed more than 15 min, a 17.5%-point reduction in scans delayed by 60 min or more, and a reduction in median delay time by 15 min (<em>P</em> < .001).</div></div><div><h3>Discussion</h3><div>Structured interventions significantly reduced delays in MRIs under sedation and GA, potentially improving outcomes for both patients and providers. Key factors included a diversity of perspectives in the study team, continued stakeholder engagement and structured quality improvement tools including PDSA cycles.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages 1765-1773"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.08.011
Expert Panel on Urological Imaging, Marielia Gerena MD , Brian C. Allen MD , Baris Turkbey MD , Samantha J. Barker MD , Daniel N. Costa MD , Carl Flink MD , Mariana L. Meyers MD , Ranjith Ramasamy MD , Javier Rosario MD , Akash Sharma MD, MBA , Pat Whitworth III MD , Winter L. Williams MD , Aytekin Oto MD
Acute scrotum is a medical emergency that requires prompt accurate diagnosis to appropriately triage potentially surgical conditions. Numerous differential diagnoses with overlapping clinical presentations make this a diagnostic challenge. Ultrasound is the established first-line imaging modality for acute scrotal disease and can be used to diagnose most scrotal disorders promptly and with high accuracy.
The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
{"title":"ACR Appropriateness Criteria® Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass: 2024 Update","authors":"Expert Panel on Urological Imaging, Marielia Gerena MD , Brian C. Allen MD , Baris Turkbey MD , Samantha J. Barker MD , Daniel N. Costa MD , Carl Flink MD , Mariana L. Meyers MD , Ranjith Ramasamy MD , Javier Rosario MD , Akash Sharma MD, MBA , Pat Whitworth III MD , Winter L. Williams MD , Aytekin Oto MD","doi":"10.1016/j.jacr.2024.08.011","DOIUrl":"10.1016/j.jacr.2024.08.011","url":null,"abstract":"<div><div>Acute scrotum is a medical emergency that requires prompt accurate diagnosis to appropriately triage potentially surgical conditions. Numerous differential diagnoses with overlapping clinical presentations make this a diagnostic challenge. Ultrasound is the established first-line imaging modality for acute scrotal disease and can be used to diagnose most scrotal disorders promptly and with high accuracy.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages S364-S371"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.07.022
Ali Khader MD , Nicholas Befera MD , Ryan Short MD , Jalil Afnan MD , Christoph Wald MD, PhD
{"title":"Assessing the Impact of Patient-Friendly Radiology Reports on Patient-Centered Outcomes Using Artificial Intelligence Sentiment Analysis","authors":"Ali Khader MD , Nicholas Befera MD , Ryan Short MD , Jalil Afnan MD , Christoph Wald MD, PhD","doi":"10.1016/j.jacr.2024.07.022","DOIUrl":"10.1016/j.jacr.2024.07.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages 1792-1795"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.03.013
Amanda Rees BSE , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Ryan C. Rizk MS
{"title":"New Old Age Meets the Same Old Ageism: Leveraging Technology to Promote Healthier Aging","authors":"Amanda Rees BSE , Elliot K. Fishman MD , Linda C. Chu MD , Steven P. Rowe MD, PhD , Ryan C. Rizk MS","doi":"10.1016/j.jacr.2024.03.013","DOIUrl":"10.1016/j.jacr.2024.03.013","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages 1830-1831"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.08.015
Expert Panel on Thoracic Imaging, Brent P. Little MD , Christopher M. Walker MD , Tami J. Bang MD , Anupama G. Brixey MD , Jared D. Christensen MD, MBA , Jose De Cardenas MD , Stephen B. Hobbs MD , Alan Klitzke MD , Rachna Madan MBBS , Fabien Maldonado MD , M. Blair Marshall MD , William H. Moore MD , Edwin Rosas MD , Jonathan H. Chung MD
A variety of thoracic imaging modalities and techniques have been used to evaluate diseases of the trachea and central bronchi. This document evaluates evidence for the use of thoracic imaging in the evaluation of tracheobronchial disease, including clinically suspected tracheal or bronchial stenosis, tracheomalacia or bronchomalacia, and bronchiectasis. Appropriateness guidelines for initial imaging evaluation of tracheobronchial disease and for pretreatment planning or posttreatment evaluation are included.
The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
{"title":"ACR Appropriateness Criteria® Tracheobronchial Disease","authors":"Expert Panel on Thoracic Imaging, Brent P. Little MD , Christopher M. Walker MD , Tami J. Bang MD , Anupama G. Brixey MD , Jared D. Christensen MD, MBA , Jose De Cardenas MD , Stephen B. Hobbs MD , Alan Klitzke MD , Rachna Madan MBBS , Fabien Maldonado MD , M. Blair Marshall MD , William H. Moore MD , Edwin Rosas MD , Jonathan H. Chung MD","doi":"10.1016/j.jacr.2024.08.015","DOIUrl":"10.1016/j.jacr.2024.08.015","url":null,"abstract":"<div><div>A variety of thoracic imaging modalities and techniques have been used to evaluate diseases of the trachea and central bronchi. This document evaluates evidence for the use of thoracic imaging in the evaluation of tracheobronchial disease, including clinically suspected tracheal or bronchial stenosis, tracheomalacia or bronchomalacia, and bronchiectasis. Appropriateness guidelines for initial imaging evaluation of tracheobronchial disease and for pretreatment planning or posttreatment evaluation are included.</div><div>The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.</div></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages S518-S533"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.08.023
Ihab R. Kamel MD, PhD
{"title":"ACR Appropriateness Criteria® Introduction to the JACR Appropriateness Criteria November 2024 Supplement","authors":"Ihab R. Kamel MD, PhD","doi":"10.1016/j.jacr.2024.08.023","DOIUrl":"10.1016/j.jacr.2024.08.023","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages S353-S354"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the Effect of Domain-Specific Transfer Learning for Thyroid Nodule Classification","authors":"Sanaz Vahdati MD , Bardia Khosravi MD, MPH, MHPE , Pouria Rouzrokh MD, MPH, MHPE , Bradley J. Erickson MD, PhD","doi":"10.1016/j.jacr.2024.06.011","DOIUrl":"10.1016/j.jacr.2024.06.011","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages 1796-1799"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.jacr.2024.06.022
Kevin Vo BS , Garrett Trang BS , Ami Gokli MD , Cory M. Pfeifer MD, MBA, MPH, MS
{"title":"Diagnostic Radiology Continues to Fail to Capture the Preliminary Year","authors":"Kevin Vo BS , Garrett Trang BS , Ami Gokli MD , Cory M. Pfeifer MD, MBA, MPH, MS","doi":"10.1016/j.jacr.2024.06.022","DOIUrl":"10.1016/j.jacr.2024.06.022","url":null,"abstract":"","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":"21 11","pages":"Pages 1810-1812"},"PeriodicalIF":4.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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