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Development and Deployment of an Emergency Department Radiology Dashboard to Improve Communication and Transparency of Radiologic Imaging and Report Status 开发和部署急诊科放射仪表板,以改善放射成像和报告状态的沟通和透明度。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.jacr.2024.11.024
Ali H. Dhanaliwala MD, PhD , Amanda J. Deutsch MD , Jeffrey Moon MD , Darco Lalevic MCIT , Charles Chambers MCIT, MHCI , Tessa S. Cook MD, PhD

Purpose

The status of radiology examinations affects the flow of patients through the emergency department (ED). Yet this information is not readily available to ED physicians, nurses, and staff members (collectively referred to as ED staff members) or patients. The aim of this study was to improve ED workflow by providing real-time information about the status of radiology reports to ED staff members.

Methods

A dashboard displaying real-time information on the status of pending radiology examinations as extracted from the electronic medical record and radiology information system was developed for display in the ED. An algorithm based on historical trends was developed for predicting expected turnaround times (TATs). Focus groups, surveys, and dashboard use data were used to gather feedback and understand utility.

Results

The ED radiology dashboard was successfully deployed to four EDs within the health system. The dashboard received an average of 9,397 unique views per week the first year and 802 views per week in the following 2 years after deployment. Most examinations had TATs better than the estimated time, and fewer than 1% had TATs greater than 2 hours from the estimated time. No differences were found between pre- and postsurvey opinion results.

Conclusions

A web-based dashboard that displays radiologic imaging study status is a low-cost, high-yield method to improve communication between radiology and ED staff members.
背景:放射学检查的状况影响着急诊科(ED)的患者流量。然而,对于急诊科医生、护士、工作人员(急诊科工作人员)或患者来说,这些信息并不容易获得。目的:通过向急诊科工作人员提供有关放射报告状态的实时信息,改善急诊科工作流程。材料和方法:开发了一个仪表板,显示从电子病历和放射学信息系统中提取的待处理放射学检查状态的实时信息,用于在急诊科显示。开发了基于历史趋势的算法,用于预测预期的周转时间。使用焦点小组、调查和仪表板使用数据来收集反馈并了解效用。结果:ED-Radiology仪表板成功部署到卫生系统内的四个急诊科。在部署后的第一年,仪表板平均每周接收9397个唯一视图,在接下来的两年里,每周接收802个视图。大多数考试的周转时间(TAT)优于估计时间,少于1%的考试的TAT超过估计时间2小时。调查前后的意见结果没有差异。结论:基于网络的显示放射学影像学研究状态的仪表板是一种低成本、高收益的方法,可改善放射科和急诊科人员之间的沟通。
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引用次数: 0
Planning for the Future: Modeling Growth and Attrition in the Radiologist Workforce
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-02-01 DOI: 10.1016/j.jacr.2024.11.002
Matthew D. Phelps MD , Diana L. Lam MD
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引用次数: 0
Classification and Communication of Critical Findings in Emergency Radiology: A Scoping Review 急诊放射学重要发现的分类和交流:范围界定综述。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.09.006
Lucas Corallo HBSc , D. Blair Macdonald MD, FRCPC , Fatma Eldehimi MD , Anirudh Venugopalan Nair MD, FRCR, MBA , Simeon Mitchell MD, CM, MScHQ

Purpose

To identify the published standards for the classification and communication of critical actionable findings in emergency radiology and the associated facilitators and barriers to communication and message management or dissemination of such findings.

Materials and methods

Search terms for resources pertaining to critical findings (CFs) in emergency radiology were applied to two databases (PubMed, Embase). Screening of hits using the following pre-established inclusion and exclusion criteria were performed by three analysts with subsequent consensus discussion for discrepancies: (1) the resources include any standards for the classification and communication of imaging findings as critical, or (2) the resource discusses any facilitators to the communication of CFs, or (3) the resource discusses any barriers to the communication of CFs. Resources with explicit focus on a pediatric population or predominant focus on artificial intelligence or natural language processing were omitted. Accompanying gray literature search was used to expand included resources. Data extraction included year, country, resource type, scope or purpose, participants, context, standards to identifying or communicating CFs, facilitators and barriers, method type, recommendations, applicability, and disclosures.

Results

Seventy-six resources were included in the final analysis, including 16 societal or commission guidelines. Among the guidelines, no standardized list of CFs was identified, with typical recommendations suggesting application of a local policy. Communication standards included direct closed-loop communication for high acuity findings, with more flexible communication channels for less acute findings. Applied interventions for CFs management most frequently fell into four categories: electronic (n = 10), hybrid (ie, electronic or administrative) (n = 3), feedback or education (n = 5), and administrative (n = 4).

Conclusion

There are published standards, policies, and interventions for the management of CFs in emergency radiology. Three-tier stratification (eg, critical, urgent, incidental) based on time sensitivity and severity is most common with most CFs necessitating closed-loop communication. Awareness of systemic facilitators and barriers should inform local policy development. Electronic and administrative communication pathways are useful adjuncts. Further research should offer comparative analyses of different CF interventions with regard to cost-effectiveness, notification time, and user feedback.
目的:确定已公布的急诊放射学关键可操作结果的分类和交流标准,以及交流和信息管理/传播此类结果的相关促进因素和障碍:在 2 个数据库(PubMed、Embase)中搜索与急诊放射学重要发现(CFs)相关的资源。由 3 位分析师使用以下预先确定的纳入和排除标准对点击率进行筛选,随后就差异进行一致讨论:1)资料中包含任何关于危重成像结果分类和/或交流的标准;或 2)资料中讨论了任何关于危重成像结果交流的促进因素;或 3)资料中讨论了任何关于危重成像结果交流的障碍。明确关注儿科人群或主要关注人工智能/自然语言处理的资源被忽略。同时还使用了灰色文献检索来扩展所包含的资源。数据提取包括:年份、国家、资源类型、范围/目的、参与者、背景、识别/交流 CF 的标准、促进因素/障碍、方法类型、建议、适用性和披露:最终分析包括 76 项资源,其中包括 16 项社会/委员会指南。在这些指南中,没有发现标准化的 CF 列表,典型的建议是采用当地政策。沟通标准包括针对高危急性检查结果的直接闭环沟通,以及针对非急症检查结果的更为灵活的沟通渠道。应用于CFs管理的干预措施最常见的分为4类:电子(10人)、电子/行政混合(3人)、反馈/教育(5人)和行政(4人):结论:急诊放射科有已公布的 CFs 管理标准、政策和干预措施。基于时间敏感性和严重程度的三级分层(如危重/急诊/意外)最为常见,大多数危重结果需要闭环沟通。对系统促进因素和障碍的认识应为地方政策的制定提供依据。电子和行政沟通途径是有用的辅助手段。进一步的研究应从成本效益、通知时间和用户反馈等方面对不同的 CF 干预措施进行比较分析。
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引用次数: 0
Spaced Repetition Learning in Radiology Education: Exploring Its Potential and Practical Application 间隔重复学习:探索其在放射学教育中的潜力和实际应用。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.11.020
Kaelan Yao MS , Jeffers Nguyen MD , Mahan Mathur MD
In today’s medical landscape, rapidly learning vast amounts of information requires innovative learning methods. Spaced repetition tools (like Anki) aid efficient knowledge absorption and retention among medical trainees. Yet, adoption of these tools in radiology medical student education lags despite proven effectiveness. This article highlights spaced repetition as a learning tool alongside other evidence-based educational practices, aiming to revolutionize radiology education among medical students. We (1) describe the educational theory and current application of spaced repetition in the setting of other learning techniques often found in undergraduate medical education; (2) underscore the underutilization of tools such as Anki in radiology education; and (3) offer practical guidance for educators interested in integrating spaced repetition into their teaching methodologies.
在当今的医疗领域,快速学习大量信息需要创新的学习方法。间隔重复工具(如Anki)有助于医学学员有效地吸收和保留知识。然而,采用这些工具在放射医学学生的教育滞后,尽管证明了有效性。该手稿强调间隔重复作为一种学习工具以及其他循证教育实践,旨在彻底改变医学学生的放射学教育。我们1)描述了在医学本科教育中经常发现的其他学习技巧的背景下,空间重复的教育理论和目前的应用;2)强调Anki等工具在放射学教育中的利用不足;3)为有意将间隔重复方法整合到教学方法中的教育者提供实用指导。
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引用次数: 0
JACR Annual Awards 2024
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.11.001
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引用次数: 0
Preference Signaling in the Radiology Residency Match: National Survey of Applicants 放射科住院医师配对中的偏好信号:全国申请人调查。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.08.009
Dhairya A. Lakhani MD , Mahla Radmard MD , Armin Tafazolimoghadam MD , Sahil Patel MD , Arun Murugesan MD , Hammad Malik MD , Jeffery P. Hogg MD , Ziling Shen ScM , David M. Yousem MD, MBA , Francis Deng MD

Objective

Two-tiered preference signaling has been implemented in the radiology residency application system to reduce congestion in the setting of high-volume applications. Signals are an indicator of strong interest that an applicant can transmit to a limited number of programs. This study assessed the impact of program signaling on interview invitations, how applicants strategically used signals based on their application’s competitiveness, and applicants’ attitudes toward the current signaling system.

Methods

A survey was sent to radiology residency applicants registered with TheRadRoom during the 2024 application cycle. We queried the applicants’ background, applications, signal distribution, and interview outcome depending on the type of signal sent. We also asked whether respondents received an interview invitation from a hypothetical “comparator nonsignaled program” if they had one additional signal to use. Group differences were assessed using nonparametric Wilcoxon signed rank test.

Results

A total of 202 applicants completed the survey (28% response rate). Most applied to diagnostic radiology (81%). Nearly all respondents used all six gold (98%) and six silver (96.5%) signals. Interview invitation rates were significantly higher for signaled programs (59.8% ± 27.4%) than nonsignaled (8.5% ± 8.5%); the invitation rate at the comparator nonsignaled programs was 37%. Gold-signaled programs had significantly higher interview rates (67.8% ± 29.3) than silver (51.8% ± 31.3%). Respondents used 49.2% (±21.7%) of their signals for “likely to match” programs, 33.1% (±20.9%) for “aspirational” programs, and 17.6% (±15.8%) for “safety” programs. Most respondents (146; 76%) supported continuing the signaling system for future cycles.

Conclusion

Signaling programs significantly enhanced interview invitation rates, with gold signals being more effective than silver. The applicants used about six total signals for “likely-to-match” programs, two for “aspirational” programs, and about four for “safety” programs.
目的:放射科住院医师申请系统采用了两级偏好信号,以减少大量申请时的拥堵情况。信号是一种表示强烈兴趣的指标,申请人可将其传递给数量有限的项目。本研究评估了项目信号对面试邀请的影响、申请人如何根据其申请的竞争力战略性地使用信号,以及申请人对当前信号系统的态度:我们向2024年申请周期内在TheRadRoom注册的放射学住院医师申请者发送了一份调查问卷。我们根据发送信号的类型询问了申请人的背景、申请情况、信号分布和面试结果。我们还询问了受访者,如果他们有一个额外的信号可使用,他们是否收到了一个假定的 "无信号参照程序 "的面试邀请。组间差异采用非参数 Wilcoxon 符号秩检验进行评估:共有 202 名申请人完成了调查(回复率为 28%)。大多数申请者从事放射诊断工作(81%)。几乎所有受访者都使用了全部 6 种金信号(98%)和 6 种银信号(96.5%)。金牌项目的面试邀请率(59.8%±27.4%)明显高于非金牌项目(8.5%±8.5%);非金牌项目的面试邀请率为 37%。金牌项目的面试率(67.8%±29.3)明显高于银牌项目(51.8%±31.3%)。受访者将 49.2%(±21.7%)的信号用于 "可能匹配 "的项目,33.1%(±20.9%)用于 "有抱负 "的项目,17.6%(±15.8%)用于 "安全 "的项目。大多数受访者(146;76%)支持在今后的周期中继续采用信号系统:信号系统大大提高了面试邀请率,金信号比银信号更有效。申请人在 "可能匹配 "项目中总共使用了约 6 个信号,在 "有抱负 "项目中使用了 2 个信号,在 "安全 "项目中使用了约 4 个信号。
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引用次数: 0
Examining the Effects of a Narrative-Based Educational Animation for Radiology Technologists About Discontinuing Gonadal Shielding 研究以叙事为基础的教育动画片对放射技术人员停止性腺屏蔽的影响。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.09.004
Ann Seliger MA , Mahadevappa Mahesh MS, PhD , Lydia Gregg MA, CMI
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引用次数: 0
Patient-Friendly Summary of the ACR Appropriateness Criteria®: Imaging After Breast Surgery ACR 适宜性标准® 患者友好型摘要:乳房手术后成像。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.09.012
Elizabeth M. McGuire , Samantha L. Heller PhD, MD
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引用次数: 0
Ranking the Relative Importance of Image Quality Features in CT by Consensus Survey 通过共识调查排列 CT 图像质量特征的相对重要性。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.10.006
Dustin A. Gress MS , Ehsan Samei PhD , Donald P. Frush MD , Casey E. Pelzl MPH , Joel G. Fletcher MD , Mahadevappa Mahesh MS, PhD , David B. Larson MD, MBA , Mythreyi Bhargavan-Chatfield PhD

Objective

This study sought to determine consensus opinions from subspecialty radiologists and imaging physicists on the relative importance of image quality features in CT.

Methods

A prospective survey of subspecialty radiologists and medical physicists was conducted to collect consensus opinions on the relative importance of 10 image quality features: axial sharpness, blooming, contrast, longitudinal sharpness, low-contrast axial sharpness, metal artifact, motion, noise magnitude, noise texture, and streaking. The survey was first sent to subspecialty radiologists in volunteer leadership roles in the ACR and RSNA, thereafter relying on snowball sampling. Surveyed subspecialties were abdominal, cardiac, emergency, musculoskeletal, neuroradiology, pediatric, and thoracic radiology and medical physics. Individual respondents’ ratings were normalized for calculation of mean normalized ratings and priority rankings for each feature within subspecialties. Also calculated were intraclass correlation coefficients across image quality features within subspecialties and analysis of variance across subspecialties within each feature.

Results

Most subspecialties had moderate to excellent intraclass agreement. For every radiology subspecialty except musculoskeletal, motion was the most important image quality feature. There was agreement across subspecialties that axial sharpness and contrast are only moderately important. There was disagreement across subspecialties on the relative importance of noise magnitude. Blooming was highly important to cardiac radiologists, and noise texture was highly important to musculoskeletal radiologists.

Conclusion

Image quality preferences differ based on clinical tasks and challenges in each anatomical radiology subspecialty. CT image analysis and development of quantitative measures of quality and protocol optimization—and related policy initiatives—should be specific to radiology subspecialty.
目的本研究旨在确定放射专科医师和成像物理学家对 CT 图像质量特征相对重要性的一致意见:对亚专科放射科医师和医学物理学家进行了一项前瞻性调查,以收集他们对以下十种图像质量特征相对重要性的一致意见:轴向锐利度、发花、对比度、纵向锐利度、低对比度轴向锐利度、金属伪影、运动、噪声大小、噪声纹理和条纹。调查表首先发给了美国放射学会和北美放射学会中担任志愿领导职务的亚专科放射科医师,之后依靠滚雪球式抽样进行调查。接受调查的亚专科包括腹部、心脏、急诊、肌肉骨骼、神经、儿科、胸部放射学和医学物理学。对每个受访者的评分进行归一化处理,以计算平均归一化评分和亚专科内每个特征的优先级排名。此外,还计算了各亚专科内不同图像质量特征的类内相关系数,以及各亚专科内不同特征的方差分析:结果:大多数亚专科的类内相关系数在中等到优秀之间。对于除肌肉骨骼外的每个放射学亚专科来说,运动都是最重要的图像质量特征。各亚专科一致认为,轴向锐利度和对比度仅具有中等程度的重要性。各亚专科对噪声大小的相对重要性存在分歧。对于心脏放射科医生来说,噪点非常重要,而对于肌肉骨骼放射科医生来说,噪点纹理非常重要:结论:每个解剖放射学亚专业的临床任务和挑战不同,对图像质量的偏好也不同。CT 图像分析和质量定量衡量标准的制定、方案优化以及相关政策措施应针对放射学亚专科的具体情况。
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引用次数: 0
Demographic Differences in the Radiology Residency Match, 2022 to 2024 2022-2024 年放射科住院医师配对中的人口统计学差异。
IF 4 3区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2025-01-01 DOI: 10.1016/j.jacr.2024.10.016
Taha Lodhi BS , Francis Deng MD

Purpose

Ranking preferences by residency programs in the Match could shape the diversity of selective specialties. We investigated demographic characteristics of applicants and matched residents in radiology and other specialties to identify changes in representation.

Methods

Survey data from the National Resident Matching Program were obtained for applicants to radiology (diagnostic radiology, interventional radiology, and combined diagnostic radiology and nuclear medicine) and nonradiology programs in the 2022 to 2024 Main Residency Matches. Demographics among applicants preferring a specialty and matched residents were compared using χ2 tests.

Results

Radiology had a 73.9% match rate (3,486 of 4,718 applicants). Women represented 29.0% of radiology applicants compared with 52.0% in other specialties. In radiology, only US citizenship had higher representation among matched residents compared with applicants (+4.0%, 95% confidence interval [CI], 2.8%-5.3%) (P = .001). Other demographics were not significantly different between applicants and matched residents in radiology overall. A higher representation of women was observed in matched residents compared with applicants in diagnostic radiology (+2.4%, 95% CI, 0.2%-4.6%) (P = .031) but not interventional radiology (+0.2%, 95% CI, −5.1% to 5.5%) (P = .944). In nonradiology specialties, female sex, nonheterosexual orientation, White race, US citizenship, first-generation medical graduate, and nonurban childhood were associated with higher match rates.

Conclusion

US citizenship but not other demographic variables was associated with higher rates of matching into radiology. Women are underrepresented among radiology applicants and have slightly higher match rates in diagnostic radiology but not interventional radiology.
目的:住院医师项目在 Match 中的排名偏好可能会影响选择性专科的多样性。我们调查了放射学和其他专业的申请人和匹配住院医师的人口统计学特征,以确定代表性的变化:我们从国家住院医师匹配计划中获得了 2022-2024 年主要住院医师匹配中放射学(诊断放射学、介入放射学和诊断放射学/核医学联合)和非放射学项目申请人的调查数据。通过卡方检验比较了选择专业的申请人和匹配住院医师的人口统计学特征:放射学的匹配率为 73.9%(3486/4718 名申请人)。女性占放射科申请者的 29.0%,而其他专业为 52.0%。在放射科,只有美国公民身份在匹配住院医师中的比例高于申请人(+4.0% [95% CI, 2.8%-5.3%], p=0.001)。在放射学领域,申请人和配对住院医师的其他人口统计学特征没有明显差异。与放射诊断专业的申请者相比,配对住院医师中女性比例较高(+2.4% [95% CI, 0.2-4.6%],p=0.031),但介入放射学专业中女性比例不高(+0.2% [95% CI, -5.1-5.5%],p=0.944)。在非放射学专业中,女性性别、非异性恋性取向、白种人、美国公民身份、第一代医学毕业生和非城市童年与较高的匹配率相关:结论:美国公民身份而非其他人口统计学变量与较高的放射学匹配率有关。女性在放射学申请者中的比例偏低,在诊断放射学中的匹配率略高于介入放射学:在2022-2024年放射学专业住院医师主要匹配周期中,美国公民身份而非其他人口统计学变量与较高的放射学匹配率相关。
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引用次数: 0
期刊
Journal of the American College of Radiology
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