Journal of the American College of Radiology最新文献

英文中文

Treatments for Early Hepatocellular Carcinoma: Resection or Ablation—How to Make a Decision 早期肝细胞癌的治疗：切除还是消融，如何做出决定？

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2023.02.045

引用次数: 0

Share of Diagnostic Imaging Interpretation: Radiology and Other Specialties 诊断成像解释份额：放射学和其他专业。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.05.003

Purpose

The aim of this study was to examine radiology’s and other specialties’ market shares for diagnostic imaging interpretation for Medicare fee-for-service claims by modality, body region, and place of service.

Methods

In this cross-sectional study of Physician/Supplier Procedure Summary data for 2022, the authors examined the proportion of diagnostic imaging interpretation by specialty. All claims for CT, MR, nuclear medicine (NM), ultrasound, and radiography and fluoroscopy (XR) were included. Claims were aggregated into 52 specialty groups using Medicare specialty codes. The market share for each specialty group was computed by modality, body region, and place of service.

Results

For Medicare fee-for-service beneficiaries, there were 122,851,716 imaging studies, of which 88,559,272 (72.1%) were interpreted by radiologists. This percentage varied by modality: 97.3% for CT, 91.0% for MR, 76.6% for XR, 50.9% for NM, and 33.9% for ultrasound. Radiologists interpreted a lower percentage of cardiac (67.6% for CT, 42.2% for MR, 11.8% for NM, and 0.4% for ultrasound) than noncardiac studies (97.6% for CT, 91.4% for MR, 95.6% for NM, and 53.0% for ultrasound). Among noncardiac studies, radiologists interpreted nearly all in the outpatient hospital, inpatient, and emergency department (99.5% for CT, 99.4% for MR, 98.9% for NM, 79.3% for ultrasound, and 97.9% for XR) compared with the office setting (84.4% for CT, 78.7% for MR, 85.4% for NM, 29.2% for ultrasound, and 43.1% for XR).

Conclusions

Radiologists perform the dominant share of CT and MR interpretation and more so for noncardiac imaging and imaging performed in outpatient hospital, inpatient, and emergency department places of service.

目的：本研究旨在按方式、身体部位和服务地点研究放射科和其他专科在医疗保险付费服务报销的诊断成像解释市场份额：在这项对 2022 年医生/供应商程序摘要数据的横截面研究中，作者按专业检查了诊断成像解释的比例。所有 CT、MR、核医学 (NM)、超声波以及射线照相术和透视 (XR) 的索赔都包括在内。使用医疗保险专业代码将索赔汇总为 52 个专业组。按方式、身体部位和服务地点计算各专业组的市场份额：医疗保险付费服务受益人共进行了 122,851,716 次成像检查，其中 88,559,272 次（72.1%）由放射科医生判读。这一比例因检查方式而异：CT 为 97.3%，MR 为 91.0%，XR 为 76.6%，NM 为 50.9%，超声波为 33.9%。与非心脏检查（CT 为 97.6%、MR 为 91.4%、NM 为 95.6%、超声为 53.0%）相比，放射医师解释心脏检查的比例较低（CT 为 67.6%、MR 为 42.2%、NM 为 11.8%、超声为 0.4%）。在非心脏检查中，放射科医生在医院门诊、住院部和急诊科几乎对所有检查都进行了解释（CT 为 99.5%、MR 为 99.4%、NM 为 98.9%、超声波为 79.3%、XR 为 97.9%），而在诊室环境中（CT 为 84.4%、MR 为 78.7%、NM 为 85.4%、超声波为 29.2%、XR 为 43.1%）：结论：放射科医生在 CT 和 MR 解译中占主导地位，在医院门诊、住院和急诊科服务场所进行的非心脏成像和成像解译中更是如此。

{"title":"Share of Diagnostic Imaging Interpretation: Radiology and Other Specialties","authors":"","doi":"10.1016/j.jacr.2024.05.003","DOIUrl":"10.1016/j.jacr.2024.05.003","url":null,"abstract":"<div><h3>Purpose</h3><p>The aim of this study was to examine radiology’s and other specialties’ market shares for diagnostic imaging interpretation for Medicare fee-for-service claims by modality, body region, and place of service.</p></div><div><h3>Methods</h3><p>In this cross-sectional study of Physician/Supplier Procedure Summary data for 2022, the authors examined the proportion of diagnostic imaging interpretation by specialty. All claims for CT, MR, nuclear medicine (NM), ultrasound, and radiography and fluoroscopy (XR) were included. Claims were aggregated into 52 specialty groups using Medicare specialty codes. The market share for each specialty group was computed by modality, body region, and place of service.</p></div><div><h3>Results</h3><p>For Medicare fee-for-service beneficiaries, there were 122,851,716 imaging studies, of which 88,559,272 (72.1%) were interpreted by radiologists. This percentage varied by modality: 97.3% for CT, 91.0% for MR, 76.6% for XR, 50.9% for NM, and 33.9% for ultrasound. Radiologists interpreted a lower percentage of cardiac (67.6% for CT, 42.2% for MR, 11.8% for NM, and 0.4% for ultrasound) than noncardiac studies (97.6% for CT, 91.4% for MR, 95.6% for NM, and 53.0% for ultrasound). Among noncardiac studies, radiologists interpreted nearly all in the outpatient hospital, inpatient, and emergency department (99.5% for CT, 99.4% for MR, 98.9% for NM, 79.3% for ultrasound, and 97.9% for XR) compared with the office setting (84.4% for CT, 78.7% for MR, 85.4% for NM, 29.2% for ultrasound, and 43.1% for XR).</p></div><div><h3>Conclusions</h3><p>Radiologists perform the dominant share of CT and MR interpretation and more so for noncardiac imaging and imaging performed in outpatient hospital, inpatient, and emergency department places of service.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1546144024004538/pdfft?md5=4413ba9832cb881a85846791ab576a45&pid=1-s2.0-S1546144024004538-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Current State of Artificial Intelligence and Its Intersection With Radiology 人工智能的现状及其与放射学的交叉。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2023.07.025

引用次数: 0

Feasibility of Screening for Financial Hardship and Health-Related Social Needs at Radiology Encounters 在放射科就诊时筛查经济困难和与健康相关的社会需求的可行性

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2023.12.025

Objective

To evaluate the prevalence of financial hardship and health-related social needs (HRSNs) among outpatients undergoing advanced imaging services and assess the feasibility of screening for financial and social needs during radiology encounters.

Methods

Adult patients receiving CT, MRI, or PET/CT at outpatient imaging centers of an academic tertiary center were asked to complete a 15-minute survey with adapted validated questions inquiring about their experience of financial hardship related to imaging and HRSNs, and the appropriateness of screening for financial and social needs at radiology encounters. Logistic regression analyses were performed to assess factors associated with perceived appropriateness of screening and level of interest in meeting with financial counselors.

Results

A total of 430 patients responded (10.0% response rate; mean age: 57.1 years; 57.4% female; 54.5% White; 22.1% Hispanic; 19.1% Asian; 1% Black). A total of 35% reported experiencing financial hardship with imaging; 47.5% reported material hardship, 15.3% reported cost-related care nonadherence, and 5.3% reported cost-related imaging nonadherence. Overall, 35.9% had at least one HRSN, with food insecurity being the most common (28.3%). The majority (79.7%) felt that being screened for HRSNs at radiology encounters is appropriate, with those experiencing imaging hardship being more likely to feel that screening is appropriate (odds ratio [OR]: 2.93; 95% confidence interval [CI], 1.31-6.56). Overall, 29.5% were interested in meeting with a financial counselor, with those with imaging hardship (OR: 3.70; 95% CI, 1.96-6.97) and HRSNs (OR: 2.87; 95% CI, 1.32-6.24) and who felt uncomfortable with screening (OR: 2.83; 95% CI, 1.14-7.03) being more likely to be interested.

Discussion

Financial hardship and HRSNs are common among outpatients undergoing advanced imaging, with the majority reporting that getting screened at radiology encounters is appropriate.

目的评估门诊接受高级成像服务的患者中经济困难和健康相关社会需求（HRSN）的普遍程度，并评估在放射科就诊时筛查经济和社会需求的可行性。方法要求在一家学术性三级中心的门诊成像中心接受 CT、MRI 或 PET/CT 检查的成人患者完成一项 15 分钟的调查，调查内容包括经过改编的验证问题，询问与成像和健康相关社会需求有关的经济困难经历，以及在放射科就诊时筛查经济和社会需求的适当性。结果 430 名患者做出了回复（回复率为 10.0%）（平均年龄：57.1 岁；57.4% 为女性；54.5% 为白人；22.1% 为西班牙裔；19.1% 为亚裔；1% 为黑人）。共有 35% 的人表示在成像方面有经济困难；47.5% 的人表示有物质困难，15.3% 的人表示与护理费用相关的不坚持治疗，5.3% 的人表示与成像费用相关的不坚持治疗。总体而言，35.9%的人至少有一个 HRSN，其中最常见的是食物不安全（28.3%）。大多数人（79.7%）认为在放射科就诊时接受 HRSN 筛查是合适的，而那些经历过影像困难的人更有可能认为筛查是合适的（OR：2.93；95%CI,1.31-6.56）。总体而言，29.5%的患者有兴趣与财务顾问会面，其中有影像困难（OR：3.70；95%CI：1.96-6.97）、HRSN（OR：2.87；95%CI：1.32-6.24）和对筛查感到不舒服（OR：2.83；95%CI：1.14-7.03）的患者更有可能有兴趣与财务顾问会面。

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引用次数: 0

Improving the Value Proposition of Multiparametric Prostate MRI 提高多参数前列腺磁共振成像的价值主张。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.05.001

引用次数: 0

Improving Prostate MR Image Quality in Practice—Initial Results From the ACR Prostate MR Image Quality Improvement Collaborative 在实践中提高前列腺 MR 图像质量--ACR 前列腺 MR 图像质量提高合作组织的初步成果。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.04.008

Objective

Variability in prostate MRI quality is an increasingly recognized problem that negatively affects patient care. This report aims to describe the results and key learnings of the first cohort of the ACR Learning Network Prostate MR Image Quality Improvement Collaborative.

Methods

Teams from five organizations in the United States were trained on a structured improvement method. After reaching a consensus on image quality and auditing their images using the Prostate Imaging Quality (PI-QUAL) system, teams conducted a current state analysis to identify barriers to obtaining high-quality images. Through plan-do-study-act cycles involving frontline staff, each site designed and tested interventions targeting image quality key drivers. The percentage of examinations meeting quality criteria (ie, PI-QUAL score ≥4) was plotted on a run chart, and project progress was reviewed in weekly meetings. At the collaborative level, the goal was to increase the percentage of examinations with PI-QUAL ≥4 to at least 85%.

Results

Across 2,380 examinations audited, the mean weekly rates of prostate MR examinations meeting image quality criteria increased from 67% (range: 60%-74%) at baseline to 87% (range: 80%-97%) upon program completion. The most commonly employed interventions were MR protocol adjustments, development and implementation of patient preparation instructions, personnel training, and development of an auditing process mechanism.

Conclusion

A learning network model, in which organizations share knowledge and work together toward a common goal, can improve prostate MR image quality at multiple sites simultaneously. The inaugural cohort’s key learnings provide a road map for improvement on a broader scale.

目的：前列腺磁共振成像质量的不一致性是一个日益公认的问题，它对患者护理产生了负面影响。本报告旨在介绍 ACR 学习网络前列腺 MR 图像质量改进协作项目第一批学员的成果和主要心得：来自美国五家机构的团队接受了结构化改进方法的培训。在就图像质量达成共识并使用前列腺成像质量（PI-QUAL）系统对其图像进行审核后，各小组进行了现状分析，以确定获得高质量图像的障碍。通过有一线员工参与的 "计划-实施-研究-行动 "周期，每个站点都设计并测试了针对图像质量关键驱动因素的干预措施。符合质量标准（即 PI-QUAL 分数≥4）的检查百分比被绘制在运行图上，并在每周会议上对项目进展情况进行审查。在合作层面，目标是将 PI-QUAL ≥ 4 分的考试百分比至少提高到 85%：结果：在接受审核的 2380 例检查中，符合图像质量标准的前列腺 MR 检查的每周平均比例从基线时的 67%（范围：60-74%）提高到计划完成时的 87%（范围：80-97%）。最常采用的干预措施包括磁共振检查方案调整、制定和实施患者准备指导、人员培训以及制定审核流程机制：在学习网络模式下，各组织共享知识并为实现共同目标而合作，可同时提高多个地点的前列腺磁共振成像质量。首批学员的主要学习成果为更大范围的改进提供了路线图。

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引用次数: 0

Teaching Diversity, Equity, and Inclusion and Health Disparities in Radiology Through a Morbidity and Mortality Conference Framework 通过发病率和死亡率会议框架在放射学中教授多样性、公平、包容和健康差异。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.05.011

引用次数: 0

Patient-Friendly Summary of the ACR Appropriateness Criteria®: Pelvic Floor Dysfunction in Female Patients 便于患者理解的 ACR 适宜性标准®摘要：女性盆底功能障碍。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.04.016

引用次数: 0

Identifying and Addressing Health-Related Social Risks and Needs: Our Role 重点问题介绍：确定并解决与健康相关的社会风险和需求：我们的作用是什么？

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.07.002

引用次数: 0

Accuracy of Financial Disclosures in Radiology Journals 放射学期刊财务披露的准确性。

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology

Pub Date : 2024-09-01 DOI: 10.1016/j.jacr.2024.01.027

Purpose

The accuracy and completeness of self-disclosures of the value of industry payments by authors publishing in radiology journals are not well known. The aim of this study was to assess the accuracy of financial disclosures by US authors in five prominent radiology journals.

Methods

Financial disclosures provided by US-based authors in five prominent radiology journals from original research and review articles published in 2021 were reviewed. For each author, payment reports were extracted from the Open Payments Database (OPD) in the previous 36 months related to general, research, and ownership payments. Each author was analyzed individually to determine if the reported disclosures matched results from the OPD.

Results

A total of 4,076 authorships, including 3,406 unique authors, were selected from 643 articles across the five journals; 1,388 (1,032 unique authors) received industry payments within the previous 36 months, with a median total amount received per authorship of $6,650 (interquartile range, $355-$87,725). Sixty-one authors (4.4%) disclosed all industry relationships, 205 (14.8%) disclosed some of the OPD-reported relationships, and 1,122 (80.8%) failed to disclose any relationships. Undisclosed payments totaled $186,578,350, representing 67.2% of all payments. Radiology had the highest proportion of authorships disclosing some or all OPD-reported relationships (32.3%), compared with the Journal of Vascular and Interventional Radiology (18.2%), the American Journal of Neuroradiology (17.3%), JACR (13.1%), and the American Journal of Roentgenology (10.3%).

Conclusions

Financial relationships with industry are common among US physician authors in prominent radiology journals, and nondisclosure rates are high.

背景：在放射学期刊上发表论文的作者自我披露行业支付价值的准确性和完整性并不为人所知：本研究旨在评估美国作者在五种著名放射学期刊上披露财务信息的准确性：我们审查了五种著名放射学期刊中美国作者提供的财务披露信息，这些信息来自 2021 年发表的原创研究和综述文章。我们从公开支付数据库（Open Payments Database，OPD）中提取了每位作者在过去 36 个月中与一般类别、研究和所有权支付类别相关的支付报告。我们对每位作者进行了逐一分析，以确定所报告的披露信息是否与 OPD 的结果相符：我们从五种期刊的 643 篇文章中选出了 4076 位作者，其中包括 3406 位唯一作者。1388位作者（1032位唯一作者）在过去36个月内收到了行业支付，每位作者收到的总金额中位数为6650美元（四分位间范围=355美元至87725美元）。61位作者（4.4%）披露了所有的行业关系，205位作者（14.8%）披露了OPD报告的部分关系，1122位作者（80.8%）未披露任何关系。未披露的付款总额为 186,578,350 美元，占所有付款的 67.2%。放射科披露部分或全部 OPD 报告关系的作者比例最高（32.3%），相比之下，JVIR（18.2%）、AJNR（17.3%）、JACR（13.1%）和 AJR（10.3%）：结论：在著名放射学期刊上发表文章的美国医生作者中，与企业有财务关系的情况很普遍，而且未披露率很高。

{"title":"Accuracy of Financial Disclosures in Radiology Journals","authors":"","doi":"10.1016/j.jacr.2024.01.027","DOIUrl":"10.1016/j.jacr.2024.01.027","url":null,"abstract":"<div><h3>Purpose</h3><p>The accuracy and completeness of self-disclosures of the value of industry payments by authors publishing in radiology journals are not well known. The aim of this study was to assess the accuracy of financial disclosures by US authors in five prominent radiology journals.</p></div><div><h3>Methods</h3><p>Financial disclosures provided by US-based authors in five prominent radiology journals from original research and review articles published in 2021 were reviewed. For each author, payment reports were extracted from the Open Payments Database (OPD) in the previous 36 months related to general, research, and ownership payments. Each author was analyzed individually to determine if the reported disclosures matched results from the OPD.</p></div><div><h3>Results</h3><p>A total of 4,076 authorships, including 3,406 unique authors, were selected from 643 articles across the five journals; 1,388 (1,032 unique authors) received industry payments within the previous 36 months, with a median total amount received per authorship of $6,650 (interquartile range, $355-$87,725). Sixty-one authors (4.4%) disclosed all industry relationships, 205 (14.8%) disclosed some of the OPD-reported relationships, and 1,122 (80.8%) failed to disclose any relationships. Undisclosed payments totaled $186,578,350, representing 67.2% of all payments. <em>Radiology</em> had the highest proportion of authorships disclosing some or all OPD-reported relationships (32.3%), compared with the <span><em>Journal of </em><em>Vascular and Interventional Radiology</em></span> (18.2%), the <span><em>American Journal of </em><em>Neuroradiology</em></span> (17.3%), <em>JACR</em> (13.1%), and the <em>American Journal of Roentgenology</em> (10.3%).</p></div><div><h3>Conclusions</h3><p>Financial relationships with industry are common among US physician authors in prominent radiology journals, and nondisclosure rates are high.</p></div>","PeriodicalId":49044,"journal":{"name":"Journal of the American College of Radiology","volume":null,"pages":null},"PeriodicalIF":4.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140289838","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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