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We describe our experience in synchronous virtual radiologist consultations, whereby a radiologist at the PACS uses a conferencing platform to join a primary care visit between a patient at home and a referring provider, at home or at clinic, to directly explain imaging results and partner with the referrer in forming management recommendations. We explore the model's significance in the context of patient-centered care. Implementation, obstacles, and potential impact on health care disparities are also discussed.
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Radiologia , Humanos , Assistência Centrada no Paciente , Radiografia , Radiologistas , Radiologia/métodos , Encaminhamento e ConsultaRESUMO
Although the transition from peer review to peer learning has had favorable outcomes in diagnostic radiology, experience with implementing a team-based peer review system in interventional radiology (IR) remains limited. Peer learning systems benefit diverse IR teams composed of multiple clinical roles and could contribute value in archiving events that have potential educational value. With multiple stakeholder input from clinical roles within the IR division at our institution (ie, radiologic technologists, nurses, advanced practice providers, residents, fellows, and attending physicians), we launched a HIPAA-compliant secure IR complication and learning opportunity reporting platform in April 2022. Case submissions were monitored over the subsequent 24 weeks, with monthly dashboard reports provided to departmental leadership. Preintervention and postintervention surveys were used to assess the impact of the peer learning platform and adverse event reporting in IR (IR-PEER) on perceptions of complication reporting in the IR division across clinical roles. Ninety-two peer learning submissions were collected for a weekly average ± standard error of 3.8 ± 0.6 submissions per week, and an additional 26 submissions were collected as part of the division's ongoing monthly complication review conference, for a total of 98 unique total case references. A total of 64.1% of submissions (59 of 92) involved a complication and/or adverse event, and 35.9% of submissions (33 of 92) identified a learning opportunity (no complication or adverse event). Nurses reported that IR-PEER made the complication-reporting process easier (P = .01), and all clinical roles reported that IR-PEER improved the overall process of complication reporting. Peer learning frameworks such as IR-PEER provide a more equitable communication platform for multidisciplinary teams to capture and archive learning opportunities that support quality and safety improvement efforts.
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Revisão por Pares , Radiologia Intervencionista , Humanos , AprendizagemRESUMO
Liver cancer is a leading cause of cancer-related death worldwide, and its early detection and treatment are crucial for improving morbidity and mortality. Biomarkers have the potential to facilitate the early diagnosis and management of liver cancer, but identifying and implementing effective biomarkers remains a major challenge. In recent years, artificial intelligence has emerged as a promising tool in the cancer sphere, and recent literature suggests that it is very promising in facilitating biomarker use in liver cancer. This review provides an overview of the status of AI-based biomarker research in liver cancer, with a focus on the detection and implementation of biomarkers for risk prediction, diagnosis, staging, prognostication, prediction of treatment response, and recurrence of liver cancers.
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PURPOSE: Synchronous virtual visits are an emerging model of care, and their feasibility has been demonstrated in radiology. The purpose of this study was to assess the value of point-of-care virtual radiology primary care consultations for atherosclerotic vascular disease management. METHODS: In this institutional review board-approved study, 107 age- and gender-matched patients were assigned to control (n = 62) and intervention (n = 45) arms with the following inclusion criteria: (1) age > 45 years, (2) consult with a primary care physician (PCP), and (3) recent CT of the chest or abdomen demonstrating atherosclerotic calcification. In the intervention arm, virtual real-time radiology consultation with referring PCPs and patients was conducted, with review of CT images focused on the extent of vascular atherosclerosis. Patients in the control arm followed the current standard of care of PCPs' discussing relevant imaging results, if any. RESULTS: Thirty-one patients in the intervention arm and 31 patients in the control arm completed the study (control: 64.5% women; mean age, 68 years; intervention: 67.7% women; mean age, 67 years). Discussion of imaging findings occurred with all patients in the intervention arm (discussion with PCP and virtual consultation with radiologist) and with 45% of patients in the control arm (PCP only; P < .001). All patients in the intervention arm indicated that seeing or discussing their images improved their understanding of their disease, compared with 85% of patients in the control arm (P = .04). In the intervention arm, 10 of 31 patients (32.2%) left the visit with changes in prescriptions for statins or antihypertensive medications, compared with only 4 of 31 patients (13%) in the control arm (P = .04). CONCLUSIONS: Point-of-care radiology virtual visits enhance patient understanding and may influence the longitudinal management of atherosclerotic disease in primary care.
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Aterosclerose , Radiologia , Idoso , Aterosclerose/diagnóstico por imagem , Aterosclerose/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sistemas Automatizados de Assistência Junto ao Leito , Atenção Primária à Saúde , Encaminhamento e ConsultaRESUMO
Interactions between microbes are central to the dynamics of microbial communities. Understanding these interactions is essential for the characterization of communities, yet challenging to accomplish in practice. There are limited available tools for characterizing diffusion-mediated, contact-independent microbial interactions. A practical and widely implemented technique in such characterization involves the simultaneous co-culture of distinct bacterial species and subsequent analysis of relative abundance in the total population. However, distinguishing between species can be logistically challenging. In this paper, we present a low-cost, vertical membrane, co-culture plate to quantify contact-independent interactions between distinct bacterial populations in co-culture via real-time optical density measurements. These measurements can be used to facilitate the analysis of the interaction between microbes that are physically separated by a semipermeable membrane yet able to exchange diffusible molecules. We show that diffusion across the membrane occurs at a sufficient rate to enable effective interaction between physically separate cultures. Two bacterial species commonly found in the cystic fibrotic lung, Pseudomonas aeruginosa and Burkholderia cenocepacia, were co-cultured to demonstrate how this plate may be implemented to study microbial interactions. We have demonstrated that this novel co-culture device is able to reliably generate real-time measurements of optical density data that can be used to characterize interactions between microbial species.