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2.
Swiss Dent J ; 131(5): 447-450, 2021 May 10.
Artículo en Alemán | MEDLINE | ID: mdl-33952810

RESUMEN

A considerable number of new regulations for oral and maxillofacial radiology was introduced in Switzerland roughly three years ago. The rules had to be followed immediately (date of entry was 1 January 2018) without any transition period. Since then, additional guidance papers have been published by the Swiss government. A current guidance paper is focusing on diagnostic monitors. Different demands for these must be met, which are related to the respective medical field, the type of imaging technology, and also environmental factors. Together with the many other regulations already enacted mainly in 2018 this is another piece of the puzzle on the road to perfecting regulations in oral and maxillofacial radiology with the aim to improve patient care.


Asunto(s)
Radiología , Humanos , Radiografía Dental , Suiza
3.
Br J Radiol ; 94(1121): 20210198, 2021 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-33793317

RESUMEN

There has been some concern expressed by UK regulator, the Professional Standards Authority regarding the risks arising from Independent sonographer practices. The Professional Standards Authority presented evidence demonstrating that there are instances of harm occurring because of errors made by non-radiologists performing musculoskeletal ultrasound (MSKUS), particularly MSKUS-guided interventions. This document summarises British Society of Skeletal Radiologists position for Musculoskeletal use of ultrasound in UK, representing the agreed consensus of experts from the British Society of Skeletal Radiologists Ultrasound committee. The purpose of this position statement is to review the current practices affecting the delivery of MSKUS. Recommendations are given for education and training, audit and clinical governance, reporting, and medicolegal issues.


Asunto(s)
Consenso , Radiología/normas , Sociedades Médicas/normas , Ultrasonido/educación , Ultrasonografía/normas , Humanos , Errores Médicos , Sistema Musculoesquelético/diagnóstico por imagen , Ultrasonografía Intervencional/normas , Reino Unido
5.
Wiad Lek ; 74(2): 351-354, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813499

RESUMEN

OBJECTIVE: The aim: Is to study and analyze the dynamics of the indicators of the emergency medical service of the Ukrainian and the Poltava region in the context of the reforms of the healthcare system in Ukraine. PATIENTS AND METHODS: Materials and methods: In this work, the indicators of development of the emergency medical service of the Ukrainian and the Poltava region were studied and analyzed. CONCLUSION: Conclusions: The provision of emergency medical care in the Poltava region is provided by the Poltava Regional Center for Emergency Medicine and Disaster Medicine. The structure of the center includes 4 emergency medical stations, which are located in cities such as Poltava, Kremenchuk, Lubny, Mirgorod. А modern telemedicine center was built іn 2018 for emergency counseling on-line in new directions was carried out: ultrasound and endoscopic diagnostics, radiology, counseling during surgical interventions, laboratory diagnostics, etc. Emergencymedical care reform Poltava Regional should be aimed at increasing the efficiency of the use of resources; provision of the EMC system by the relevant vehicles; qualitative training of doctors in emergency medicine; informatization of the EMC system.


Asunto(s)
Servicios Médicos de Urgencia , Radiología , Prestación de Atención de Salud , Servicio de Urgencia en Hospital , Humanos , Ucrania
6.
Radiographics ; 41(2): E64-E65, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33646904

Asunto(s)
Radiología , Humanos
7.
J Radiol Case Rep ; 15(1): 30-32, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33717405

RESUMEN

This special issue of the Journal of Radiology Case Reports honors the reviewers who donated their time and expertise throughout the year 2020 to the high quality and success of this journal.


Asunto(s)
Revisión de la Investigación por Pares , Publicaciones Periódicas como Asunto , Radiología , Humanos
12.
JAMA Netw Open ; 4(3): e213304, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33779742

RESUMEN

Importance: During the COVID-19 pandemic, cancer therapy may put patients at risk of SARS-CoV-2 infection and mortality. The impacts of proposed alternatives on reducing infection risk are unknown. Objective: To investigate how the COVID-19 pandemic is associated with the risks and benefits of standard radiation therapy (RT). Design, Setting, and Participants: This comparative effectiveness study used estimated individual patient-level data extracted from published Kaplan-Meier survival figures from 8 randomized clinical trials across oncology from 1993 to 2014 that evaluated the inclusion of RT or compared different RT fractionation regimens. Included trials were Dutch TME and TROG 01.04 examining rectal cancer; CALGB 9343, OCOG hypofractionation trial, FAST-Forward, and NSABP B-39 examining early stage breast cancer, and CHHiP and HYPO-RT-PC examining prostate cancer. Risk of SARS-CoV-2 infection and mortality associated with receipt of RT in the treatment arms were simulated and trials were reanalyzed. Data were analyzed between April 1, 2020, and June 30, 2020. Exposures: COVID-19 risk associated with treatment was simulated across different pandemic scenarios, varying infection risk per fractions (IRFs) and case fatality rates (CFRs). Main Outcomes and Measures: Overall survival was evaluated using Cox proportional hazards modeling under different pandemic scenarios. Results: Estimated IPLD from a total of 14 170 patients were included in the simulations. In scenarios with low COVID-19-associated risks (IRF, 0.5%; CFR, 5%), fractionation was not significantly associated with outcomes. In locally advanced rectal cancer, short-course RT was associated with better outcomes than long-course chemoradiation (TROG 01.04) and was associated with similar outcomes as RT omission (Dutch TME) in most settings (eg, TROG 01.04 median HR, 0.66 [95% CI, 0.46-0.96]; Dutch TME median HR, 0.91 [95% CI, 0.80-1.03] in a scenario with IRF 5% and CFR 20%). Moderate hypofractionation in early stage breast cancer (OCOG hypofractionation trial) and prostate cancer (CHHiP) was not associated with survival benefits in the setting of COVID-19 (eg, OCOG hypofractionation trial median HR, 0.89 [95% CI, 0.74-1.06]; CHHiP median HR, 0.87 [95% CI, 0.75-1.01] under high-risk scenario with IRF 10% and CFR 30%). More aggressive hypofractionation (FAST-Forward, HYPO-RT-PC) and accelerated partial breast irradiation (NSABP B-39) were associated with improved survival in higher risk scenarios (eg, FAST-Forward median HR, 0.58 [95% CI, 0.49-0.68]; HYPO-RT-PC median HR, 0.60 [95% CI, 0.48-0.75] under scenario with IRF 10% and CFR 30%). Conclusions and Relevance: In this comparative effectiveness study of data from 8 clinical trials of patients receiving radiation therapy to simulate COVID-19 risk and mortality rates, treatment modification was not associated with altered risk from COVID-19 in lower-risk scenarios and was only associated with decreased mortality in very high COVID-19-risk scenarios. This model, which can be adapted to dynamic changes in COVID-19 risk, provides a flexible, quantitative approach to assess the potential impact of treatment modifications and supports the continued delivery of standard evidence-based care with appropriate precautions against COVID-19.


Asunto(s)
Neoplasias de la Mama/radioterapia , Fraccionamiento de la Dosis de Radiación , Pandemias , Atención al Paciente/métodos , Neoplasias de la Próstata/radioterapia , Neoplasias del Recto/radioterapia , Algoritmos , /prevención & control , Investigación sobre la Eficacia Comparativa , Conjuntos de Datos como Asunto , Femenino , Humanos , Control de Infecciones , Masculino , Modelos de Riesgos Proporcionales , Hipofraccionamiento de la Dosis de Radiación , Radiología , Ensayos Clínicos Controlados Aleatorios como Asunto , Riesgo , Medición de Riesgo , Nivel de Atención
14.
BMC Med Inform Decis Mak ; 21(1): 84, 2021 03 04.
Artículo en Inglés | MEDLINE | ID: mdl-33663479

RESUMEN

BACKGROUND: With a motivation of quality assurance, machine learning techniques were trained to classify Norwegian radiology reports of paediatric CT examinations according to their description of abnormal findings. METHODS: 13.506 reports from CT-scans of children, 1000 reports from CT scan of adults and 1000 reports from X-ray examination of adults were classified as positive or negative by a radiologist, according to the presence of abnormal findings. Inter-rater reliability was evaluated by comparison with a clinician's classifications of 500 reports. Test-retest reliability of the radiologist was performed on the same 500 reports. A convolutional neural network model (CNN), a bidirectional recurrent neural network model (bi-LSTM) and a support vector machine model (SVM) were trained on a random selection of the children's data set. Models were evaluated on the remaining CT-children reports and the adult data sets. RESULTS: Test-retest reliability: Cohen's Kappa = 0.86 and F1 = 0.919. Inter-rater reliability: Kappa = 0.80 and F1 = 0.885. Model performances on the Children-CT data were as follows. CNN: (AUC = 0.981, F1 = 0.930), bi-LSTM: (AUC = 0.978, F1 = 0.927), SVM: (AUC = 0.975, F1 = 0.912). On the adult data sets, the models had AUC around 0.95 and F1 around 0.91. CONCLUSIONS: The models performed close to perfectly on its defined domain, and also performed convincingly on reports pertaining to a different patient group and a different modality. The models were deemed suitable for classifying radiology reports for future quality assurance purposes, where the fraction of the examinations with abnormal findings for different sub-groups of patients is a parameter of interest.


Asunto(s)
Radiología , Tomografía Computarizada por Rayos X , Adulto , Niño , Humanos , Redes Neurales de la Computación , Radiografía , Reproducibilidad de los Resultados
15.
Pac Symp Biocomput ; 26: 55-66, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33691004

RESUMEN

Intimate partner violence (IPV) is an urgent, prevalent, and under-detected public health issue. We present machine learning models to assess patients for IPV and injury. We train the predictive algorithms on radiology reports with 1) IPV labels based on entry to a violence prevention program and 2) injury labels provided by emergency radiology fellowship-trained physicians. Our dataset includes 34,642 radiology reports and 1479 patients of IPV victims and control patients. Our best model predicts IPV a median of 3.08 years before violence prevention program entry with a sensitivity of 64% and a specificity of 95%. We conduct error analysis to determine for which patients our model has especially high or low performance and discuss next steps for a deployed clinical risk model.


Asunto(s)
Violencia de Pareja , Radiología , Biología Computacional , Humanos
16.
JAMA Netw Open ; 4(3): e211974, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33764423

RESUMEN

Importance: Breast cancer screening, surveillance, and diagnostic imaging services were profoundly limited during the initial phase of the coronavirus disease 2019 (COVID-19) pandemic. Objective: To develop a risk-based strategy for triaging mammograms during periods of decreased capacity. Design, Setting, and Participants: This population-based cohort study used data collected prospectively from mammography examinations performed in 2014 to 2019 at 92 radiology facilities in the Breast Cancer Surveillance Consortium. Participants included individuals undergoing mammography. Data were analyzed from August 10 to November 3, 2020. Exposures: Clinical indication for screening, breast symptoms, personal history of breast cancer, age, time since last mammogram/screening interval, family history of breast cancer, breast density, and history of high-risk breast lesion. Main Outcomes and Measures: Combinations of clinical indication, clinical history, and breast cancer risk factors that subdivided mammograms into risk groups according to their cancer detection rate were identified using classification and regression trees. Results: The cohort included 898 415 individuals contributing 1 878 924 mammograms (mean [SD] age at mammogram, 58.6 [11.2] years) interpreted by 448 radiologists, with 1 722 820 mammograms in individuals without a personal history of breast cancer and 156 104 mammograms in individuals with a history of breast cancer. Most individuals were aged 50 to 69 years at imaging (1 113 174 mammograms [59.2%]), and 204 305 (11.2%) were Black, 206 087 (11.3%) were Asian or Pacific Islander, 126 677 (7.0%) were Hispanic or Latina, and 40 021 (2.2%) were another race/ethnicity or mixed race/ethnicity. Cancer detection rates varied widely based on clinical indication, breast symptoms, personal history of breast cancer, and age. The 12% of mammograms with very high (89.6 [95% CI, 82.3-97.5] to 122.3 [95% CI, 108.1-138.0] cancers detected per 1000 mammograms) or high (36.1 [95% CI, 33.1-39.3] to 47.5 [95% CI, 42.4-53.3] cancers detected per 1000 mammograms) cancer detection rates accounted for 55% of all detected cancers and included mammograms to evaluate an abnormal mammogram or breast lump in individuals of all ages regardless of breast cancer history, to evaluate breast symptoms other than lump in individuals with a breast cancer history or without a history but aged 60 years or older, and for short-interval follow-up in individuals aged 60 years or older without a breast cancer history. The 44.2% of mammograms with very low cancer detection rates accounted for 13.1% of detected cancers and included annual screening mammograms in individuals aged 50 to 69 years (3.8 [95% CI, 3.5-4.1] cancers detected per 1000 mammograms) and all screening mammograms in individuals younger than 50 years regardless of screening interval (2.8 [95% CI, 2.6-3.1] cancers detected per 1000 mammograms). Conclusions and Relevance: In this population-based cohort study, clinical indication and individual risk factors were associated with cancer detection and may be useful for prioritizing mammography in times and settings of decreased capacity.


Asunto(s)
Neoplasias de la Mama/diagnóstico , Asignación de Recursos para la Atención de Salud/métodos , Mamografía , Tamizaje Masivo/métodos , Pandemias , Triaje/métodos , Anciano , Mama/diagnóstico por imagen , Mama/patología , Estudios de Cohortes , Detección Precoz del Cáncer , Femenino , Humanos , Anamnesis , Persona de Mediana Edad , Examen Físico , Radiología , Factores de Riesgo
17.
AJR Am J Roentgenol ; 216(5): 1400-1406, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33729878

RESUMEN

OBJECTIVE. The purpose of this study was to assess the profile of articles published in the American Journal of Roentgenology (AJR) and potential associations with bibliometric indexes over a 5-year period. MATERIALS AND METHODS. Citable documents published from 2014 to 2018 were retrieved from the Journal Citation Reports database. Six bibliometric indexes were assessed. The following article parameters were retrieved: type, subspecialty (17 topics covered by AJR), origin, and title. Differences between groups were assessed by t test, ANOVA, Kruskal-Wallis test, or chi-square test. Citability was assessed by regression analysis. RESULTS. After exclusions, 2210 articles were considered citable and included in the analyses. Most of the metrics improved slightly, except for the Eigenfactor score and article influence score, which decreased. Original articles were preponderant; AJR published significantly more review articles than did three other general radiology journals. The mean number of citations per year of original articles (2.03 ± 2.18) was significantly larger than that of review articles (2.06 ± 2.47) (p = .02). The mean number of citations per year was significantly higher for articles with mixed-origin authorship (3.12 ± 3.19) than for articles with American (2.02 ± 2.17) or non-American (1.93 ± 2.26) authors only (p < .001). The distributions of mean number of citations per year among subspecialties differed significantly (p = .001). Articles on abdominal, musculoskeletal, pediatric, and women's imaging were more frequently cited. Multivariate regression analysis showed that subspecialty and presence of acronyms or initialisms in the title were the only independent predictors of citability (both, p = .001). CONCLUSION. The main AJR bibliometric indexes increased slightly from 2014 to 2018, except for those from the Eigenfactor Project. The presence of acronyms or initialisms in the title and subspecialty were the only independent predictors of citability.


Asunto(s)
Bibliometría , Publicaciones Periódicas como Asunto , Radiología , Bases de Datos Factuales , Humanos , Estados Unidos
20.
Eur J Radiol ; 137: 109615, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33657477

RESUMEN

PURPOSE: To determine the prevalence and determinants of radiologic imaging requests that are of inadequate quality according to the Reason for exam Imaging Reporting and Data System (RI-RADS). METHODS: This study included a random sample of 673 radiologic examinations performed at a tertiary care center. The quality of each imaging request was graded according to RI-RADS. Ordinal regression analysis was performed to determine the association of RI-RADS grade with patient age, gender, and hospital status, indication for imaging, requesting specialty, imaging modality, body region, time of examination, and relationship with previous imaging within the past one year. RESULTS: RI-RADS grades A (adequate request), B (barely adequate request), C (considerably limited request), and D (deficient request) were assigned to 159 (23.6 %), 166 (24.7 %), 214 (31.8 %), and 134 (19.9 %) of cases, respectively. Indication for imaging, requesting specialty, and body region were independently significantly associated with RI-RADS grades. Specifically, routine preoperative imaging (odds ratio [OR]: 3.422, P = 0.030) and transplantation imaging requests (OR: 8.710, P = 0.000) had a higher risk of poorer RI-RADS grades, whereas infection/inflammation as indication for imaging (OR: 0.411, P = 0.002), pediatrics as requesting specialty (OR: 0.400, P = 0.007), and head (OR: 0.384, P = 0.017), spine (OR: 0.346, P = 0.016), and upper extremity (OR: 0.208, P = 0.000) as body regions had a lower risk of poorer RI-RADS grades. CONCLUSION: The quality of radiologic imaging requests is inadequate in >75 % of cases, and is affected by several factors. The data from this study can be used as a baseline and benchmark for further investigation and improvement.


Asunto(s)
Imagen por Resonancia Magnética , Radiología , Niño , Sistemas de Datos , Humanos , Prevalencia , Radiografía , Estudios Retrospectivos
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