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1.
Acad Radiol ; 28(9): 1209-1218, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34210612

RESUMO

PURPOSE: To report the impact of the coronavirus disease 2019 (COVID-19) pandemic on interventional radiology (IR). MATERIALS AND METHODS: A 78-question survey was distributed to practicing interventional radiologists and IR trainees. The survey consisted of demographic and practice environment queries. Anxiety symptoms were evaluated using the Generalized Anxiety Disorder-7 (GAD-7) screener, and coping strategies were assessed using the Brief-Coping Orientation to Problems Experienced (Brief-COPE) questionnaire. RESULTS: There were 422 respondents including 333 (78.9%) attending interventional radiologists and 89 (21.1%) interventional radiologists-in-training from 15 counties. Most respondents were from academic medical centers (n = 218; 51.7%). A large majority (n = 391; 92.7%) performed a procedure on a patient with confirmed COVID-19 infection. An N95 mask was the most common (n = 366; 93.6%) safety measure employed. Cancellation or limitation of elective procedures were reported by 276 (65.4%) respondents. Many respondents (n = 177; 41.9%) had self-reported anxiety (GAD-7 score >5) with an overall mean GAD-7 score of 4.64 ± 4.63 (range: 0-21). Factors associated with reporting anxiety included female gender (p = 0.045), increased call coverage (p = 0.048), lack of adequate departmental adjustments (p <0.0001), and lack of adjustments in a timely manner (p <0.0001). The most utilized coping strategy was acceptance (mean of 5.49 ± 1.88), while the most employed dysfunctional coping strategy was self-distraction (mean of 4.16 ± 1.67). The odds of reporting anxiety increased by >125% with adoption of dysfunctional strategies. CONCLUSION: The COVID-19 pandemic induced practice alterations and high rates of self-reported anxiety in IR. Female gender, increased call coverage, and lack of adequate or timely departmental adjustments were associated with increased anxiety levels.


Assuntos
COVID-19 , Radiologistas/psicologia , Radiologia Intervencionista , Adaptação Psicológica , Ansiedade , Feminino , Humanos , Masculino , Pandemias , Radiologia Intervencionista/tendências
2.
Clin Radiol ; 76(10): 774-778, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34112510

RESUMO

AIM: To evaluate the use of apps in radiology and consider advised changes to practice. MATERIALS AND METHODS: A survey was conducted of all radiology consultants and specialty trainees within Devon and Cornwall. The responses were collated, including the list of all medical applications used. These were assessed using the Medicine & Healthcare Products Regulatory Agency (MHRA) "Medical device stand-alone software including apps" guidance. RESULTS: The response rate was 88/150 (59%) radiologists who responded with the majority 48/88 (54.4%) using apps. Forty-four of 66 (67%) states that they did not assess the reliability or accuracy of these devices prior to use with 71/81 (88%) indicating that they were unaware of any regulations. Thirty-three items were identified of which 27 functioning apps were identified and three of these were considered medical devices and did not have complete and recognisable CE marking as required by the MHRA. CONCLUSION: This study highlights that application use is widespread. The vast majority of these applications are not considered medical devices; however, there are some devices that, according to the MHRA flow chart, are used in a way that classifies them as medical devices and should therefore be CE marked. This highlights the need for guidance and regulation of the medical application market with recommendations provided.


Assuntos
Atitude do Pessoal de Saúde , Aplicativos Móveis/legislação & jurisprudência , Aplicativos Móveis/estatística & dados numéricos , Radiologistas/educação , Radiologia/educação , Humanos , Radiologistas/psicologia , Reprodutibilidade dos Testes , Inquéritos e Questionários/estatística & dados numéricos
3.
AJR Am J Roentgenol ; 217(5): 1232-1238, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34106755

RESUMO

Depositions are critical components of any medical malpractice lawsuit and seek to help uncover the facts of the case to allow justice to be served. Depositions often create considerable anxiety for physician-defendants, including radiologists. Defendants unfamiliar with the rules of questioning or interviewing techniques used by plaintiffs' attorneys may fail to appreciate important and nuanced details of questions from the plaintiff's attorney, which in turn could impact the outcome of the case. Thorough and informed deposition preparation is thus essential. Highlighting issues relevant to radiologist-defendants, we discuss the role and structure of medical malpractice depositions as well as common scenarios, lines of questioning, and attorney strategies.


Assuntos
Imperícia/legislação & jurisprudência , Radiologistas/psicologia , Radiologia/legislação & jurisprudência , Decepção , Humanos , Angústia Psicológica , Terminologia como Assunto , Revelação da Verdade , Estados Unidos
4.
Medicine (Baltimore) ; 100(23): e26270, 2021 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-34115023

RESUMO

ABSTRACT: The aim of this investigation was to compare the diagnostic performance of radiographers and deep learning algorithms in pulmonary nodule/mass detection on chest radiograph.A test set of 100 chest radiographs containing 53 cases with no pathology (normal) and 47 abnormal cases (pulmonary nodules/masses) independently interpreted by 6 trained radiographers and deep learning algorithems in a random order. The diagnostic performances of both deep learning algorithms and trained radiographers for pulmonary nodules/masses detection were compared.QUIBIM Chest X-ray Classifier, a deep learning through mass algorithm that performs superiorly to practicing radiographers in the detection of pulmonary nodules/masses (AUCMass: 0.916 vs AUCTrained radiographer: 0.778, P < .001). In addition, heat-map algorithm could automatically detect and localize pulmonary nodules/masses in chest radiographs with high specificity.In conclusion, the deep-learning based computer-aided diagnosis system through 4 algorithms could potentially assist trained radiographers by increasing the confidence and access to chest radiograph interpretation in the age of digital age with the growing demand of medical imaging usage and radiologist burnout.


Assuntos
Esgotamento Profissional/prevenção & controle , Competência Clínica , Aprendizado Profundo , Pulmão/diagnóstico por imagem , Nódulos Pulmonares Múltiplos/diagnóstico , Radiologistas , Nódulo Pulmonar Solitário/diagnóstico , Algoritmos , Esgotamento Profissional/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica/métodos , Radiografia Torácica/normas , Radiologistas/educação , Radiologistas/psicologia , Radiologistas/normas , Sensibilidade e Especificidade , Taiwan
5.
Pediatr Radiol ; 51(9): 1589-1596, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33988753

RESUMO

BACKGROUND: Work-related stress and burnout were documented to be high among pediatric radiologists prior to the coronavirus disease 2019 (COVID-19) pandemic. New challenges arose from the COVID-19 pandemic, potentially introducing new stressors and anxieties. OBJECTIVE: To evaluate potential sources of stress and anxiety for pediatric radiology faculty during the early phase of the COVID-19 pandemic. MATERIALS AND METHODS: We conducted a survey of attending physician members of the Society for Pediatric Radiology in North America from April 27, 2020, to May 22, 2020. The response rate was 21% (251/1,206). Survey questions included demographic information and questions regarding working remotely, personal protective equipment, redeployment, personal wellness, wellness resources and financial concerns. A psychometrician reviewed the questions to ensure minimal risk of misinterpretation. RESULTS: Median age of respondents was 48 years (range 33-70 years) with median number of years in practice of 14 (range 1-45 years). Fifty-three percent of respondents were women and 46% were men. Because of an increase in remote work, 69% of respondents endorsed feeling more isolated from a lack of regular interaction with colleagues. Fifty-three percent of respondents indicated that it is challenging to work remotely while overseeing home schooling for children. In comparison to men, women reported overall higher work-related stress and anxiety (P=0.02), higher feelings of guilt from radiology staff (i.e. technologists and nurses) being more exposed to COVID-19 (P=0.02) and higher levels of stress providing for dependents (P=0.04). Most respondents thought that departmental leadership was effective and respondents were not concerned about meeting financial obligations or job loss. CONCLUSION: The early phase of the COVID-19 pandemic caused additional stress and anxiety for pediatric radiology faculty and disproportionally affected women. Given the continuously evolving state of the COVID-19 pandemic, these results could aid in planning and implementation of future strategies to combat burnout in radiology. Specific attention should be directed to different stressors experienced by female versus male radiologists, especially in regard to dependent care.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , COVID-19/psicologia , Pediatria , Médicos/psicologia , Radiologistas/psicologia , Radiologia , Estresse Psicológico , Adulto , Idoso , Ansiedade/psicologia , COVID-19/epidemiologia , Criança , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , SARS-CoV-2 , Sociedades Médicas , Inquéritos e Questionários
6.
PLoS One ; 16(5): e0251889, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34010332

RESUMO

BACKGROUND AND PURPOSE: During a period of 6 months, we provided our entire neuroradiological staff including physicians, radiographers, and researchers with systematic feedback via email on the further clinical course of stroke patients who underwent mechanical thrombectomy. We analyzed the effects of this feedback on work satisfaction, work meaningfulness and valuation of the therapy among our staff. METHODS: Our staff completed two self-reported questionnaires before and after the period of six months with systematic feedback. RESULTS: Employees with higher work meaningfulness and higher work satisfaction valuated endovascular stroke therapy as more useful (p<0.001). A good clinical outcome was regarded more motivating than a good interventional outcome (p<0.001). Receiving systematic feedback did not increase work satisfaction (p = 0.318) or work meaningfulness (p = 0.178). Radiographers valuated the usefulness of interventional therapy the worst of all employees (p≤ 0.017). After the feedback period, 75% of radiographers estimated stroke as a more severe disease than before. Also, their desire for feedback decreased significantly (p = 0.007). Primarily patient cases with unfavorable outcomes were remembered by the staff. CONCLUSIONS: Systematic email feedback does not per se enhance work satisfaction or work meaningfulness among employees. However, receiving feedback is educative for the staff. Evaluating work satisfaction and the perception of treatment may help to identify unexpected issues and may therefore help to find specific measures that increase work satisfaction and motivation.


Assuntos
Feedback Formativo , Satisfação no Emprego , Médicos/psicologia , Radiologistas/psicologia , Pesquisadores/psicologia , Acidente Vascular Cerebral/cirurgia , Trombectomia/métodos , Idoso , Idoso de 80 Anos ou mais , Atitude do Pessoal de Saúde , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Autorrelato , Resultado do Tratamento
7.
PLoS One ; 16(5): e0250952, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33961635

RESUMO

The development of medical assisting tools based on artificial intelligence advances is essential in the global fight against COVID-19 outbreak and the future of medical systems. In this study, we introduce ai-corona, a radiologist-assistant deep learning framework for COVID-19 infection diagnosis using chest CT scans. Our framework incorporates an EfficientNetB3-based feature extractor. We employed three datasets; the CC-CCII set, the MasihDaneshvari Hospital (MDH) cohort, and the MosMedData cohort. Overall, these datasets constitute 7184 scans from 5693 subjects and include the COVID-19, non-COVID abnormal (NCA), common pneumonia (CP), non-pneumonia, and Normal classes. We evaluate ai-corona on test sets from the CC-CCII set, MDH cohort, and the entirety of the MosMedData cohort, for which it gained AUC scores of 0.997, 0.989, and 0.954, respectively. Our results indicates ai-corona outperforms all the alternative models. Lastly, our framework's diagnosis capabilities were evaluated as assistant to several experts. Accordingly, We observed an increase in both speed and accuracy of expert diagnosis when incorporating ai-corona's assistance.


Assuntos
COVID-19/diagnóstico , Aprendizado Profundo , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Área Sob a Curva , COVID-19/virologia , Bases de Dados Factuais , Humanos , Pneumonia/diagnóstico , Pneumonia/patologia , RNA Viral/análise , RNA Viral/metabolismo , Curva ROC , Radiologistas/psicologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética , SARS-CoV-2/isolamento & purificação , Sensibilidade e Especificidade
8.
J Med Radiat Sci ; 68(2): 111-120, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33590670

RESUMO

INTRODUCTION: Radiographers and radiation therapists are key patient-facing health practitioners supporting the delivery of optimal patient care during the COVID-19 pandemic. The aim of this research was to investigate the impact of COVID-19 on clinical service delivery and well-being of these healthcare professionals in Australia. METHODS: A cross-sectional online survey of Australian radiographers and radiation therapists was conducted in June-July 2020. The survey collected data on demographic characteristics, and the impact of COVID-19 on professional practice, infection control and workplace-related stress. RESULTS: A total of 218 responses were received. Changes in work hours (P < 0.001) and workload (P = 0.022) were experienced due to COVID-19. Diagnostic radiographers reported increased procedural pressure on mobile radiography, computed tomography and general radiography. For radiation therapists, most pressure included areas of simulation and linear accelerator. PPE was in short supply at the start of the pandemic, and at the time of the study, shortages were identified for all PPE items. There was no difference in PPE supply reported by diagnostic radiographers and radiation therapists except for hand sanitiser (P = 0.003). Respondents experienced increased personal stress (61.4%) and anxiety (58.2%) at work due to COVID-19. In addition, their work caused increased stress to their family, partners or friends (57.4%). CONCLUSIONS: COVID-19 has resulted in changes to clinical working patterns and service delivery. PPE shortages, as well as increased workplace-related stress, were identified. Workplaces should seek to mitigate the pandemic impact through the provision of adequate PPE for safe practice as well as implement strategies to support and enhance staff well-being.


Assuntos
COVID-19/psicologia , Radiologistas/psicologia , Estresse Psicológico/epidemiologia , Adulto , Austrália , COVID-19/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equipamento de Proteção Individual/provisão & distribuição , Admissão e Escalonamento de Pessoal , Inquéritos e Questionários
11.
CMAJ Open ; 9(1): E10-E18, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33436451

RESUMO

BACKGROUND: Burnout and distress have a negative impact on physicians and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among physicians in a cardiovascular centre of a quaternary hospital network in Canada, and compare these outcomes to those for physicians at academic health science centres (AHSCs) in the United States. METHODS: We conducted a survey of physicians practising in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, mental and physical quality of life, work-life integration, meaning in work and distress; a score of 3 or higher indicated high distress. We also evaluated physicians' perception of the adequacy of staffing levels and of fair treatment in the workplace, and satisfaction with the electronic health record. We carried out standard univariate statistical comparisons using the χ2, Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 3 or higher and demographic characteristics. We compared univariate associations among WBI data for physicians at AHSCs in the US who completed the WBI to responses from our participants. RESULTS: The response rate to the survey was 84.1% (127/151). Of the 127 respondents, 83 (65.4%) reported burnout in the previous month, and 68 (53.5%) reported emotional problems. Sixty-nine respondents (54.3%) had a WBI score of 3 or higher. Respondents were more likely to have a WBI score of 3 or higher versus a score less than 3 if they perceived insufficient staffing levels (52/69 [75%] v. 26/58 [45%], p = 0.02) or unfair treatment (23/69 [33%] v. 8/58 [14%], p = 0.03), or were anesthesiologists (26/35 [74%] v. 43/92 [47%] for other specialists, p = 0.005). Compared to 21 594 physicians in practice at AHSCs in the US, our respondents had a higher mean WBI score (2.4 v. 1.8, p = 0.004) and reported a higher prevalence of burnout (65.4% v. 56.6%, p = 0.048). INTERPRETATION: Physicians in this study had high levels of burnout and distress, driven by the perception of inadequate staffing levels and being treated unfairly in the workplace. Addressing these institutional factors may improve physicians' work experience and patient outcomes.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Institutos de Cardiologia , Depressão/epidemiologia , Fadiga/epidemiologia , Médicos/estatística & dados numéricos , Qualidade de Vida , Anestesiologistas/psicologia , Anestesiologistas/estatística & dados numéricos , Ansiedade/psicologia , Esgotamento Profissional/psicologia , Cardiologistas/psicologia , Cardiologistas/estatística & dados numéricos , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Satisfação no Emprego , Masculino , Sistemas Multi-Institucionais , Ontário/epidemiologia , Admissão e Escalonamento de Pessoal , Médicos/psicologia , Angústia Psicológica , Radiologistas/psicologia , Radiologistas/estatística & dados numéricos , Cirurgiões/psicologia , Cirurgiões/estatística & dados numéricos , Inquéritos e Questionários , Centros de Atenção Terciária , Cirurgia Torácica , Equilíbrio Trabalho-Vida
12.
Radiography (Lond) ; 27(2): 360-368, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33032889

RESUMO

INTRODUCTION: This study aimed to investigate the response of the radiology workforce to the impact of the coronavirus disease 2019 (COVID-19) pandemic on professional practice in India and eight other Middle Eastern and North African countries. It further investigated the levels of fear and anxiety among this workforce during the pandemic. METHODS: A quantitative cross-sectional study was conducted using an online survey from 22 May-2 June 2020 among radiology workers employed during the COVID-19 pandemic. The survey collected information related to the following themes: (1) demographic characteristics, (2) the impact of COVID-19 on radiology practice, and (3) fear and (4) anxiety emanating from the global pandemic. RESULTS: We received 903 responses. Fifty-eight percent had completed training on infection control required for handling COVID-19 patients. A large proportion (79.5%) of the respondents strongly agreed or agreed that personal protective equipment (PPE) was adequately available at work during the pandemic. The respondents reported experiences of work-related stress (42.9%), high COVID-19 fear score (83.3%) and anxiety (10%) during the study period. CONCLUSION: There was a perceived workload increase in general x-ray and Computed Tomography imaging procedures because they were the key modalities for the initial and follow-up investigations of COVID-19. However, there was adequate availability of PPE during the study period. Most radiology workers were afraid of being infected with the virus. Fear was predominant among workers younger than 30 years of age and also in temporary staff. Anxiety occurred completely independent of gender, age, experience, country, place of work, and work status. IMPLICATIONS FOR PRACTICE: It is important to provide training and regular mental health support and evaluations for healthcare professionals, including radiology workers, during similar future pandemics.


Assuntos
Ansiedade/etiologia , COVID-19/epidemiologia , Medo , Pandemias , Radiografia/psicologia , Radiologistas/psicologia , Adolescente , Adulto , África do Norte/epidemiologia , Atitude do Pessoal de Saúde , COVID-19/diagnóstico por imagem , COVID-19/transmissão , Estudos Transversais , Feminino , Humanos , Índia/epidemiologia , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional , Capacitação em Serviço , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , Estresse Ocupacional , Equipamento de Proteção Individual/provisão & distribuição , Radiologistas/educação , SARS-CoV-2 , Carga de Trabalho , Adulto Jovem
13.
Korean J Radiol ; 22(3): 297-307, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33289355

RESUMO

OBJECTIVE: To compare the performance of simulated abbreviated breast MRI (AB-MRI) and full diagnostic (FD)-MRI in distinguishing between benign and malignant lesions detected by MRI and investigate the features of discrepant lesions of the two protocols. MATERIALS AND METHODS: An AB-MRI set with single first postcontrast images was retrospectively obtained from an FD-MRI cohort of 111 lesions (34 malignant, 77 benign) detected by contralateral breast MRI in 111 women (mean age, 49.8. ± 9.8; range, 28-75 years) with recently diagnosed breast cancer. Five blinded readers independently classified the likelihood of malignancy using Breast Imaging Reporting and Data System assessments. McNemar tests and area under the receiver operating characteristic curve (AUC) analyses were performed. The imaging and pathologic features of the discrepant lesions of the two protocols were analyzed. RESULTS: The sensitivity of AB-MRI for lesion characterization tended to be lower than that of FD-MRI for all readers (58.8-82.4% vs. 79.4-100%), although the findings of only two readers were significantly different (p < 0.05). The specificity of AB-MRI for lesion characterization was higher than that of FD-MRI for 80% of readers (39.0-74.0% vs. 19.5-45.5%, p ≤ 0.001). The AUC of AB-MRI was comparable to that of FD-MRI for all readers (p > 0.05). Fifteen percent (5/34) of the cancers were false-negatives on AB-MRI. More suspicious margins or internal enhancement on the delayed phase images were related to the discrepancies. CONCLUSION: The overall performance of AB-MRI was similar to that of FD-MRI in distinguishing between benign and malignant lesions. AB-MRI showed lower sensitivity and higher specificity than FD-MRI, as 15% of the cancers were misclassified compared to FD-MRI.


Assuntos
Neoplasias da Mama/diagnóstico , Mama/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Radiologistas/psicologia , Adulto , Idoso , Área Sob a Curva , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Meios de Contraste/química , Feminino , Humanos , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade
14.
Strahlenther Onkol ; 197(5): 423-428, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33231713

RESUMO

PURPOSE: Stereotactic body radiation therapy (SBRT) is an effective treatment modality for inoperable early-stage lung cancer or metastatic lung lesions. Post-SBRT, acute radiological lung changes sometimes mimic tumor progression, so over-investigation may be applied. We aimed to reveal the interobserver agreement among physicians regarding acute radiographic changes on CT of the thorax obtained shortly after SBRT MATERIALS AND METHODS: Radiologic images of 20 lesions treated with SBRT were evaluated for acute lung changes. Two physicians, one senior and one junior, from diagnostic radiology, radiation oncology, nuclear medicine, and chest disease departments reviewed these images. The final interpretations were categorized as stable, regression/consolidation, progressive disease, and SBRT-related changes. The evaluations of the physicians were compared with the experienced reference radiation oncologist. The gold standard was accepted as the reference physician's final score. Unweighted Cohen's kappa (κ) coefficient was used for assessing interobserver agreement between physicians. RESULTS: The evaluations of the physicians were compared with the reference radiation oncologist. The strongest coherence coefficient was found with the senior radiation oncologist (κ: 0.72). The kappa coefficients between the junior radiation oncologist, junior nuclear medicine physician, and the reference physician were 0.61 and 0.55, respectively. The disciplines with the lowest kappa coefficients were junior chest disease and senior radiologist, and the kappa values were 0.37 and 0.44, respectively. CONCLUSION: Disciplines dealing with lung cancer treatment may not be aware of the various radiologic changes after SBRT or inexperienced in interpreting them from recurrence. Therefore, physicians must have detailed radiotherapy information such as planning target volume (PTV), dose/fractionation, etc. In addition, final evaluations should be performed in the multidisciplinary team dealing with the treatment of the patient.


Assuntos
Pulmão/efeitos da radiação , Variações Dependentes do Observador , Médicos/psicologia , Radiocirurgia , Tórax/efeitos da radiação , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/secundário , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Tomografia Computadorizada Quadridimensional , Humanos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Medicina Nuclear , Posicionamento do Paciente , Pneumologia , Radioterapia (Especialidade) , Radiologistas/psicologia , Radiocirurgia/efeitos adversos , Estudos Retrospectivos , Tórax/diagnóstico por imagem
15.
Cardiovasc Intervent Radiol ; 44(1): 127-133, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33078233

RESUMO

PURPOSE: To characterize perceptions of palliative versus futile care in interventional radiology (IR) as a roadmap for quality improvement. METHODS: Interventional radiologists (IRs) and referring physicians were recruited for anonymous interviews and/or focus groups to discuss their perceptions and experiences related to palliative verse futile care in IR. Sessions were recorded, transcribed, and systematically analyzed using dedicated software, content analysis, and grounded theory. Data collection and analysis continued simultaneously until additional interviews stopped revealing new themes: 24 IRs (21 males, 3 females, 1-39 years of experience) and 7 referring physicians (3 males, 4 females, 6-14 years of experience) were analyzed. RESULTS: Many IRs (75%) perceived futility as an important issue. Years of experience (r = 0.60, p = 0.03) and being in academics (r = 0.62, p = 0.04) correlated with greater perceived importance. Perceptions of futility and whether a potentially inappropriate procedure was performed involved a balance between four sets of factors (patient, clinician, procedural, and cultural). These assessments tended to be qualitative in nature and are challenged by a lack of data, education, and consistent workflows. Referring clinicians were unaware of this issue and assumed IR had guidelines for differentiating between palliation and futility. CONCLUSION: This study characterized the complexity and qualitative nature of assessments of palliative verses futile care in IR while highlighting potential means of improving current practices. This is important given the number of critically ill patients referred to IR and costs of potentially inappropriate interventions.


Assuntos
Futilidade Médica/psicologia , Percepção , Radiologistas/psicologia , Radiologia Intervencionista/educação , Encaminhamento e Consulta , Feminino , Humanos , Masculino
18.
AJR Am J Roentgenol ; 215(6): 1549-1550, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33052733

RESUMO

OBJECTIVE. The purpose of this article is to help radiologists achieve a balance between narrow and broad perspectives in their work. CONCLUSION. There are two fundamentally different perspectives from which radiologists can work: narrow and broad. Both have important roles, yet if the balance between these perspectives shifts excessively in one direction or the other, problems can arise. By understanding the respective strengths and weaknesses of each perspective, radiologists can achieve a more appropriate balance between them.


Assuntos
Atitude do Pessoal de Saúde , Padrões de Prática Médica , Prática Profissional , Radiologistas/psicologia , Humanos
19.
Proc Natl Acad Sci U S A ; 117(41): 25935-25941, 2020 10 13.
Artigo em Inglês | MEDLINE | ID: mdl-32999072

RESUMO

Diagnostic radiologists are experts in discriminating and classifying medical images for clinically significant anomalies. Does their perceptual expertise confer an advantage in unfamiliar visual tasks? Here, this issue was investigated by comparing the performance of 10 radiologists and 2 groups of novices on the ability to detect novel visual signals: band-limited textures in noise. Observers performed a yes/no detection task in which texture spatial frequency and external noise levels were varied. The task was performed on two consecutive days. Contrast thresholds and response bias were measured. Contrast thresholds of radiologists were superior to the control groups in all stimulus conditions on both days. Performance improved by an equivalent amount for all groups across days. Response bias differed consistently across stimulus conditions and days but not across groups. The difference in thresholds between the radiologists and control groups suggests that experience in diagnostic medical imaging produces perceptual skills that that transfer beyond the trained domain.


Assuntos
Reconhecimento Visual de Modelos , Radiologistas/psicologia , Adulto , Feminino , Humanos , Ruído , Adulto Jovem
20.
Eur J Radiol ; 132: 109285, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32957001

RESUMO

PURPOSE: The COVID-19 pandemic has led to an urgent reorganisation of the healthcare system to prevent hospitals from overflowing and the virus from spreading. Our objective was to evaluate the socioeconomic and psychological impact of the COVID-19 outbreak on radiologists. MATERIAL AND METHODS: French radiologists were invited to answer an online survey during the pandemic through mailing lists. The questionnaire was accessible for nine days. It covered socio-demographic information, exposure to COVID-19 at work and impact on work organisation, and included the Insomnia Severity Index and Hospital Anxiety and Depression Scale. Outcomes were moderate to severe insomnia, definite symptoms of depression or anxiety. Risk and protective factors were identified through multivariate binary logistic regression. RESULTS: 1515 radiologists answered the survey. Overall, 674 (44.5 %) worked in a highCOVID-19 density area, 671 (44.3 %) were women, and 809 (53.4 %) worked in private practice. Among responders, 186 (12.3 %) expressed insomnia, 222 (14.6 %) anxiety, and 189 (12.5 %) depression symptoms. Lack of protective equipment, increased teleradiology activity and negative impact on education were risk factors for insomnia (respectively OR [95 %CI]:1.7[1.1-2.7], 1.5[1.1-2.2], and 2.5[1.8-3.6]). Female gender, respiratory history, working in COVID-19 high density area, increase of COVID-19 related activity, and impacted education were risk factors for anxiety (OR[95 %CI]:1.7[1.2-2.3], 2[1.1-3.4], 1.5[1.1-2], 1.2[1-1.4], and 2.1[1.5-3]). Conversely, working in a public hospital was a protective factor against insomnia, anxiety, and depression (OR[95 %CI]:0.4[0.2-0.7], 0.6[0.4-0.9], and 0.5[0.3-0.8]). CONCLUSIONS: During COVID-19 pandemic, many radiologists expressed depression, anxiety and insomnia symptoms. Working in a public hospital was a protective factor against every psychological symptom. Socio-economic impact was also major especially in private practice.


Assuntos
Infecções por Coronavirus/economia , Infecções por Coronavirus/psicologia , Hospitais Públicos/economia , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/psicologia , Prática Privada/economia , Radiologistas/economia , Radiologistas/psicologia , Fatores Socioeconômicos , Adulto , Betacoronavirus , COVID-19 , Feminino , França , Hospitais Públicos/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prática Privada/estatística & dados numéricos , Radiologistas/estatística & dados numéricos , Fatores de Risco , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
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