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Ghoshal S, Stovall N, King AH, Miller AS, Harris MB, Succi MD. Orthopedic Surgery Volume Trends During the COVID-19 Pandemic and Postvaccination Era: Implications for Healthcare Planning. J Arthroplasty 2024; 39:1959-1966.e1. [PMID: 38513749 DOI: 10.1016/j.arth.2024.03.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/10/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) pandemic decreased surgical volumes, but prior studies have not investigated recovery through 2022, or analyzed specific procedures or cases of urgency within orthopedic surgery. The aims of this study were to (1) quantify the declines in orthopedic surgery volume during and after the pandemic peak, (2) characterize surgical volume recovery during the postvaccination period, and (3) characterize recovery in the 1-year postvaccine release period. METHODS We conducted a retrospective cohort study of 27,476 orthopedic surgeries from January 2019 to December 2022 at one urban academic quaternary referral center. We reported trends over the following periods: baseline pre-COVID-19 period (1/6/2019 to 1/4/2020), COVID-19 peak (3/15/2020 to 5/16/2020), post-COVID-19 peak (5/17/2020 to 1/2/2021), postvaccine release (1/3/2021 to 1/1/2022), and 1-year postvaccine release (1/2/2022 to 12/30/2022). Comparisons were performed with 2 sample t-tests. RESULTS Pre-COVID-19 surgical volume fell by 72% at the COVID-19 peak, especially impacting elective procedures (P < .001) and both hip and knee joint arthroplasty (P < .001) procedures. Nonurgent (P = .024) and urgent or emergency (P = .002) cases also significantly decreased. Postpeak recovery before the vaccine saw volumes rise to 92% of baseline, which further rose to 96% and 94% in 2021 and 2022, respectively. While elective procedures surpassed the baseline in 2022, nonurgent and urgent or emergency surgeries remained low. CONCLUSIONS The COVID-19 pandemic substantially reduced orthopedic surgical volumes, which have still not fully recovered through 2022, particularly nonelective procedures. The differential recovery within an orthopedic surgery program may result in increased morbidity and can serve to inform department-level operational recovery.
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Affiliation(s)
- Soham Ghoshal
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Nasir Stovall
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Alexander H King
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Amitai S Miller
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
| | - Mitchel B Harris
- Harvard Medical School, Boston, Massachusetts; Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Marc D Succi
- Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts
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Crombé A, Lecomte JC, Seux M, Banaste N, Gorincour G. Using the Textual Content of Radiological Reports to Detect Emerging Diseases: A Proof-of-Concept Study of COVID-19. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024; 37:620-632. [PMID: 38343242 PMCID: PMC11031522 DOI: 10.1007/s10278-023-00949-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 04/20/2024]
Abstract
Changes in the content of radiological reports at population level could detect emerging diseases. Herein, we developed a method to quantify similarities in consecutive temporal groupings of radiological reports using natural language processing, and we investigated whether appearance of dissimilarities between consecutive periods correlated with the beginning of the COVID-19 pandemic in France. CT reports from 67,368 consecutive adults across 62 emergency departments throughout France between October 2019 and March 2020 were collected. Reports were vectorized using time frequency-inverse document frequency (TF-IDF) analysis on one-grams. For each successive 2-week period, we performed unsupervised clustering of the reports based on TF-IDF values and partition-around-medoids. Next, we assessed the similarities between this clustering and a clustering from two weeks before according to the average adjusted Rand index (AARI). Statistical analyses included (1) cross-correlation functions (CCFs) with the number of positive SARS-CoV-2 tests and advanced sanitary index for flu syndromes (ASI-flu, from open-source dataset), and (2) linear regressions of time series at different lags to understand the variations of AARI over time. Overall, 13,235 chest CT reports were analyzed. AARI was correlated with ASI-flu at lag = + 1, + 5, and + 6 weeks (P = 0.0454, 0.0121, and 0.0042, respectively) and with SARS-CoV-2 positive tests at lag = - 1 and 0 week (P = 0.0057 and 0.0001, respectively). In the best fit, AARI correlated with the ASI-flu with a lag of 2 weeks (P = 0.0026), SARS-CoV-2-positive tests in the same week (P < 0.0001) and their interaction (P < 0.0001) (adjusted R2 = 0.921). Thus, our method enables the automatic monitoring of changes in radiological reports and could help capturing disease emergence.
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Affiliation(s)
- Amandine Crombé
- IMADIS, Lyon, France.
- SARCOTARGET Team, University of Bordeaux, Inserm, UMR1312, BRIC, BoRdeaux Institute of Oncology, 146 Rue Léo Saignat, Bordeaux, F-33076, France.
- Department of Radiology, Pellegrin University Hospital, CHU Bordeaux, Place Amélie Raba-Léon, Bordeaux, F-33076, France.
| | - Jean-Christophe Lecomte
- IMADIS, Lyon, France
- Centre Aquitain d'Imagerie médicale, Mérignac, France
- Centre Hospitalier de Saintes, Saintes, France
- Clinique Mutualiste Bordeaux Pessac, Pessac, France
| | | | - Nathan Banaste
- IMADIS, Lyon, France
- Clinique Convert, Ramsay, Bourg en Bresse, France
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Rigney GH, King AH, Chung J, Ghoshal S, Jain A, Shi Z, Razak S, Hirsch JA, Lev MH, Buch K, Succi MD. Trends in non-focal neurological chief complaints and CT angiography utilization among adults in the emergency department. Intern Emerg Med 2024:10.1007/s11739-024-03569-9. [PMID: 38512433 DOI: 10.1007/s11739-024-03569-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/22/2024] [Indexed: 03/23/2024]
Abstract
Prudent imaging use is essential for cost reduction and efficient patient triage. Recent efforts have focused on head and neck CTA in patients with emergent concerns for non-focal neurological complaints, but have failed to demonstrate whether increases in utilization have resulted in better care. The objective of this study was to examine trends in head and neck CTA ordering and determine whether a correlation exists between imaging utilization and positivity rates. This is a single-center retrospective observational study at a quaternary referral center. This study includes patients presenting with headache and/or dizziness to the emergency department between January 2017 and December 2021. Patients who received a head and neck CTA were compared to those who did not. The main outcomes included annual head and neck CTA utilization and positivity rates, defined as the percent of scans with attributable acute pathologies. Among 24,892 emergency department visits, 2264 (9.1%) underwent head and neck CTA imaging. The percentage of patients who received a scan over the study period increased from 7.89% (422/5351) in 2017 to 13.24% (662/5001) in 2021, representing a 67.4% increase from baseline (OR, 1.14; 95% CI 1.11-1.18; P < .001). The positivity rate, or the percentage of scans ordered that revealed attributable acute pathology, dropped from 16.8% (71/422) in 2017 to 10.4% (69/662) in 2021 (OR, 0.86; 95% CI 0.79-0.94; P = .001), a 38% reduction in positive examinations. Throughout the study period, there was a 67.4% increase in head and neck CTA ordering with a concomitant 38.1% decrease in positivity rate.
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Affiliation(s)
- Grant H Rigney
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Alexander H King
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Janice Chung
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Soham Ghoshal
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Aditya Jain
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Zhuo Shi
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Shahaan Razak
- Harvard Medical School, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Joshua A Hirsch
- Harvard Medical School, Boston, USA
- Department of Radiology, Massachusetts General Hospital, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Michael H Lev
- Harvard Medical School, Boston, USA
- Department of Radiology, Massachusetts General Hospital, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Karen Buch
- Harvard Medical School, Boston, USA
- Department of Radiology, Massachusetts General Hospital, Boston, USA
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA
| | - Marc D Succi
- Harvard Medical School, Boston, USA.
- Department of Radiology, Massachusetts General Hospital, Boston, USA.
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, USA.
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Goldfarb JW, Mossa-Basha M, Nguyen KL, Hecht EM, Finn JP. Trends in magnetic resonance and computed tomography angiography utilization among Medicare beneficiaries between 2013 and 2020. Clin Imaging 2024; 107:110088. [PMID: 38277858 DOI: 10.1016/j.clinimag.2024.110088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
PURPOSE To evaluate relative and absolute utilization trends and practice patterns in the United States for MRA and CTA. METHODS Using Medicare Part B physician payment databases (2013-2020), MRA and CTA interpreting physicians and exams were identified using the unique MRA and CTA Healthcare Common Procedure Coding System codes. The number of exams, physicians, demographics, use of contrast, and payments were summarized annually and analyzed to evaluate trends before and during the first year of the COVID-19 pandemic. RESULTS From 2013 to 2019, the annual number of MRA exams performed decreased by 17.9 %, while the number of CTA exams increased by 90.3 %. The number of physicians interpreting MRA decreased in both hospital (-17.2 %) and outpatient (-7.5 %) environments. The number of physicians interpreting CTA increased in both hospital (+29.4 %) and outpatient (+54.3 %) environments. During the first year of the COVID-19 pandemic, MRA utilization decreased across all imaging environments by 25.0 % whereas CTA only decreased by 5.5 %. Intracranial MRA studies were most often performed without contrast, while contrast use for neck MRA was performed at similar rates as non-contrast exams. CONCLUSION The overall utilization of MRA and the number of interpreting physicians are decreasing. On the other hand, CTA use and its number of interpreting physicians are increasing. During the first year of the COVID-19 pandemic, use of both MRA and CTA decreased, but the utilization of MRA decreased at five times the rate of CTA.
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Affiliation(s)
- James W Goldfarb
- Division of Cardiovascular Imaging, St. Francis Hospital and Heart Center, Roslyn, NY, USA.
| | - Mahmud Mossa-Basha
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kim-Lien Nguyen
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Division of Cardiology, David Geffen School of Medicine at UCLA, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | | | - J Paul Finn
- Diagnostic Cardiovascular Imaging Research Laboratory, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Shubayr N. Investigation of the Radiographic Imaging Volume and Occupational Dose of Radiologic Technologists before and during the COVID-19 Pandemic. HEALTH PHYSICS 2023; 125:362-368. [PMID: 37548570 DOI: 10.1097/hp.0000000000001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
ABSTRACT This study aimed to assess occupational radiation doses for radiologic technologists (RTs) in Saudi Arabia shortly before and during the COVID-19 pandemic, considering changes in imaging volume during that time. This retrospective study included the imaging volume data and the RTs' occupational dose records from a central hospital for 2019 and 2020. The occupational dose-in terms of annual and quarterly mean effective doses (AMEDs and QMEDs)-was estimated for 115 RTs using thermoluminescent dosimeter records. There was a 22% increase in the AMED in 2020 compared with 2019, though the overall imaging volume decreased by 9% in 2020. The percentage changes in AMEDs between 2019 and 2020 for general radiography (GR), computed tomography (CT), interventional radiology (IR), nuclear medicine (NM), and mammography (MG) were 45%, 56%, 9%, 18% and -2%, respectively. The highest contribution to AMEDs in 2020 for modalities was due to GR and CT procedures, accounting for 0.50 mSv and 0.58 mSv, respectively. The percentage change in imaging volumes between 2019 and 2020 depicted a slight decrease in Q2 (-1%) and a substantial decrease in Q1 (-10%), Q3 (-12%), and Q4 (-11%) for 2020. The overall percentage changes in imaging volumes in 2020 for GR (conventional and mobile), CT, IR, NM, and MG were -7% (-19% and 48%), -11%, 13%, -26%, and -46%, respectively. Investigating the changes in 2020 by comparing Q1 of 2020 (before the pandemic restrictions) with Q2 (during the pandemic restrictions and changes in workflow) revealed that the QMED during Q2 increased by 5% with a 17.4% decrease in the imaging volume. However, CT procedures were increased by 11.1% during the pandemic restrictions in Q2 of 2020, with an increase in the corresponding QMED of 66%. Moreover, mobile GR procedures increased by 21% in Q2 of 2020 compared to Q1. This study indicated the impact of the COVID-19 pandemic on imaging volume and occupational dose. Overall, the study observed a decrease in the imaging volume and an increase in RTs' effective doses by 2020. However, there was an increase in mobile GR and CT examinations during the COVID-19 pandemic restrictions in 2020. This study suggested that the increased mobile GR and CT examinations contributed to greater effective doses for RTs in 2020.
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Affiliation(s)
- Nasser Shubayr
- Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
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Rao A, Kim J, Kamineni M, Pang M, Lie W, Dreyer KJ, Succi MD. Evaluating GPT as an Adjunct for Radiologic Decision Making: GPT-4 Versus GPT-3.5 in a Breast Imaging Pilot. J Am Coll Radiol 2023; 20:990-997. [PMID: 37356806 PMCID: PMC10733745 DOI: 10.1016/j.jacr.2023.05.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/16/2023] [Accepted: 05/23/2023] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Despite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT (Generative Pre-trained Transformer)-3.5 and GPT-4's (OpenAI, San Francisco, California) capacity for clinical decision support in radiology via the identification of appropriate imaging services for two important clinical presentations: breast cancer screening and breast pain. METHODS We compared ChatGPT's responses to the ACR Appropriateness Criteria for breast pain and breast cancer screening. Our prompt formats included an open-ended (OE) and a select all that apply (SATA) format. Scoring criteria evaluated whether proposed imaging modalities were in accordance with ACR guidelines. Three replicate entries were conducted for each prompt, and the average of these was used to determine final scores. RESULTS Both ChatGPT-3.5 and ChatGPT-4 achieved an average OE score of 1.830 (out of 2) for breast cancer screening prompts. ChatGPT-3.5 achieved a SATA average percentage correct of 88.9%, compared with ChatGPT-4's average percentage correct of 98.4% for breast cancer screening prompts. For breast pain, ChatGPT-3.5 achieved an average OE score of 1.125 (out of 2) and a SATA average percentage correct of 58.3%, as compared with an average OE score of 1.666 (out of 2) and a SATA average percentage correct of 77.7%. DISCUSSION Our results demonstrate the eventual feasibility of using large language models like ChatGPT for radiologic decision making, with the potential to improve clinical workflow and responsible use of radiology services. More use cases and greater accuracy are necessary to evaluate and implement such tools.
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Affiliation(s)
- Arya Rao
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - John Kim
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Meghana Kamineni
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Michael Pang
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Winston Lie
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Keith J Dreyer
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; and Chief Data Science Officer and Chief Imaging Information Officer for Mass General Brigham, Boston, Massachusetts
| | - Marc D Succi
- Harvard Medical School, Boston, Massachusetts; Medically Engineered Solutions in Healthcare, Innovation in Operations Research Center and Associate Chair of Innovation & Commercialization, Mass General Brigham Enterprise Radiology; Executive Director, MESH Incubator. Massachusetts General Hospital, Boston, Massachusetts; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
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Collins BW, Robart A, Lockyer EJ, Fairbridge NA, Rector T, Hartery A. Effect of the COVID-19 pandemic on emergency department utilization of computed tomography scans of appendicitis and diverticulitis. Emerg Radiol 2023; 30:297-306. [PMID: 36988852 PMCID: PMC10054211 DOI: 10.1007/s10140-023-02125-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/10/2023] [Indexed: 03/30/2023]
Abstract
PURPOSE Investigating the effect of the COVID-19 lockdown on adult patient visits, computed tomography (CT) abdominal scans, and presentations of appendicitis and diverticulitis, to emergency departments (ED) in St. John's NL. METHODS A retrospective quantitative analysis was applied, using ED visits and Canadian Triage and Acuity Scale (CTAS) scores. mPower (Nuance Communications, UK) identified CT abdominal scan reports, which were categorized into (1) normal/other, (2) appendicitis, or (3) diverticulitis. Time intervals included pre-lockdown (January-February), lockdown (March-June), and post-lockdown (July-August). Data from 2018 to 2019 (January-August) were used to generate expected patient volumes for 2020, and pre- and post-lockdown were included to control for other variables outside the lockdown. RESULTS Chi-squared goodness of fit tested for deviations from predicted means for 2018-2019. Compared to expectations, daily ED visits from January to August 2020 showed a significant (p < 0.001) decrease in patient volumes independent of gender, age, and CTAS scores. During and post-lockdown, CT abdominal scans did not drop in proportion to patient volume. Appendicitis presentations remained indifferent to lockdown, while diverticulitis presentations appeared to wane, with no difference in combined complicated cases in comparison to what was expected. CONCLUSION During lockdown, significantly fewer patients presented to the ED. The proportion of ordered CT abdominal scans increased significantly per person seen, without change in CTAS scores. Considering combined pathology cases increased during the lockdown, ED physicians were warranted in increasing abdominal imaging as patients did not avoid the ED. This may have resulted from a change in clinical practice where the uncertainty of COVID-19 increased CT scan usage.
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Affiliation(s)
| | - Andrew Robart
- Faculty of Medicine, Memorial University, St. John's, Canada
| | | | | | - Tara Rector
- Faculty of Medicine, Memorial University, St. John's, Canada
| | - Angus Hartery
- Faculty of Medicine, Memorial University, St. John's, Canada.
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An TJ, Kim N, King AH, Panzarini B, Little BP, Goiffon RJ, Meyersohn N, Garrana S, Stowell J, Saini S, Ghoshhajra BB, Hedgire S, Succi MD. Trends in coronary calcium score and coronary CT angiography imaging volume during the COVID-19 pandemic. Curr Probl Diagn Radiol 2023; 52:175-179. [PMID: 36473800 PMCID: PMC9673185 DOI: 10.1067/j.cpradiol.2022.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/10/2022] [Accepted: 11/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The COVID-19 pandemic disrupted the delivery of preventative care and management of acute diseases. This study assesses the effect of the COVID-19 pandemic on coronary calcium score and coronary CT angiography imaging volume. MATERIALS AND METHODS A single institution retrospective review of consecutive patients presenting for coronary calcium score or coronary CT angiography examinations between January 1, 2020 to January 4, 2022 was performed. The weekly volume of calcium score and coronary CT angiogram exams were compared. RESULTS In total, 1,817 coronary calcium score CT and 5,895 coronary CT angiogram examinations were performed. The average weekly volume of coronary CTA and coronary calcium score CT exams decreased by up to 83% and 100%, respectively, during the COVID-19 peak period compared to baseline (P < 0.0001). The post-COVID recovery through 2020 saw weekly coronary CTA volumes rebound to 86% of baseline (P = 0.024), while coronary calcium score CT volumes remained muted at only a 53% recovery (P < 0.001). In 2021, coronary CTA imaging eclipsed pre-COVID rates (P = 0.012), however coronary calcium score CT volume only reached 67% of baseline (P < 0.001). CONCLUSIONS A significant decrease in both coronary CTA and coronary calcium score CT volume occurred during the peak-COVID-19 period. In 2020 and 2021, coronary CTA imaging eventually superseded baseline rates, while coronary calcium score CT volumes only reached two thirds of baseline. These findings highlight the importance of resumption of screening exams and should prompt clinicians to be aware of potential undertreatment of patients with coronary artery disease.
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Affiliation(s)
- Thomas J An
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Nicole Kim
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Alexander H King
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Bruno Panzarini
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Brent P Little
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Reece J Goiffon
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Nandini Meyersohn
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sherief Garrana
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Justin Stowell
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sanjay Saini
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA
| | - Brian B Ghoshhajra
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Sandeep Hedgire
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA
| | - Marc D Succi
- Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Boston, MA; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA.
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9
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Cheng D, Ghoshal S, Zattra O, Flash M, Lang M, Liu R, Lev MH, Hirsch JA, Saini S, Gee MS, Succi MD. Trends in oncological imaging during the COVID-19 pandemic through the vaccination era. Cancer Med 2023; 12:9902-9911. [PMID: 36775966 PMCID: PMC10166903 DOI: 10.1002/cam4.5678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/22/2023] [Accepted: 01/31/2023] [Indexed: 02/14/2023] Open
Abstract
BACKGROUND This study examines the impact that the COVID-19 pandemic has had on computed tomography (CT)-based oncologic imaging utilization. METHODS We retrospectively analyzed cancer-related CT scans during four time periods: pre-COVID (1/5/20-3/14/20), COVID peak (3/15/20-5/2/20), post-COVID peak (5/3/20-12/19/20), and vaccination period (12/20/20-10/30/21). We analyzed CTs by imaging indication, setting, and hospital type. Using percentage decrease computation and Student's t-test, we calculated the change in mean number of weekly cancer-related CTs for all periods compared to the baseline pre-COVID period. This study was performed at a single academic medical center and three affiliated hospitals. RESULTS During the COVID peak, mean CTs decreased (-43.0%, p < 0.001), with CTs for (1) cancer screening, (2) initial workup, (3) cancer follow-up, and (4) scheduled surveillance of previously treated cancer dropping by 81.8%, 56.3%, 31.7%, and 45.8%, respectively (p < 0.001). During the post-COVID peak period, cancer screenings and initial workup CTs did not return to prepandemic imaging volumes (-11.4%, p = 0.028; -20.9%, p = 0.024). The ED saw increases in weekly CTs compared to prepandemic levels (+31.9%, p = 0.008), driven by increases in cancer follow-up CTs (+56.3%, p < 0.001). In the vaccination period, cancer screening CTs did not recover to baseline (-13.5%, p = 0.002) and initial cancer workup CTs doubled (+100.0%, p < 0.001). The ED experienced increased cancer-related CTs (+75.9%, p < 0.001), driven by cancer follow-up CTs (+143.2%, p < 0.001) and initial workups (+46.9%, p = 0.007). CONCLUSIONS AND RELEVANCE The pandemic continues to impact cancer care. We observed significant declines in cancer screening CTs through the end of 2021. Concurrently, we observed a 2× increase in initial cancer workup CTs and a 2.4× increase in cancer follow-up CTs in the ED during the vaccination period, suggesting a boom of new cancers and more cancer examinations associated with emergency level acute care.
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Affiliation(s)
- Debby Cheng
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Soham Ghoshal
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ottavia Zattra
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Moses Flash
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Min Lang
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Raymond Liu
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael H Lev
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Joshua A Hirsch
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sanjay Saini
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael S Gee
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marc D Succi
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
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10
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Rizzetto F, Gnocchi G, Travaglini F, Di Rocco G, Rizzo A, Carbonaro LA, Vanzulli A. Impact of COVID-19 Pandemic on the Workload of Diagnostic Radiology: A 2-Year Observational Study in a Tertiary Referral Hospital. Acad Radiol 2023; 30:276-284. [PMID: 35781400 PMCID: PMC9186449 DOI: 10.1016/j.acra.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 01/11/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate the impact of COVID-19 pandemic on diagnostic imaging workload in a tertiary referral hospital. MATERIALS AND METHODS Radiological examinations performed in pre-pandemic period (2015-2019) and in pandemic period (2020-2021) were retrospectively included. Based on epidemiological data and restriction measures, four pandemic waves were identified. For each of them, the relative change (RC) in workload was calculated and compared to the 5-year averaged workload in the corresponding pre-COVID-19 periods. Workload variations were also assessed according to technique (radiographs, CT, MRI, ultrasounds), body district (chest, abdomen, breast, musculoskeletal, head/neck, brain/spine, cardiovascular) and care setting (inpatient, outpatient, emergency imaging, pre-admission imaging). RESULTS A total of 1384380 examinations were included. In 2020 imaging workload decreased (RC = -11%) compared to the average of the previous 5 years, while in 2021 only a minimal variation (RC = +1%) was observed. During first wave, workload was reduced for all modalities, body regions and types of care setting (RC from -86% to -10%), except for CT (RC = +3%). In subsequent waves, workload increased only for CT (mean RC = +18%) and, regarding body districts, for breast (mean RC = +23%) and cardiovascular imaging (mean RC = +23%). For all other categories, a workload comparable to pre-pandemic period was almost only restored in the fourth wave. In all pandemics periods workload decrease was mainly due to reduced outpatient activity (p < 0.001), while inpatient and emergency imaging was increased (p < 0.001). CONCLUSION Evaluating imaging workload changes throughout COVID-19 pandemic helps to understand the response dynamics of radiological services and to improve institutional preparedness to face extreme contingency.
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Affiliation(s)
- Francesco Rizzetto
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy.
| | - Giulia Gnocchi
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Francesca Travaglini
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Gabriella Di Rocco
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Aldo Rizzo
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Luca Alessandro Carbonaro
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
| | - Angelo Vanzulli
- Department of Radiology (F.R., G.G., F.T., G.D.R., A.R., L.A.C., A.V.), ASST Grande Ospedale Metropolitano Niguarda, Piazza Ospedale Maggiore 3, 20162, Milan, Italy; Postgraduation School of Diagnostic and Interventional Radiology (F.R., G.G., G.D.R., A.R.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy; Department of Oncology and Hemato-Oncology (L.A.C., A.V.), University of Milan, via Festa del Perdono 7, 20122, Milan, Italy
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11
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Chan A, Flash MJ, Guo T, Zattra O, Boms O, Succi MD, Hirsch JA. Trends in Academic Productivity Among Radiologists During the COVID-19 Pandemic. J Am Coll Radiol 2023; 20:276-281. [PMID: 36496090 PMCID: PMC9729584 DOI: 10.1016/j.jacr.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE There is a scarcity of literature examining changes in radiologist research productivity during the COVID-19 pandemic. The current study aimed to investigate changes in academic productivity as measured by publication volume before and during the COVID-19 pandemic. METHODS This single-center, retrospective cohort study included the publication data of 216 researchers consisting of associate professors, assistant professors, and professors of radiology. Wilcoxon's signed-rank test was used to identify changes in publication volume between the 1-year-long defined prepandemic period (publications between May 1, 2019, and April 30, 2020) and COVID-19 pandemic period (May 1, 2020, to April 30, 2021). RESULTS There was a significantly increased mean annual volume of publications in the pandemic period (5.98, SD = 7.28) compared with the prepandemic period (4.98, SD = 5.53) (z = -2.819, P = .005). Subset analysis demonstrated a similar (17.4%) increase in publication volume for male researchers when comparing the mean annual prepandemic publications (5.10, SD = 5.79) compared with the pandemic period (5.99, SD = 7.60) (z = -2.369, P = .018). No statistically significant changes were found in similar analyses with the female subset. DISCUSSION Significant increases in radiologist publication volume were found during the COVID-19 pandemic compared with the year before. Changes may reflect an overall increase in academic productivity in response to clinical and imaging volume ramp down.
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Affiliation(s)
- Alex Chan
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Moses J.E. Flash
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Teddy Guo
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Ottavia Zattra
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Okechi Boms
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; and Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
| | - Marc D. Succi
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Associate Chair, Innovation and Commercialization, Mass General Brigham Enterprise Radiology; and Member, ACR Economics Committee,Corresponding authors and reprints: Marc D. Succi, MD, Massachusetts General Hospital, Department of Radiology, 55 Fruit Street, Boston, MA 02114
| | - Joshua A. Hirsch
- Medically Engineered Solutions in Healthcare Incubator, Innovations in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Vice Chair Procedural Services, Director Interventional Neuroradiology, Chief Interventional Spine, Associate Department Quality Chair at Massachusetts General Hospital; Councilor to the ACR for Society of NeuroInterventional Surgery; Chair, Future Trends and Academic Committees ACR; Deputy Editor; JNIS; and Senior Affiliate Research Fellow, Neiman Health Policy Institute Joint Grant Program,Joshua A. Hirsch, MD, Massachusetts General Hospital, Department of Radiology, 55 Fruit Street, Boston, MA 02114
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12
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Li T, Nickel B, Ngo P, McFadden K, Brennan M, Marinovich ML, Houssami N. A systematic review of the impact of the COVID-19 pandemic on breast cancer screening and diagnosis. Breast 2023; 67:78-88. [PMID: 36646004 PMCID: PMC9813855 DOI: 10.1016/j.breast.2023.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/27/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Breast cancer care has been affected by the COVID-19 pandemic. This systematic review aims to describe the observed pandemic-related changes in clinical and health services outcomes for breast screening and diagnosis. METHODS Seven databases (January 2020-March 2021) were searched to identify studies of breast cancer screening or diagnosis that reported observed outcomes before and related to the pandemic. Findings were presented using a descriptive and narrative approach. RESULTS Seventy-four studies were included in this systematic review; all compared periods before and after (or fluctuations during) the pandemic. None were assessed as being at low risk of bias. A reduction in screening volumes during the pandemic was found with over half of studies reporting reductions of ≥49%. A majority (66%) of studies reported reductions of ≥25% in the number of breast cancer diagnoses, and there was a higher proportion of symptomatic than screen-detected cancers. The distribution of cancer stage at diagnosis during the pandemic showed lower proportions of early-stage (stage 0-1/I-II, or Tis and T1) and higher proportions of relatively more advanced cases than that in the pre-pandemic period, however population rates were generally not reported. CONCLUSIONS Evidence of substantial reductions in screening volume and number of diagnosed breast cancers, and higher proportions of advanced stage cancer at diagnosis were found during the pandemic. However, these findings reflect short term outcomes, and higher-quality research examining the long-term impact of the pandemic is needed.
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Affiliation(s)
- Tong Li
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia; School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Brooke Nickel
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Preston Ngo
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Kathleen McFadden
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Meagan Brennan
- Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia
| | - M Luke Marinovich
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Nehmat Houssami
- The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSW, Sydney, Australia,School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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13
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Minamimoto R. Oncology and cardiology positron emission tomography/computed tomography faced with COVID-19: A review of available literature data. Front Med (Lausanne) 2022; 9:1052921. [PMID: 36341267 PMCID: PMC9626818 DOI: 10.3389/fmed.2022.1052921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/07/2022] [Indexed: 09/07/2024] Open
Abstract
The COVID-19 pandemic has forced people to significantly change their lifestyles and attitudes, and has greatly burdened healthcare delivery systems worldwide. The redistribution of the medical delivery system to maintain normal medical care while responding generously to COVID-19 is a continuing challenge that weighs heavily on medical institutions. Among imaging modalities, chest X-rays and computed tomography (CT) examinations have clearly made a large contribution to treatment of COVID-19. In contrast, it is difficult to express the standpoint of nuclear medicine examinations in a straightforward manner, as the greatest emphasis in this modality has been on how necessary medical care can continue to be provided. Many clinical reports of nuclear medicine examinations related to COVID-19 have been published, and knowledge continues to accumulate. This review provides a summary of the current state of oncology and cardiology positron emission tomography (PET) examinations related to COVID-19, and includes preparation of the nuclear medicine department, trends in PET examinations, specific imaging findings on 18F-fluorodeoxyglucose (FDG) PET/CT, imaging of complications of COVID-19, PET tracers other than FDG, and the effects of vaccines on PET imaging findings.
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Affiliation(s)
- Ryogo Minamimoto
- Division of Nuclear Medicine, National Center for Global Health and Medicine, Tokyo, Japan
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14
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Virji AZ, Cheloff AZ, Ghoshal S, Nagle B, Guo TZ, Lev MH, Raja AS, Gee MS, Succi MD. Analysis of self-initiated visits for cervical trauma at urgent care centers and subsequent emergency department referral. Clin Imaging 2022; 91:14-18. [PMID: 35973271 DOI: 10.1016/j.clinimag.2022.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Following trauma involving the cervical spine (c-spine), patients often seek care at urgent care centers (UCCs) or emergency departments (EDs). PURPOSE The purpose was to assess whether UCCs could effectively image acute self-selected c-spine trauma without referral to the ED as well as to estimate costs differences between UCC and ED imaging assessment. MATERIALS AND METHODS This retrospective study identified patients receiving c-spine imaging at UCCs affiliated with a large academic hospital system from 5/1/-8/31/2021. Patients receiving c-spine X-rays with an indication of trauma following low acuity injury, at UCCs were compared to patients receiving any c-spine imaging in the main campus ED. Medical record numbers were cross-referenced to identify patients receiving imaging at both a UCC and ED within 24 h and within 7 days. Work relative value units (wRVUs) for each UCC and ED imaging type were calculated. For the hypothetical scenario of patients presenting to the ED in the absence of UCC, patients were assumed to receive c-spine computed tomography (CT) without contrast per "usually appropriate" designation by the American College of Radiology Appropriateness Criteria®. RESULTS Among 143 self-selected, low acuity, patients who received c-spine X-rays at UCCs with an indication of trauma, one required referral to the ED within 24 h and two required referrals to the ED within 7 days. During the 4-month study period, 105.94 wRVUs ($3696.25) were saved by performing a c-spine X-ray in an UCC instead of a CT in the ED, extrapolated to 317.82 wRVUs ($11,088.74) per year. Using the average total costs of an UCC visit versus an ED visit, a total $145,976 was estimated to be saved during the study period or $437,928 per year. CONCLUSION Offering access for patient-initiated visits at UCCs for low-acuity c-spine trauma may help reduce the need for an ED visit, reducing imaging and healthcare visit costs. SUMMARY STATEMENT Urgent Care Centers (UCCs) reduced the need for an Emergency Department (ED) referral visit in nearly 100% of self-selected, low acuity, patients with cervical trauma. KEY RESULTS
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Affiliation(s)
- Azan Z Virji
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Abraham Z Cheloff
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Soham Ghoshal
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Baily Nagle
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Teddy Z Guo
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Michael H Lev
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Ali S Raja
- Harvard Medical School, Boston, MA, United States; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Michael S Gee
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States
| | - Marc D Succi
- Harvard Medical School, Boston, MA, United States; Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States.
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15
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Camilleri S, Micallef V, Zarb F, Borg Grima K. Detection of incidental adrenal nodules on computed tomography by radiographers. Radiography (Lond) 2022; 28:1025-1031. [PMID: 35939961 DOI: 10.1016/j.radi.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/27/2022] [Accepted: 07/07/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This research investigated whether radiographers' age, qualifications, shift rotations and years of post-qualification experience as a radiographer affect the detection rate of incidental adrenal nodules, also known as adrenal incidentalomas in Malta. Additionally, local statistics of adrenal incidentaloma findings were evaluated. METHODS This research consisted of two phases and employed a non-experimental, cross-sectional quantitative approach. Phase 1 comprised of a self-designed data collection sheet to retrospectively determine the occurrence of recalled computed tomography (CT) examinations resulting from an adrenal incidentaloma finding during a six-month period between July 2020 and December 2020. In phase 2, a self-designed questionnaire with anonymised CT scan images (n = 30) displayed on ViewDex (Viewer for Digital Evaluation of X-ray images) was prospectively completed by CT radiographers (n = 23) to identify adrenal incidentalomas on the images. RESULTS In phase 1, adrenal incidentalomas were present in 1.4% of contrast-enhanced CT (CECT) examinations (n = 12139), out of which, 79.8% were not acknowledged by the radiographers on the initial scans and patients had to be recalled for a dedicated adrenal CT scan. In phase 2, a statistically significant (p < 0.05) relationship was determined between the radiographers' qualifications, shift rotations and years of post-qualification experience as a radiographer, with their detection rate of adrenal incidentalomas. CONCLUSION Findings suggest that radiographers' qualifications, shift rotations and years of post-qualification experience were found to be statistically significant factors affecting their detection rate of adrenal incidentalomas. These could have contributed to one of the reasons for recalling patients, which in turn results in an added burden to both the patient and the Radiology Department. IMPLICATIONS FOR PRACTICE Detection of adrenal incidentalomas by radiographers has a direct impact on clinical practice. If identified during the initial CT examination and a further delay scan is performed, this will benefit patients by reducing the risks of additional radiation and potential risks from contrast media administration; prompt diagnosis and treatment. While the Radiology Department benefits in terms of cost effectiveness, work load and appointment scheduling.
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Affiliation(s)
- S Camilleri
- Medical Imaging Department, Mater Dei Hospital, Msida, Malta.
| | - V Micallef
- Medical Imaging Department, Mater Dei Hospital, Msida, Malta
| | - F Zarb
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - K Borg Grima
- Department of Radiography, Faculty of Health Sciences, University of Malta, Msida, Malta
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16
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Ghoshal S, Rigney G, Cheng D, Brumit R, Gee MS, Hodin RA, Lillemoe KD, Levine WC, Succi MD. Institutional Surgical Response and Associated Volume Trends Throughout the COVID-19 Pandemic and Postvaccination Recovery Period. JAMA Netw Open 2022; 5:e2227443. [PMID: 35980636 PMCID: PMC9389350 DOI: 10.1001/jamanetworkopen.2022.27443] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 07/01/2022] [Indexed: 11/14/2022] Open
Abstract
Importance The COVID-19 pandemic is associated with decreased surgical procedure volumes, but existing studies have not investigated this association beyond the end of 2020, analyzed changes during the post-vaccine release period, or quantified these changes by patient acuity. Objective To quantify changes in the volume of surgical procedures at a 1017-bed academic quaternary care center from January 6, 2019, to December 31, 2021. Design, Setting, and Participants In this cohort study, 129 596 surgical procedure volumes were retrospectively analyzed during 4 periods: pre-COVID-19 (January 6, 2019, to January 4, 2020), COVID-19 peak (March 15, 2020, to May 2, 2020), post-COVID-19 peak (May 3, 2020, to January 2, 2021), and post-vaccine release (January 3, 2021, to December 31, 2021). Surgery volumes were analyzed by subspecialty and case class (elective, emergent, nonurgent, urgent). Statistical analysis was by autoregressive integrated moving average modeling. Main Outcomes and Measures The primary outcome of this study was the change in weekly surgical procedure volume across the 4 COVID-19 periods. Results A total of 129 596 records of surgical procedures were reviewed. During the COVID-19 peak, overall weekly surgical procedure volumes (mean [SD] procedures per week, 406.00 [171.45]; 95% CI, 234.56-577.46) declined 44.6% from pre-COVID-19 levels (mean [SD] procedures per week, 732.37 [12.70]; 95% CI, 719.67-745.08; P < .001). This weekly volume decrease occurred across all surgical subspecialties. During the post-COVID peak period, overall weekly surgical volumes (mean [SD] procedures per week, 624.31 [142.45]; 95% CI, 481.85-766.76) recovered to only 85.8% of pre-COVID peak volumes (P < .001). This insufficient recovery was inconsistent across subspecialties and case classes. During the post-vaccine release period, although some subspecialties experienced recovery to pre-COVID-19 volumes, others continued to experience declines. Conclusions and Relevance This quaternary care institution effectively responded to the pressures of the COVID-19 pandemic by substantially decreasing surgical procedure volumes during the peak of the pandemic. However, overall surgical procedure volumes did not fully recover to pre-COVID-19 levels well into 2021, with inconsistent recovery rates across subspecialties and case classes. These declines suggest that delays in surgical procedures may result in potentially higher morbidity rates in the future. The differential recovery rates across subspecialties may inform institutional focus for future operational recovery.
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Affiliation(s)
- Soham Ghoshal
- Harvard Medical School, Boston, Massachusetts
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston
| | - Grant Rigney
- Harvard Medical School, Boston, Massachusetts
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston
| | - Debby Cheng
- Harvard Medical School, Boston, Massachusetts
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston
| | - Ryan Brumit
- Department of Anesthesia, Massachusetts General Hospital Boston
| | - Michael S. Gee
- Harvard Medical School, Boston, Massachusetts
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston
- Department of Radiology, Massachusetts General Hospital, Boston
| | - Richard A. Hodin
- Harvard Medical School, Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital, Boston
| | - Keith D. Lillemoe
- Harvard Medical School, Boston, Massachusetts
- Department of Surgery, Massachusetts General Hospital, Boston
| | - Wilton C. Levine
- Harvard Medical School, Boston, Massachusetts
- Department of Anesthesia, Massachusetts General Hospital Boston
| | - Marc D. Succi
- Harvard Medical School, Boston, Massachusetts
- Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center, Massachusetts General Hospital, Boston
- Department of Radiology, Massachusetts General Hospital, Boston
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17
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AKIN ME. Rate and reasons of missed screening mammography in the COVID-19 pandemic from Turkey. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2022. [DOI: 10.32322/jhsm.1110424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aim: While screening mammography has been interrupted in many countries during the coronavirus disease (COVID-19) pandemic lockdowns, less is known about missed mammography screening and its reasons in the later periods of pandemic. In this study it was aimed to find out the rate and the reasons for missed mammography screening, and the associated factors in Turkey during the COVID-19 pandemic.
Material and Method: In this single center, cross-sectional observational study women who underwent mammography screening between September 1st to October 1st 2021 (15 months after the start of the COVID-19 pandemic) were recruited. A questionnaire developed for the purpose of this study was used to assess the participant characteristics, whether a screening mammography has been missed during pandemic and its reasons.
Results: The sample comprised of 144 women with a mean age of 50.2±8.0. Most of the sample were married and had children, 34.0% had chronic diseases. Ninety women (62.5%) misssed a screening mammography in the pandemic. Having equal or less than primary school education was associated with higher delay in mammography screening when compared to being having higher education (OR=2.26, 95%CI= 1.09- 4.69, p=0.027). Fear of COVID-19 transmission (92.2%) was the most common reason for missed mammography screening.
Conclusion: This study firstly demonstrated that most of the women delayed their screening mammography after the lockdown periods in the COVID-19 pandemic in Turkey and having equal or less than primary school education was associated with higher missed screening rates than having higher education levels. Effective solutions are needed to address the reasons for missed mammography screening to reduce breast cancer related morbidity and mortality both for this pandemic and for regular times.
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18
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Machado-Rivas F, Gallo-Bernal S, Briggs D, Pianykh O, Gee MS. Characterization of Pediatric Imaging Trends and Likelihood of Exam Cancellation in the COVID-19 Pandemic. Acad Radiol 2022; 29:508-513. [PMID: 35031152 PMCID: PMC8687757 DOI: 10.1016/j.acra.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/08/2021] [Accepted: 12/14/2021] [Indexed: 01/08/2023]
Abstract
Rationale and Objective The COVID-19 pandemic has caused unprecedented changes in radiology practice worldwide. There is a need for a framework of pediatric radiology resource allocation for future acute resource-limited settings.The aim of this study is to quantify and analyze changes in pediatric radiology practice during the COVID-19 pandemic considering demographic and clinical characteristics. Materials and Methods We retrospectively searched our institution's electronic health record for pediatric imaging exams from 09/15/19 to 05/01/20, with 03/15/20 as the dividing date between baseline and pandemic periods. Age, modality, exam indication, need for anesthesia/sedation, and exam completion or cancellation were recorded. All exams were compared between baseline and pandemic periods using a chi-square test and a logistic regression multivariate analysis. Results 15,424 exams were included for analysis [13,715 baseline period (mean age 10±5 years; 7440 males); 1047 COVID-19 period (mean age 9±5 years; 565 males)]. A statistically significantly lower proportion of adolescent exams (45.5% vs 53.3%), radiography modality (62.4% vs 70.4%) and non-traumatic pain indication (39.1% vs 46.3%) was observed during the COVID-19 period. Conversely, we found a higher proportion of neonatal (5.8% vs 3.8%), infant (5.6% vs 4.1%) and early childhood patients (12.9% vs 9.8%), CT (7.4% vs 5.9%) and ultrasound modalities (18.3% vs 13.5%), oncologic (8.8% vs 6.5%) and congenital/development disorder indications (6% vs 3.9%), and studies performed under anesthesia (2.7% vs 1.3%). Regarding exam completion rates, the neonatal age group (OR 1.960 [95% CI 0.353 – 0.591]; p <0.020) and MRI modality (OR 1.502 [95% CI: 0.214 – 0.318]; p <0.049) had higher odds of completion during the COVID-19 pandemic, while fluoroscopy modality was associated with lower odds of completion (OR 0.524 [95% CI: 0.328 – 0.839]; p = 0.011). Conclusion The composition and completion of pediatric radiology exams changed substantially during the COVID-19 pandemic. A sub-set of exams resilient to cancellation was identified.
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Affiliation(s)
- Fedel Machado-Rivas
- Department of Radiology (F.M.R., S.G.B., D.B., O.P., M.S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts 02114; Department of Radiology (F.M.R., S.G.B., O.P., M.S.G.), Harvard Medical School, Boston, Massachusetts
| | - Sebastian Gallo-Bernal
- Department of Radiology (F.M.R., S.G.B., D.B., O.P., M.S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts 02114; Department of Radiology (F.M.R., S.G.B., O.P., M.S.G.), Harvard Medical School, Boston, Massachusetts
| | - Daniel Briggs
- Department of Radiology (F.M.R., S.G.B., D.B., O.P., M.S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts 02114; Department of Radiology (F.M.R., S.G.B., O.P., M.S.G.), Harvard Medical School, Boston, Massachusetts
| | - Oleg Pianykh
- Department of Radiology (F.M.R., S.G.B., D.B., O.P., M.S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts 02114; Department of Radiology (F.M.R., S.G.B., O.P., M.S.G.), Harvard Medical School, Boston, Massachusetts
| | - Michael S Gee
- Department of Radiology (F.M.R., S.G.B., D.B., O.P., M.S.G.), Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts 02114; Department of Radiology (F.M.R., S.G.B., O.P., M.S.G.), Harvard Medical School, Boston, Massachusetts.
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19
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Impact of COVID-19 on CT-diagnosed acute appendicitis and diverticulitis: was there collateral damage? Clin Radiol 2022; 77:514-521. [DOI: 10.1016/j.crad.2022.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/18/2022] [Indexed: 11/23/2022]
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20
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Schmidbauer M, Grenacher L, Juchems MS, Memmel E, Lauenstein T, Schreyer AG, Verloh N, Becker C, Vogl TJ, Wessling J, Wacker FK, Ringe KI. Impact of the COVID 19 Pandemic on Radiological Imaging in Germany. ROFO-FORTSCHR RONTG 2021; 194:625-633. [PMID: 34963189 DOI: 10.1055/a-1710-3767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze the impact of the COVID-19 pandemic in 2020 on the radiological imaging volume in Germany. MATERIALS UND METHODS In this retrospective multicenter study, we analyzed CT and MRI examinations of 7 radiology institutes across Germany from January to December 2020. The imaging volume was compared to 2019 (Wilcoxon-Mann-Whitney test). Modality, patient service locations, and examined body parts were assessed in consideration of time periods of the pandemic. In addition, correlation with the incidence of SARS-CoV-2 cases and associated death was performed (Spearman-test). RESULTS In total, in 2020, imaging volume declined by 4 % (n = 8314) compared with 2019 (p < 0.05). The hard lockdown during the first pandemic wave (calendar week 12-16, March 22 - April 19) revealed the highest decrease with 29 % (n = 894, p < 0.01), with the greatest decrease in CT (36 % vs. MRI 26 %), outpatients (38 %, p < 0.01), and imaging of the spine and extremities (51-72 %, < 0.05 - p < 0.01). Examinations referred from the emergency department (-13 %, p < 0.05) and CT of the chest (-16 %, p < 0.05) were least affected. With the end of the first wave, gradual normalization of the imaging volume was observed and persisted until the end of the observation period. A reduction of imaging volume negatively correlated with the incidence of SARS-CoV-2-positive cases and associated deaths (r = 0.28 and 0.49, p < 0.05 and p < 0.001). CONCLUSION The COVID-19 pandemic was associated with a significant temporary decline in imaging volume. After the first lockdown period, a quick recovery was observed with radiologic imaging examinations steadily approaching prior-year figures. KEY POINTS · This study assesses the impact of dynamic pandemic activity on radiological imaging in a multicenter analysis in Germany.. · The COVID-19 pandemic was associated with a temporary decline in CT and MRI scans.. · Relaxation of restrictions was associated with fast normalization of imaging volumes to prior-year levels, which persisted until the end of the year.. · Significant catch-up effects were not observed.. CITATION FORMAT · Schmidbauer M, Grenacher L, Juchems MS et al. Impact of the COVID 19 Pandemic on Radiological Imaging in Germany. Fortschr Röntgenstr 2021; DOI: 10.1055/a-1710-3767.
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Affiliation(s)
- Martina Schmidbauer
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Lars Grenacher
- Imaging and Prevention Center, Conradia Radiology Munich, Germany
| | - Markus S Juchems
- Diagnostic and Interventional Radiology, Klinikum Konstanz, Germany
| | - Erik Memmel
- Diagnostic and Interventional Radiology, Klinikum Konstanz, Germany
| | - Thomas Lauenstein
- Department of Radiology, Evangelisches Krankenhaus Düsseldorf, Dusseldorf, Germany
| | - Andreas G Schreyer
- Institute for Diagnostic and Interventional Radiology, Brandenburg Medical School Theodor Fontane, Brandenburg a.d. Havel, Germany
| | - Niklas Verloh
- Department of Radiology, University Hospital Regensburg, Germany
| | - Claus Becker
- Department of Radiology, University Hospital Regensburg, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | | | - Frank K Wacker
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
| | - Kristina Imeen Ringe
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
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21
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Abdominal Imaging Utilization during the First COVID-19 Surge and Utility of Abdominal MRI. Tomography 2021; 7:972-979. [PMID: 34941652 PMCID: PMC8709073 DOI: 10.3390/tomography7040080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
We sought to determine relative utilization of abdominal imaging modalities in coronavirus disease 2019 (COVID-19) patients at a single institution during the first surge and evaluate whether abdominal magnetic resonance imaging (MRI) changed diagnosis and management. 1107 COVID-19 patients who had abdominal imaging were analyzed for modality and imaging setting. Patients who underwent abdominal MRI were reviewed to determine impact on management. Of 2259 examinations, 80% were inpatient, 14% were emergency, and 6% were outpatient consisting of 55% radiograph (XR), 31% computed tomography (CT), 13% ultrasound (US), and 0.6% MRI. Among 1107 patients, abdominal MRI was performed in 12 within 100 days of positive SARS-CoV-2 PCR. Indications were unrelated to COVID-19 in 75% while MRI was performed for workup of acute liver dysfunction in 25%. In 1 of 12 patients, MRI resulted in change to management unrelated to COVID-19 diagnosis. During the first surge of COVID-19 at one institution, the most common abdominal imaging examinations were radiographs and CT followed by ultrasound with the majority being performed as inpatients. Future COVID-19 surges may place disproportionate demands on inpatient abdominal radiography and CT resources. Abdominal MRI was rarely performed and did not lead to change in diagnosis or management related to COVID-19 but needs higher patient numbers for accurate assessment of utility.
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22
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Amornsiripanitch N, Chikarmane SA, Bay CP, Giess CS. Patients characteristics related to screening mammography cancellation and rescheduling rates during the COVID-19 pandemic. Clin Imaging 2021; 80:205-210. [PMID: 34340204 PMCID: PMC8320406 DOI: 10.1016/j.clinimag.2021.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/01/2021] [Accepted: 07/19/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To identify patient characteristics associated with screening mammography cancellations and rescheduling during the COVID-19 pandemic. METHODS Scheduled screening mammograms during three time periods were retrospectively reviewed: state-mandated shutdown (3/17/2020-6/16/2020) during which screening mammography was cancelled, a period of 2 months immediately after screening mammography resumed (6/17/2020-8/16/2020), and a representative period prior to COVID-19 (6/17/2019-8/16/2019). Relative risk of cancellation before COVID-19 and after reopening was compared for age, race/ethnicity, insurance, history of chronic disease, and exam location, controlling for other collected variables. Risk of failure to reschedule was similarly compared between all 3 time periods. RESULTS Overall cancellation rate after reopening was higher than before shutdown (7663/16595, 46% vs 5807/15792, 37%; p < 0.001). Relative risk of cancellation after reopening increased with age (1.20 vs 1.27 vs 1.36 for ages at 25th, 50th, and 75th quartile or 53, 61, and 70 years, respectively, p < 0.001). Relative risk of cancellation was also higher among Medicare patients (1.41) compared to Medicaid and those with other providers (1.26 and 1.21, respectively, p < 0.001) and non-whites compared to whites (1.34 vs 1.25, p = 0.03). Rescheduling rate during shutdown was higher than before COVID-19 and after reopening for all patients (10,658/13593, 78%, 3569/5807, 61%, and 4243/7663, respectively, 55%, p < 0.001). Relative risk of failure to reschedule missed mammogram was higher in hospitals compared to outpatient settings both during shutdown and after reopening (0.62 vs 0.54, p = 0.005 and 1.29 vs 1.03, p < 0.001, respectively). CONCLUSION Minority race/ethnicity, Medicare insurance, and advanced age were associated with increased risk of screening mammogram cancellation during COVID-19.
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Affiliation(s)
- Nita Amornsiripanitch
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States of America.
| | - Sona A Chikarmane
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States of America.
| | - Camden P Bay
- Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, United States of America.
| | - Catherine S Giess
- Center for Evidence-Based Imaging, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Boston, MA 02120, United States of America.
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23
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Brown SD, Hardy SM, Bruno MA. Rationing and Disparities in Health Care: Implications for Radiology Clinical Practice Guidelines. J Am Coll Radiol 2021; 19:84-89. [PMID: 34687667 DOI: 10.1016/j.jacr.2021.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/27/2021] [Accepted: 09/01/2021] [Indexed: 12/26/2022]
Abstract
We examine the relationship between the rationing of health care resources and disparities in health care delivery and the specific implications for radiologic resource allocation frameworks such as the ACR Appropriateness Criteria. We explore what rationing is in this context and how it is manifested in radiology. We review how rationing has taken many forms and how rationing has influenced the development of disparities in access and outcomes within health care and specifically within the context of radiology. We describe how the relationship between rationing and health care delivery disparities manifested during the coronavirus disease 2019 pandemic and the corrective measures that were proposed to established rationing frameworks to facilitate more equitable pandemic-related resource distribution. We offer suggestions regarding how such solutions might be brought into radiologic resource allocation schemes to help mitigate disparities in radiologic care in the future.
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Affiliation(s)
- Stephen D Brown
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; and Center for Bioethics, Harvard Medical School, Boston, Massachusetts.
| | - Seth M Hardy
- Department of Radiology, The Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Michael A Bruno
- Vice-Chair, Quality and Chief, Emergency Radiology, The Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
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24
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Naidich JJ, Boltyenkov A, Wang JJ, Cruzen E, Chusid J, Rula E, Sanelli PC. Recovery of outpatient imaging utilization during the first wave of the COVID-19 pandemic. Clin Imaging 2021; 80:277-282. [PMID: 34425546 PMCID: PMC8349737 DOI: 10.1016/j.clinimag.2021.07.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/09/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
Abstract
Objective During the COVID-19 pandemic, Radiology practices experienced marked reductions in outpatient imaging volumes. Our purpose was to evaluate the timing, rate, and degree of recovery of outpatient imaging during the first wave of the pandemic. We also sought to ascertain the relationship of outpatient imaging recovery to the incidence of COVID-19 cases. Methods Retrospective study of outpatient imaging volumes in a large healthcare system was performed from January 1, 2019-August 25, 2020. Dataset was split to compare Pre-COVID (weeks 1–9), Peak-COVID (weeks 10–15) and Recovery-COVID (weeks 16–34) periods. Chi-square and Independent-samples t-tests compared weekly outpatient imaging volumes in 2020 and 2019. Regression analyses assessed the rate of decline and recovery in Peak-COVID and Recovery-COVID periods, respectively. Results Total outpatient imaging volume in 2020 (weeks 1–34) was 327,738 exams, compared to 440,314 in 2019. The 2020 mean weekly imaging volumes were significantly decreased in Peak-COVID (p = 0.0148) and Recovery-COVID (p = 0.0003) periods. Mean weekly decline rate was −2580 exams/week and recovery rate was +617 exams/week. The 2020 Post-COVID (weeks 10–34) period had an average decrease of 36.5% (4813.4/13,178.6) imaging exams/week and total estimated decrease of 120,335 exams. Significant inverse correlation (−0.8338, p < 0.0001) was seen between positive-tested COVID-19 cases and imaging utilization with 1-week lag during Post-COVID (weeks 10–34) period. Conclusion Recovery of outpatient imaging volume during the first wave of COVID-19 pandemic showed a gradual return to pre-pandemic levels over the course of 3–4 months. The rate of imaging utilization was inversely associated with new positive-tested COVID-19 cases with a 1-week lag.
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Affiliation(s)
- Jason J Naidich
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Northwell Health, Manhasset, NY, United States of America.
| | - Artem Boltyenkov
- Siemens Medical Solutions USA, Inc., Malvern, PA, United States of America; Feinstein Institutes for Medical Research, Manhasset, NY, United States of America
| | - Jason J Wang
- Feinstein Institutes for Medical Research, Manhasset, NY, United States of America
| | - Eric Cruzen
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Northwell Health, Manhasset, NY, United States of America
| | - Jesse Chusid
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Northwell Health, Manhasset, NY, United States of America
| | - Elizabeth Rula
- Harvey L. Neiman Health Policy Institute, Reston, VA, United States of America
| | - Pina C Sanelli
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States of America; Northwell Health, Manhasset, NY, United States of America; Feinstein Institutes for Medical Research, Manhasset, NY, United States of America
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25
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Zattra O, Fraga A, Lu N, Gee MS, Liu RW, Lev MH, Brink JA, Saini S, Lang M, Succi MD. Trends in cancer imaging by indication, care setting, and hospital type during the COVID-19 pandemic and recovery at four hospitals in Massachusetts. Cancer Med 2021; 10:6327-6335. [PMID: 34355873 PMCID: PMC8420511 DOI: 10.1002/cam4.4183] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/11/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background We aimed to investigate the effects of COVID‐19 on computed tomography (CT) imaging of cancer. Methods Cancer‐related CTs performed at one academic hospital and three affiliated community hospitals in Massachusetts were retrospectively analyzed. Three periods of 2020 were considered as follows: pre‐COVID‐19 (1/5/20–3/14/20), COVID‐19 peak (3/15/20–5/2/20), and post‐COVID‐19 peak (5/3/20–11/14/20). 15 March 2020 was the day a state of emergency was declared in MA; 3 May 2020 was the day our hospitals resumed to non‐urgent imaging. The volumes were assessed by (1) Imaging indication: cancer screening, initial workup, active cancer, and surveillance; (2) Care setting: outpatient and inpatient, ED; (3) Hospital type: quaternary academic center (QAC), university‐affiliated community hospital (UACH), and sole community hospitals (SCHs). Results During the COVID‐19 peak, a significant drop in CT volumes was observed (−42.2%, p < 0.0001), with cancer screening, initial workup, active cancer, and cancer surveillance declining by 81.7%, 54.8%, 30.7%, and 44.7%, respectively (p < 0.0001). In the post‐COVID‐19 peak period, cancer screening and initial workup CTs did not recover (−11.7%, p = 0.037; −20.0%, p = 0.031), especially in the outpatient setting. CT volumes for active cancer recovered, but inconsistently across hospital types: the QAC experienced a 9.4% decline (p = 0.022) and the UACH a 41.5% increase (p < 0.001). Outpatient CTs recovered after the COVID‐19 peak, but with a shift in utilization away from the QAC (−8.7%, p = 0.020) toward the UACH (+13.3%, p = 0.013). Inpatient and ED‐based oncologic CTs increased post‐peak (+20.0%, p = 0.004 and +33.2%, p = 0.009, respectively). Conclusions Cancer imaging was severely impacted during the COVID‐19 pandemic. CTs for cancer screening and initial workup did not recover to pre‐COVID‐19 levels well into 2020, a finding that suggests more patients with advanced cancers may present in the future. A redistribution of imaging utilization away from the QAC and outpatient settings, toward the community hospitals and inpatient setting/ED was observed.
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Affiliation(s)
- Ottavia Zattra
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Anthony Fraga
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nancy Lu
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael S Gee
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Raymond W Liu
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Michael H Lev
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - James A Brink
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sanjay Saini
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Min Lang
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marc D Succi
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA.,Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, Massachusetts, USA
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26
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Vigne J, Peyronnet D, Leenhardt J, Dubegny C, Ardisson V, Pariscoat G, Bolot C, Rauscher A, Hallouard F, Clave-Darcissac C, Clotagatide A, Odouard E, Faivre-Chauvet A, Diehl J, Houdu B, Agostini D, Morello R. Quantitative impact of the first COVID-19 lockdown on nuclear medicine in France: the CORALINE study. Eur J Nucl Med Mol Imaging 2021; 48:4331-4338. [PMID: 34169368 PMCID: PMC8224993 DOI: 10.1007/s00259-021-05361-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/06/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE The coronavirus disease 2019 (COVID-19) pandemic reshaped the usual risk: benefit equilibrium that became a trade-off between the infection exposure risk for the patient (and for staff) and the risk associated with delaying or cancelling the nuclear medicine examination. This study aimed at quantifying the impact of the first COVID-19 lockdown in France on nuclear medicine examination volume together with volume of examination cancellation and non-attendance. METHODS We retrospectively assessed the volume of planned examinations from 1 month before to 1 month after the first lockdown in French high-volume nuclear medicine departments (NMD) sharing the same information management system including both university hospitals, UH (n = 7), and cancer centres, CC (n = 2). RESULTS The study enrolled 31,628 consecutive patients referred for a nuclear medicine examination performed or not (NMEP or NMEnP). The total volume of NMEP significantly dropped by 43.4% between the 4 weeks before and after the starting of the lockdown. The comparison of the percentage of NMEP and NMEnP between UH and CC is significantly different (p < 0.001). The percentage of NMEP during the study was 67.9% in UH vs 84.7% in CC. Percentages of NMEnP in UH and CC were due respectively to cancellation by the patient (14.9 vs 7.4%), cancellation by the NMD (9.5 vs 3.4%), cancellation by the referring physician (5.1 vs 4.4%) and non-attender patients (2.7 vs 0.2%). CONCLUSION The study underlines the public health issue caused by COVID-19 above the pandemic itself and should be useful in preparing for potential resource utilisation and staffing requirements.
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Affiliation(s)
- Jonathan Vigne
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France. .,Department of Pharmacy, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France. .,Normandie Université, UNICAEN, INSERM U1237, PhIND, Institut Blood and Brain @ Caen-Normandie, Centre Cyceron, 14000, Caen, France.
| | - Damien Peyronnet
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France.,Department of Pharmacy, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Julien Leenhardt
- Nuclear Medicine Department, Grenoble-Alpes University Hospital, Grenoble, France.,Radiopharmaceutiques Biocliniques, UMR UGA-INSERM U1039, Grenoble, France
| | - Constance Dubegny
- Radiopharmacy, Nuclear Medicine Department, CHU de Nantes, 44000, Nantes, France
| | - Valérie Ardisson
- Department of Pharmacy, Centre de lutte contre le cancer Eugène Marquis, 35000, Rennes, France
| | - Guillaume Pariscoat
- Department of Nuclear Medicine, CHU Bichat, Assistance Publique Hôpitaux de Paris, 75018, Paris, France
| | - Claire Bolot
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Est, Hospices Civils de Lyon, 59 boulevard Pinel, 69677, Bron Cedex, France
| | - Aurore Rauscher
- Radiopharmacy, Nuclear Medicine Department, ICO Nantes-Angers, 44800, Saint-Herblain, France
| | - François Hallouard
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France
| | - Caroline Clave-Darcissac
- Radiopharmacy Unit, Pharmacy Department, Groupement Hospitalier Sud, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69310, Pierre-Bénite, France
| | - Anthony Clotagatide
- Department of Pharmacy, CHU de Saint-Etienne, Hôpital Nord, 42055, Saint-Etienne, France.,Department of Nuclear Medicine, CHU de Saint-Etienne, 42055, Saint-Etienne, France
| | - Emmanuel Odouard
- Department of Pharmacy, CHU de Saint-Etienne, Hôpital Nord, 42055, Saint-Etienne, France.,Department of Nuclear Medicine, CHU de Saint-Etienne, 42055, Saint-Etienne, France
| | - Alain Faivre-Chauvet
- Radiopharmacy, Nuclear Medicine Department, CHU de Nantes, 44000, Nantes, France
| | - Justine Diehl
- Biostatistic and Clinical Research, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Benjamin Houdu
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Denis Agostini
- Department of Nuclear Medicine, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
| | - Rémy Morello
- Biostatistic and Clinical Research, CHU de Caen Normandie, Normandie Université, UNICAEN, 14000, Caen, France
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Succi MD, Chang K, An T, Rosman DA, Raja AS, Gee MS, Lev MH, Liu R, Saini S, Brink JA. Increased per-patient imaging utilization in an emergency department setting during COVID-19. Clin Imaging 2021; 80:77-82. [PMID: 34274685 PMCID: PMC8183018 DOI: 10.1016/j.clinimag.2021.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/24/2021] [Accepted: 06/03/2021] [Indexed: 12/29/2022]
Abstract
Introduction COVID-19 has resulted in decreases in absolute imaging volumes, however imaging utilization on a per-patient basis has not been reported. Here we compare per-patient imaging utilization, characterized by imaging studies and work relative value units (wRVUs), in an emergency department (ED) during a COVID-19 surge to the same period in 2019. Methods This retrospective study included patients presenting to the ED from April 1–May 1, 2020 and 2019. Patients were stratified into three primary subgroups: all patients (n = 9580, n = 5686), patients presenting with respiratory complaints (n = 1373, n = 2193), and patients presenting without respiratory complaints (n = 8207, n = 3493). The primary outcome was imaging studies/patient and wRVU/patient. Secondary analysis was by disposition and COVID status. Comparisons were via the Wilcoxon rank-sum or Chi-squared tests. Results The total patients, imaging exams, and wRVUs during the 2020 and 2019 periods were 5686 and 9580 (−41%), 6624 and 8765 (−24%), and 4988 and 7818 (−36%), respectively, and the percentage patients receiving any imaging was 67% and 51%, respectively (p < .0001). In 2020 there was a 170% relative increase in patients presenting with respiratory complaints. In 2020, patients without respiratory complaints generated 24% more wRVU/patient (p < .0001) and 33% more studies/patient (p < .0001), highlighted by 38% more CTs/patient. Conclusion We report increased per-patient imaging utilization in an emergency department during COVID-19, particularly in patients without respiratory complaints.
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Affiliation(s)
- Marc D Succi
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America.
| | - Ken Chang
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Thomas An
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - David A Rosman
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Ali S Raja
- Harvard Medical School, Boston, MA, United States of America; Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States of America
| | - Michael S Gee
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Michael H Lev
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Ray Liu
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - Sanjay Saini
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
| | - James A Brink
- Department of Radiology, Massachusetts General Hospital, Boston, MA, United States of America; Medically Engineered Solutions in Healthcare Incubator, Innovation in Operations Research Center (MESH IO), Massachusetts General Hospital, Boston, MA, United States of America; Harvard Medical School, Boston, MA, United States of America
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28
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Shatzkes DR, Zlochower AB, Steinklein JM, Pramanik BK, Filippi CG, Azhar S, Wang JJ, Sanelli PC. Impact of SARS-CoV-2 Pandemic on "Stroke Code" Imaging Utilization and Yield. AJNR Am J Neuroradiol 2021; 42:1017-1022. [PMID: 33541898 PMCID: PMC8191682 DOI: 10.3174/ajnr.a7038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/18/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE Indirect consequences of the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) pandemic include those related to failure of patients to seek or receive timely medical attention for seemingly unrelated disease. We report our experience with stroke code imaging during the early pandemic months of 2020. MATERIALS AND METHODS Retrospective review of stroke codes during the 2020 pandemic and both 2020 and matched 2019 prepandemic months was performed. Patient variables were age, sex, hospital location, and severity of symptoms based on the NIHSS. We reviewed the results of CT of the head, CTA, CTP, and MR imaging examinations and classified a case as imaging-positive if any of the imaging studies yielded a result that related to the clinical indication for the study. Both year-to-year and sequential comparisons were performed between pandemic and prepandemic months. RESULTS A statistically significant decrease was observed in monthly stroke code volumes accompanied by a statistically significant increased proportion of positive imaging findings during the pandemic compared with the same months in the prior year (P < .001) and prepandemic months in the same year (P < .001). We also observed statistically significant increases in average NIHSS scores (P = .045 and P = .03) and the proportion of inpatient stroke codes (P = .003 and P = .03). CONCLUSIONS During our pandemic period, there was a significantly decreased number of stroke codes but simultaneous increases in positivity rates, symptom severity, and inpatient codes. We postulate that this finding reflects the documented reluctance of patients to seek medical care during the pandemic, with the shift toward a greater proportion of inpatient stroke codes potentially reflecting the neurologic complications of the virus itself.
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Affiliation(s)
- D R Shatzkes
- Departments of Radiology and Otolaryngology (D.R.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - A B Zlochower
- Department of Radiology (A.B.Z., J.M.S., B.K.P., C.G.F., P.C.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - J M Steinklein
- Department of Radiology (A.B.Z., J.M.S., B.K.P., C.G.F., P.C.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - B K Pramanik
- Department of Radiology (A.B.Z., J.M.S., B.K.P., C.G.F., P.C.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - C G Filippi
- Department of Radiology (A.B.Z., J.M.S., B.K.P., C.G.F., P.C.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - S Azhar
- Department of Neurology (S.A.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
| | - J J Wang
- Institute for Health Innovations and Outcomes Research (J.J.W.), Feinstein Institutes for Medical Research, and Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Manhasset, New York
| | - P C Sanelli
- Department of Radiology (A.B.Z., J.M.S., B.K.P., C.G.F., P.C.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital, Northwell Health, New York, New York
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29
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Thacker PG, Menaker R, Kolbe AB, Conners AL, Amrami KK, Callstrom MR, Wood CP. Preparing for the next pandemic: It is more than just about numbers. Clin Imaging 2021; 79:179-182. [PMID: 34090113 PMCID: PMC8164499 DOI: 10.1016/j.clinimag.2021.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/06/2021] [Accepted: 05/17/2021] [Indexed: 10/26/2022]
Abstract
The COVID-19 pandemic has brought enormous hardships to our country and healthcare system. We present our experience navigating through this pandemic with emphasis on reactivating our practice while keeping patients and staff safe. It is hoped that the methods and thought processes provided in this manuscript will help those who are in various stages of managing their practice or provide lessons learned as our country eventually moves beyond this pandemic. Lastly, we aspire to provide a guide for those who are in a position to prepare for the next pandemic.
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Affiliation(s)
- Paul G Thacker
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America.
| | - Ron Menaker
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Amy B Kolbe
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Amy L Conners
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Kimberly K Amrami
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Matthew R Callstrom
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
| | - Christopher P Wood
- Mayo Clinic, Department of Radiology, 200 First Street SW, Rochester, MN 55905, United States of America
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30
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Automated tracking of emergency department abdominal CT findings during the COVID-19 pandemic using natural language processing. Am J Emerg Med 2021; 49:52-57. [PMID: 34062318 PMCID: PMC8154187 DOI: 10.1016/j.ajem.2021.05.057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 05/08/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
PURPOSE During the COVID-19 pandemic, emergency department (ED) volumes have fluctuated. We hypothesized that natural language processing (NLP) models could quantify changes in detection of acute abdominal pathology (acute appendicitis (AA), acute diverticulitis (AD), or bowel obstruction (BO)) on CT reports. METHODS This retrospective study included 22,182 radiology reports from CT abdomen/pelvis studies performed at an urban ED between January 1, 2018 to August 14, 2020. Using a subset of 2448 manually annotated reports, we trained random forest NLP models to classify the presence of AA, AD, and BO in report impressions. Performance was assessed using 5-fold cross validation. The NLP classifiers were then applied to all reports. RESULTS The NLP classifiers for AA, AD, and BO demonstrated cross-validation classification accuracies between 0.97 and 0.99 and F1-scores between 0.86 and 0.91. When applied to all CT reports, the estimated numbers of AA, AD, and BO cases decreased 43-57% in April 2020 (first regional peak of COVID-19 cases) compared to 2018-2019. However, the number of abdominal pathologies detected rebounded in May-July 2020, with increases above historical averages for AD. The proportions of CT studies with these pathologies did not significantly increase during the pandemic period. CONCLUSION Dramatic decreases in numbers of acute abdominal pathologies detected by ED CT studies were observed early on during the COVID-19 pandemic, though these numbers rapidly rebounded. The proportions of CT cases with these pathologies did not increase, which suggests patients deferred care during the first pandemic peak. NLP can help automatically track findings in ED radiology reporting.
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31
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Chalfant JS, Cohen EO, Leung JWT, Pittman SM, Kothari PD, Downey JR, Sohlich RE, Chong A, Grimm LJ, Hoyt AC, Ojeda-Fournier H, Joe BN, Trinh L, Rosen EL, Feig SA, Aminololama-Shakeri S, Ikeda DM. Adaptations of Breast Imaging Centers to the COVID-19 Pandemic: A Survey of California and Texas. JOURNAL OF BREAST IMAGING 2021; 3:343-353. [PMID: 38424771 PMCID: PMC7989354 DOI: 10.1093/jbi/wbab020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To determine the early impact of the COVID-19 pandemic on breast imaging centers in California and Texas and compare regional differences. METHODS An 11-item survey was emailed to American College of Radiology accredited breast imaging facilities in California and Texas in August 2020. A question subset addressed March-April government restrictions on elective services ("during the shutdown" and "after reopening"). Comparisons were made between states with chi-square and Fisher's tests, and timeframes with McNemar's and paired t-tests. RESULTS There were 54 respondents (54/240, 23%, 26 California, 28 Texas). Imaging volumes fell during the shutdown and remained below pre-pandemic levels after reopening, with reduction in screening greatest (ultrasound 12% of baseline, mammography 13%, MRI 23%), followed by diagnostic MRI (43%), procedures (44%), and diagnostics (45%). California reported higher volumes during the shutdown (procedures, MRI) and after reopening (diagnostics, procedures, MRI) versus Texas (P = 0.001-0.02). Most screened patients (52/54, 96% symptoms and 42/54, 78% temperatures), and 100% (53/53) modified check-in and check-out. Reading rooms or physician work were altered for social distancing (31/54, 57%). Physician mask (45/48, 94%), gown (15/48, 31%), eyewear (22/48, 46%), and face shield (22/48, 46%) use during procedures increased after reopening versus pre-pandemic (P < 0.001-0.03). Physician (47/54, 87%) and staff (45/53, 85%) financial impacts were common, but none reported terminations. CONCLUSION Breast imaging volumes during the early pandemic fell more severely in Texas than in California. Safety measures and financial impacts on physicians and staff were similar in both states.
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Affiliation(s)
- James S Chalfant
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Ethan O Cohen
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Section of Breast Imaging, Houston, TX, USA
| | - Jessica W T Leung
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Section of Breast Imaging, Houston, TX, USA
| | - Sarah M Pittman
- Stanford University School of Medicine, Department of Radiology, Stanford, CA, USA
| | - Pranay D Kothari
- Stanford University School of Medicine, Department of Radiology, Stanford, CA, USA
| | - John R Downey
- Kaiser Permanente, Department of Radiology, Walnut Creek, CA, USA
| | - Rita E Sohlich
- Sutter Health, Palo Alto Medical Foundation, Department of Radiology, Palo Alto, CA, USA
| | - Alice Chong
- University of California, San Diego, Department of Radiology, La Jolla, CA, USA
| | - Lars J Grimm
- Duke University Medical Center, Department of Radiology, Durham, NC, USA
| | - Anne C Hoyt
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | | | - Bonnie N Joe
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA, USA
| | - Long Trinh
- Santa Clara Valley Medical Center, Department of Radiology, San Jose, CA, USA
| | - Eric L Rosen
- Stanford University School of Medicine, Department of Radiology, Stanford, CA, USA
| | - Stephen A Feig
- University of California, Irvine Medical Center, Department of Radiological Sciences, Orange, CA, USA
| | | | - Debra M Ikeda
- Stanford University School of Medicine, Department of Radiology, Stanford, CA, USA
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32
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Carlon T, Finkelstein M, Maron SZ, Goldman D, Kihira S, Marinelli B, Dayan E, Sullivan N, Hart J, Doshi AH, Delman BN, Lookstein R, Drayer BP. Sources of Revenue Loss and Recovery in Radiology Practices During the Coronavirus Disease 2019 (COVID-19) Pandemic. Acad Radiol 2021; 28:447-456. [PMID: 33495075 PMCID: PMC7813500 DOI: 10.1016/j.acra.2021.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/07/2021] [Accepted: 01/11/2021] [Indexed: 02/06/2023]
Abstract
Rationale and Objectives This study seeks to quantify the financial impact of COVID-19 on radiology departments, and to describe the structure of both volume and revenue recovery. Materials and Methods Radiology studies from a large academic health system were retrospectively studied from the first 33 weeks of 2020. Volume and work relative value unit (wRVU) data were aggregated on a weekly basis for three periods: Presurge (weeks 1–9), surge (10–19), and recovery (20–33), and analyzed compared to the pre-COVID baseline stratified by modality, specialty, patient service location, and facility type. Mean and median wRVU per study were used as a surrogate for case complexity. Results During the pandemic surge, case volumes fell 57%, while wRVUs fell by 69% relative to the pre-COVID-19 baseline. Mean wRVU per study was 1.13 in the presurge period, 1.03 during the surge, and 1.19 in the recovery. Categories with the greatest mean complexity declines were radiography (−14.7%), cardiothoracic imaging (−16.2%), and community hospitals overall (−15.9%). Breast imaging (+6.5%), interventional (+5.5%), and outpatient (+12.1%) complexity increased. During the recovery, significant increases in complexity were seen in cardiothoracic (0.46 to 0.49), abdominal (1.80 to 1.91), and neuroradiology (2.46 to 2.56) at stand-alone outpatient centers with similar changes at community hospitals. At academic hospitals, only breast imaging complexity remained elevated (1.32 from 1.17) during the recovery. Conclusion Reliance on volume alone underestimates the financial impact of the COVID-19 pandemic as there was a disproportionate loss in high-RVU studies. However, increased complexity of outpatient cases has stabilized overall losses during the recovery.
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Affiliation(s)
- Timothy Carlon
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029.
| | - Mark Finkelstein
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Samuel Z Maron
- Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, New York, New York
| | - Daryl Goldman
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Shingo Kihira
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Brett Marinelli
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Etan Dayan
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Nisha Sullivan
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - John Hart
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Amish H Doshi
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Bradley N Delman
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Robert Lookstein
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
| | - Burton P Drayer
- Department of Diagnostic, Molecular, and Interventional Radiology, Icahn School of Medicine at Mount Sinai, Mount Sinai Hospital, One Gustave L. Levy Place, Box 1234, New York, NY USA 10029
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33
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Chalfant JS, Pittman SM, Kothari PD, Chong A, Grimm LJ, Sohlich RE, Leung JWT, Downey JR, Cohen EO, Ojeda-Fournier H, Hoyt AC, Joe BN, Feig SA, Trinh L, Rosen EL, Aminololama-Shakeri S, Ikeda DM. Impact of the COVID-19 Pandemic on Breast Imaging Education. JOURNAL OF BREAST IMAGING 2021; 3:354-362. [PMID: 34056594 DOI: 10.1093/jbi/wbab021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Indexed: 12/13/2022]
Abstract
Objective To determine the impact of the COVID-19 pandemic on breast imaging education. Methods A 22-item survey addressing four themes during the early pandemic (time on service, structured education, clinical training, future plans) was emailed to Society of Breast Imaging members and members-in-training in July 2020. Responses were compared using McNemar's and Mann-Whitney U tests; a general linear model was used for multivariate analysis. Results Of 136 responses (136/2824, 4.8%), 96 U.S. responses from radiologists with trainees, residents, and fellows were included. Clinical exposure declined during the early pandemic, with almost no medical students on service (66/67, 99%) and fewer clinical days for residents (78/89, 88%) and fellows (48/68, 71%). Conferences shifted to remote live format (57/78, 73%), with some canceled (15/78, 19%). Compared to pre-pandemic, resident diagnostic (75/78, 96% vs 26/78, 33%) (P < 0.001) and procedural (73/78, 94% vs 21/78, 27%) (P < 0.001) participation fell, as did fellow diagnostic (60/61, 98% vs 47/61, 77%) (P = 0.001) and procedural (60/61, 98% vs 43/61, 70%) (P < 0.001) participation. Most thought that the pandemic negatively influenced resident and fellow screening (64/77, 83% and 43/60, 72%, respectively), diagnostic (66/77, 86% and 37/60, 62%), and procedural (71/77, 92% and 37/61, 61%) education. However, a majority thought that decreased time on service (36/67, 54%) and patient contact (46/79, 58%) would not change residents' pursuit of a breast imaging fellowship. Conclusion The pandemic has had a largely negative impact on breast imaging education, with reduction in exposure to all aspects of breast imaging. However, this may not affect career decisions.
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Affiliation(s)
- James S Chalfant
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Sarah M Pittman
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | - Pranay D Kothari
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | - Alice Chong
- University of California, San Diego, Department of Radiology, La Jolla, CA,USA
| | - Lars J Grimm
- Duke University Medical Center, Department of Radiology, Durham, NC,USA
| | - Rita E Sohlich
- Sutter Health, Palo Alto Medical Foundation, Department of Radiology, Palo Alto, CA,USA
| | - Jessica W T Leung
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX,USA
| | - John R Downey
- Kaiser Permanente, Department of Radiology, Walnut Creek, CA,USA
| | - Ethan O Cohen
- The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX,USA
| | | | - Anne C Hoyt
- David Geffen School of Medicine at University of California, Los Angeles, Department of Radiological Sciences, Santa Monica, CA, USA
| | - Bonnie N Joe
- University of California, San Francisco, Department of Radiology and Biomedical Imaging, San Francisco, CA,USA
| | - Stephen A Feig
- University of California, Irvine Medical Center, Department of Radiological Sciences, Orange, CA,USA
| | - Long Trinh
- Santa Clara Valley Medical Center, Department of Radiology, San Jose, CA,USA
| | - Eric L Rosen
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
| | | | - Debra M Ikeda
- Stanford University School of Medicine, Department of Radiology, Stanford, CA,USA
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34
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Lang M, Yeung T, Shepard JAO, Sharma A, Petranovic M, Flores EJ, McLoud TC, Som A, Saini S, Prabhakar AM, D. Succi M, Little BP. Operational Challenges of a Low-Dose CT Lung Cancer Screening Program During the Coronavirus Disease 2019 Pandemic. Chest 2021; 159:1288-1291. [PMID: 33121979 PMCID: PMC7587133 DOI: 10.1016/j.chest.2020.10.045] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/01/2020] [Accepted: 10/11/2020] [Indexed: 12/16/2022] Open
Affiliation(s)
- Min Lang
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | | | - Jo-Anne O. Shepard
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Amita Sharma
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Milena Petranovic
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Efren J. Flores
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Theresa C. McLoud
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Avik Som
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Sanjay Saini
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Anand M. Prabhakar
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Marc D. Succi
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Medically Engineered Solutions in Healthcare (MESH) Incubator, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Brent P. Little
- Department of Radiology, Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA,CORRESPONDENCE TO: Brent P. Little, MD
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Guitron S, Pianykh OS, Succi MD, Lang M, Brink J. COVID-19: Recovery Models for Radiology Departments. J Am Coll Radiol 2020; 17:1460-1468. [PMID: 32979322 PMCID: PMC7476574 DOI: 10.1016/j.jacr.2020.09.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 10/28/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has greatly affected demand for imaging services, with marked reductions in demand for elective imaging and image-guided interventional procedures. To guide radiology planning and recovery from this unprecedented impact, three recovery models were developed to predict imaging volume over the course of the COVID-19 pandemic: (1) a long-term volume model with three scenarios based on prior disease outbreaks and other historical analogues, to aid in long-term planning when the pandemic was just beginning; (2) a short-term volume model based on the supply-demand approach, leveraging increasingly available COVID-19 data points to predict examination volume on a week-to-week basis; and (3) a next-wave model to estimate the impact from future COVID-19 surges. The authors present these models as techniques that can be used at any stage in an unpredictable pandemic timeline.
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Affiliation(s)
- Steven Guitron
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Oleg S Pianykh
- Director of Medical Analytics Group, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts.
| | - Marc D Succi
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Director, Medically Engineered Solutions in Healthcare Incubator, Massachusetts General Hospital, Boston, Massachusetts
| | - Min Lang
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - James Brink
- Juan M. Taveras Professor of Radiology, Harvard Medical School, Boston, Massachusetts; Radiologist-in-Chief, Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
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