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Malhotra A, Bajaj S, Garg T, Khunte M, Pahwa B, Wu X, Payabvash S, Mukherjee S, Gandhi D, Forman HP. American College of Radiology Appropriateness Criteria®: a bibliometric analysis of panel members. Insights Imaging 2023; 14:113. [PMID: 37395838 PMCID: PMC10317907 DOI: 10.1186/s13244-023-01456-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 01/12/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE To assess the features of panel members involved in the writing of the ACR-AC and identify alignment with research output and topic-specific research publications. METHODS A cross-sectional analysis was performed on the research output of panel members of 34 ACR-AC documents published in 2021. For each author, we searched Medline to record total number of papers (P), total number of ACR-AC papers (C) and total number of previously published papers that are relevant to the ACR-AC topic (R). RESULTS Three hundred eighty-three different panel members constituted 602 panel positions for creating 34 ACR-AC in 2021 with a median panel size of 17 members. Sixty-eight (17.5%) of experts had been part of ≥10 previously published ACR-AC papers and 154 (40%) were members in ≥ 5 published ACR-AC papers. The median number of previously published papers relevant to the ACR-AC topic was 1 (IQR: 0-5). 44% of the panel members had no previously published paper relevant to the ACR-AC topic. The proportion of ACR-AC papers (C/P) was higher for authors with ≥ 5 ACR-AC papers (0.21) than authors with < 5 ACR-AC papers (0.11, p < 0.0001); however, proportion of relevant papers per topic (R/P) was higher for authors with < 5 ACR-AC papers (0.10) than authors with ≥ 5 ACR-AC papers (0.07). CONCLUSION The composition of the ACR Appropriateness Criteria panels reflects many members with little or no previously published literature on the topic of consideration. Similar pool of experts exists on multiple expert panels formulating imaging appropriateness guidelines. KEY POINTS There were 68 (17.5%) panel experts on ≥ 10 ACR-AC panels. Nearly 45% of the panel experts had zero median number of relevant papers. Fifteen panels (44%) had > 50% of members having zero relevant papers.
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Affiliation(s)
- Ajay Malhotra
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT, 06520-8042, USA.
| | - Suryansh Bajaj
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT, 06520-8042, USA
| | - Tushar Garg
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mihir Khunte
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT, 06520-8042, USA
| | - Bhavya Pahwa
- University College of Medical Sciences, Delhi, India
| | - Xiao Wu
- Department of Radiology, University of California at San Francisco, San Francisco, USA
| | - Seyedmehdi Payabvash
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT, 06520-8042, USA
| | - Suresh Mukherjee
- Radiology and Radiation Oncology, University of Illinois, Peoria, IL and Robert Wood Johnson Medical School, Newark, NJ, USA
| | - Dheeraj Gandhi
- Interventional Neuroradiology, Nuclear Medicine, Neurology and Neurosurgery, University of Maryland School of Medicine, Maryland, USA
| | - Howard P Forman
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, Tompkins East 2, 333 Cedar St, Box 208042, New Haven, CT, 06520-8042, USA
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Scorziello C, Durante C, Biffoni M, Borcea MC, Consorti F, Laca A, Melcarne R, Ventrone L, Giacomelli L. The Size of a Thyroid Nodule with ACR TI-RADS Does Not Provide a Better Prediction of the Nature of the Nodule: A Single-Center Retrospective Real-Life Observational Study. Healthcare (Basel) 2023; 11:1673. [PMID: 37372791 DOI: 10.3390/healthcare11121673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
We investigated if thyroid nodule size has a predictive value of malignancy on a par with composition, echogenicity, shape, margin, and echogenic foci, and what would be the consequence of observing the rule of the American College of Radiology (ACR) to perform a fine-needle aspiration biopsy (FNAB). We conducted a retrospective real-life observational study on 86 patients who underwent surgery after a standardized diagnostic protocol. We divided the TR3, TR4, and TR5 classes into sub-classes according to the size threshold indicating FNAB (a: up to the threshold for no FNAB; b: over the threshold for FNAB suggested). We computed sensitivity, specificity, and positive (PPV) and negative predictive value (NPV) for the different sub-classes and Youden's index (Y) for the different possible cutoffs. Each sub-class showed the following PPV (0.67, 0.68, 0.70, 0.78, 0.72), NPV (0.56, 0.54, 0.51, 0.52, 0.59), and Y (0.20, 0.20, 0.22, 0.31, 0.30). In this real-life series, we did not find a significant difference in prediction of malignancy between the sub-categories according to the size threshold. All nodules have a pre-evaluation likelihood of being malignant, and the impact and utility of size thresholds may be less clear than suggested by the ACR TIRADS guidelines in patients undergoing standardized thyroid work up.
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Affiliation(s)
- Chiara Scorziello
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Cosimo Durante
- Department of Translational and Precision Medicine, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Marco Biffoni
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Maria Carola Borcea
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Fabrizio Consorti
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Angelo Laca
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Rossella Melcarne
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Luca Ventrone
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
| | - Laura Giacomelli
- Department of Surgical Sciences, Sapienza University of Rome, Viale del Policlinico, 155, I-00161 Rome, Italy
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Wang B, Ou X, Yang J, Zhang H, Cui XW, Dietrich CF, Yi AJ. Contrast-enhanced ultrasound and shear wave elastography in the diagnosis of ACR TI-RADS 4 and 5 category thyroid nodules coexisting with Hashimoto's thyroiditis. Front Oncol 2023; 12:1022305. [PMID: 36713579 PMCID: PMC9874292 DOI: 10.3389/fonc.2022.1022305] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023] Open
Abstract
Objective This study aims to evaluate the value of contrast-enhanced ultrasound (CEUS), shear wave elastography (SWE), and their combined use in the differentiation of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) 4 and 5 category thyroid nodules coexisting with Hashimoto's thyroiditis (HT). Materials and methods A total of 133 pathologically confirmed ACR TI-RADS 4 and 5 category nodules coexisting with HT in 113 patients were included; CEUS and SWE were performed for all nodules. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), accuracy, and the area under the receiver operating characteristic curve (AUC) of the SWE, CEUS, and the combined use of both for the differentiation of benign and malignant nodules were compared, respectively. Results Using CEUS alone, the sensitivity, specificity, PPV, NPV, and accuracy were 89.2%, 66.0%, 81.3%, 78.6%, and 80.5%, respectively. Using SWE alone, Emax was superior to Emin, Emean, and Eratio for the differentiation of benign and malignant nodules with the best cutoff Emax >46.8 kPa, which had sensitivity of 65.1%, specificity of 90.0%, PPV of 91.5%, NPV of 60.8%, and accuracy of 74.4%, respectively. Compared with the diagnostic performance of qualitative CEUS or/and quantitative SWE, the combination of CEUS and SWE had the best sensitivity, accuracy, and AUC; the sensitivity, specificity, PPV, NPV, accuracy, and AUC were 94.0%, 66.0%, 82.1%, 86.8%, 83.5%, and 0.80 (95% confidence interval: 0.713, 0.886), respectively. Conclusion In conclusion, CEUS and SWE were useful for the differentiation of benign and malignant ACR TI-RADS 4 and 5 category thyroid nodules coexisting with HT. The combination of CEUS and SWE could improve the sensitivity and accuracy compared with using CEUS or SWE alone. It could be a non-invasive, reliable, and useful method to differentiate benign from malignant ACR TI-RADS 4 and 5 category thyroid nodules coexisting with HT.
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Affiliation(s)
- Bin Wang
- Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Xiaoyan Ou
- Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Juan Yang
- Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Haibo Zhang
- Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, China
| | - Xin-Wu Cui
- Department of Medical Ultrasound, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China,*Correspondence: Xin-Wu Cui, ; Ai-Jiao Yi,
| | - Christoph F. Dietrich
- Department Allgemeine Innere Medizin, Kliniken Hirslanden Beau Site, Salem und Permanence, Bern, Switzerland
| | - Ai-Jiao Yi
- Department of Medical Ultrasound, Yueyang Central Hospital, Yueyang, China,*Correspondence: Xin-Wu Cui, ; Ai-Jiao Yi,
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Tan N, Lakshmi M, Hernandez D, Scuderi A. Upcoming American College of Radiology prostate MRI designation launching: what to expect. Abdom Radiol (NY) 2020; 45:4109-4111. [PMID: 32940754 DOI: 10.1007/s00261-020-02725-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/20/2020] [Accepted: 08/30/2020] [Indexed: 12/01/2022]
Abstract
The use of prostate MRI for prostate cancer evaluation continues to rise and ensuring minimum quality standards across practices will enable optimal diagnostic accuracy and thus, patient care. The American College of Radiology has been working on quality standards to meet Prostate MRI Designated Center, which is expected to launch in late 2020. We discuss the background of the American College of Radiology Prostate MRI working group's effort and summarize the criteria for Prostate MRI Designation.
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Affiliation(s)
- Nelly Tan
- Division of Abdominal Radiology, Department of Radiology, Mayo Clinic in Arizona, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA.
| | - Magge Lakshmi
- Radiology and Imaging Specialists, Lakeland, FL, 32836, USA
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Juliano AF, Aiken AH. NI-RADS for head and neck cancer surveillance imaging: What, why, and how. Cancer Cytopathol 2019; 128:166-170. [PMID: 31750995 DOI: 10.1002/cncy.22214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/29/2019] [Indexed: 11/06/2022]
Abstract
The Neck Imaging Reporting and Data System (NI-RADS) was conceived in 2016 with the objective of standardizing assessment and reporting in surveillance imaging for patients with head and neck squamous cell carcinomas and their subsequent management. The goals are to simplify radiology reports while increasing the consistency and accuracy of the interpretation of cancer surveillance imaging; enable better communication among clinicians and between clinicians and patients; facilitate outcomes research; and ultimately improve patient survival, morbidity, and mortality. The objective of the current study was to provide the background as to why and how NI-RADS was conceived and what it entails in radiology reporting.
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Affiliation(s)
- Amy F Juliano
- Department of Radiology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Ashley H Aiken
- Department of Radiology, Emory University Hospital, Emory University School of Medicine, Atlanta, Georgia
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Ehman MO, Bao Z, Stiving SO, Kasam M, Lanners D, Peterson T, Jonsgaard R, Carter R, McGee KP. Automated low-contrast pattern recognition algorithm for magnetic resonance image quality assessment. Med Phys 2017; 44:4009-4024. [PMID: 28543961 DOI: 10.1002/mp.12370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 04/06/2017] [Accepted: 05/17/2017] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Low contrast (LC) detectability is a common test criterion for diagnostic radiologic quality control (QC) programs. Automation of this test is desirable in order to reduce human variability and to speed up analysis. However, automation is challenging due to the complexity of the human visual perception system and the ability to create algorithms that mimic this response. This paper describes the development and testing of an automated LC detection algorithm for use in the analysis of magnetic resonance (MR) images of the American College of Radiology (ACR) QC phantom. METHODS The detection algorithm includes fuzzy logic decision processes and various edge detection methods to quantify LC detectability. Algorithm performance was first evaluated using a single LC phantom MR image with the addition of incremental zero mean Gaussian noise resulting in a total of 200 images. A c-statistic was calculated to determine the role of CNR to indicate when the algorithm would detect ten spokes. To evaluate inter-rater agreement between experienced observers and the algorithm, a blinded observer study was performed on 196 LC phantom images acquired from nine clinical MR scanners. The nine scanners included two MR manufacturers and two field strengths (1.5 T, 3.0 T). Inter-rater and algorithm-rater agreement was quantified using Krippendorff's alpha. RESULTS For the Gaussian noise added data, CNR ranged from 0.519 to 11.7 with CNR being considered an excellent discriminator of algorithm performance (c-statistic = 0.9777). Reviewer scoring of the clinical phantom data resulted in an inter-rater agreement of 0.673 with the agreement between observers and algorithm equal to 0.652, both of which indicate significant agreement. CONCLUSIONS This study demonstrates that the detection of LC test patterns for MR imaging QC programs can be successfully developed and that their response can model the human visual detection system of expert MR QC readers.
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Affiliation(s)
- Morgan O Ehman
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Zhonghao Bao
- Department of Information Technology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Scott O Stiving
- Department of Information Technology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Mallik Kasam
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Dianna Lanners
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Teresa Peterson
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Renee Jonsgaard
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Rickey Carter
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
| | - Kiaran P McGee
- Department of Radiology, Mayo Clinic and Foundation, 200 First St, SW, Rochester, MN, 55905, USA
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Stein MW, Frank SJ, Roberts JH, Finkelstein M, Heo M. Integrating the ACR Appropriateness Criteria Into the Radiology Clerkship: Comparison of Didactic Format and Group-Based Learning. J Am Coll Radiol 2016; 13:566-70. [PMID: 26908202 DOI: 10.1016/j.jacr.2015.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Revised: 12/16/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this study was to determine whether group-based or didactic teaching is more effective to teach ACR Appropriateness Criteria to medical students. METHODS An identical pretest, posttest, and delayed multiple-choice test was used to evaluate the efficacy of the two teaching methods. Descriptive statistics comparing test scores were obtained. RESULTS On the posttest, the didactic group gained 12.5 points (P < .0001), and the group-based learning students gained 16.3 points (P < .0001). On the delayed test, the didactic group gained 14.4 points (P < .0001), and the group-based learning students gained 11.8 points (P < .001). The gains in scores on both tests were statistically significant for both groups. However, the differences in scores were not statistically significant comparing the two educational methods. CONCLUSIONS Compared with didactic lectures, group-based learning is more enjoyable, time efficient, and equally efficacious. The choice of educational method can be individualized for each institution on the basis of group size, time constraints, and faculty availability.
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Little BP, Duong PA, Knighton J, Baugnon K, Campbell-Brown E, Kitajima HD, St Louis S, Tannir H, Applegate KE. A Comprehensive CT Dose Reduction Program Using the ACR Dose Index Registry. J Am Coll Radiol 2015; 12:1257-65. [PMID: 26475376 DOI: 10.1016/j.jacr.2015.07.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Accepted: 07/20/2015] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this article is to demonstrate the role of the ACR Dose Index Registry(®) (DIR) in a dose reduction program at a large academic health care system. METHODS Using the ACR DIR, radiation doses were collected for four common CT examination types (head without contrast, chest with contrast, chest without contrast, and abdomen and pelvis with contrast). Baseline analysis of 7,255 CT examinations from seven scanners across the institution was performed for the period from December 1, 2011, to March 15, 2012. A comprehensive dose reduction initiative was guided by the identification of targets for dose improvement from the baseline analysis. Data for 14,938 examinations from the same seven scanners were analyzed for the postimplementation period of January 1, 2013, to July 1, 2013. RESULTS The program included protocol changes, iterative reconstruction, optimization of scan acquisition, technologist education, and continuous monitoring with feedback tools. Average decrease in median dose-length product (DLP) across scanners was 30% for chest CT without contrast, 29% for noncontrast head CT, 26% for abdominal and pelvic CT with contrast, and 10% for chest CT with contrast. Compared with average median DLP in the ACR DIR, the median institution-wide CT DLPs after implementation were lower by 33% for chest CT without contrast, 32% for chest CT with contrast, 26% for abdominal and pelvic CT with contrast, and 6% for head CT without contrast. CONCLUSIONS A comprehensive CT dose reduction program using the ACR DIR can lead to substantial dose reduction within a large health care system.
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Affiliation(s)
- Brent P Little
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia.
| | - Phuong-Anh Duong
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Jessie Knighton
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Kristen Baugnon
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Erica Campbell-Brown
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Hiroumi D Kitajima
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Steve St Louis
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
| | - Habib Tannir
- Department of Radiology, MD Anderson Cancer Center, Houston, Texas
| | - Kimberly E Applegate
- Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, Georgia
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You-Ling Shyu J, Burleson J, Tallant C, Seidenwurm DJ, Rybicki FJ. Performance measures in radiology. J Am Coll Radiol 2015; 11:456-63. [PMID: 24793040 DOI: 10.1016/j.jacr.2013.11.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 11/22/2013] [Indexed: 10/25/2022]
Abstract
Performance measures in radiology play an increasingly significant role in health care quality assessment and now form the basis for a variety of pay-for-performance programs, including those administered by CMS. This article introduces the measure development process, beginning with topic selection, followed by measure development and testing, National Quality Forum endorsement, and implementation. Once implemented, measures may undergo further testing and be re-endorsed, modified, or retired. Radiologists should familiarize themselves with the measures relevant to their practice, develop ways to collect and report data efficiently, and implement the necessary practice changes to meet measure criteria and improve the quality of their practice.
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Affiliation(s)
- Jeffrey You-Ling Shyu
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Judith Burleson
- Commission of Quality and Safety, American College of Radiology, Reston, Virginia.
| | - Colleen Tallant
- Commission of Quality and Safety, American College of Radiology, Reston, Virginia
| | | | - Frank J Rybicki
- Applied Imaging Science Laboratory, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts
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Abstract
A BI-RADS (Breast Imaging Reporting and Data System) 3, or probably benign, assessment is given in approximately 7% to 12% of breast magnetic resonance (MR) images. However, the imaging features of probably benign lesions on MR imaging have not been well defined. As with mammography and ultrasonography, a BI-RADS 3 assessment should be used only when there is a less than 2% likelihood of malignancy. The use of BI-RADS 3 for classically benign findings should be avoided. Certain masses, foci, and areas of nonmass enhancement may be categorized as probably benign on baseline MR imaging.
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Affiliation(s)
- Christopher Comstock
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
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Egilman D, Wallace W, Stubbs C, Mora-Corrasco F. A little too much of the Buchenwald touch? Military radiation research at the University of Cincinnati, 1960-1972. Account Res 1998; 6:63-102. [PMID: 11660591 DOI: 10.1080/08989629808573921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schneider K. Cold war radiation test on humans to undergo a Congressional review? N Y Times Web 1994:D9. [PMID: 11647965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Annas GJ. Breast cancer screening in older women: law and patient rights. J Gerontol 1992; 47 Spec No:121-5. [PMID: 1385513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Legal principles that apply to breast cancer in older women have been developed in judicial decisions related to other medical screening tests. There are no special legal rules for either mammography or older women, although older women seldom file malpractice suits. The general standard is that a screening test must be offered to any particular age group when it is considered "reasonably prudent" to do so, and this almost always means when the medical profession--usually speaking though its specialty boards--declares it the standard of care. The standard of care should be set by medical professionals, with open opportunity for public input, rather than by lawyers or risk managers. In actual practice, private regulation may not be sufficient to protect the public, and both state and federal regulation of mammography facilities now seems inevitable. Patients have the right to be fully informed prior to screening, the right to refuse screening, and the right to have full knowledge of the consequences of such refusal. Mammography is not a consumer good, but American women should be actively involved in determining issues of costs and benefits, as well as helping to develop the best strategies for counseling and informed consent.
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Affiliation(s)
- G J Annas
- Health Law Department, Boston University School of Medicine
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