Long-Term Experience With a Mandatory Clinical Decision Rule and Mandatory d-Dimer in the Evaluation of Suspected Pulmonary Embolism
This study evaluated the long-term effectiveness of mandatory assignment of both a clinical decision rule (CDR) and highly sensitive d-dimer in the evaluation of patients with suspected pulmonary embolism (PE). (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 12, 2018 Category: Radiology Authors: Guy W. Soo Hoo, Emily Tsai, Sondra Vazirani, Zhaoping Li, Bruce M. Barack, Carol C. Wu Tags: Original article Source Type: research

Comparison of Breast Density Between  Synthesized Versus Standard Digital Mammography
To evaluate perceptual difference in breast density classification using synthesized mammography (SM) compared with standard or full-field digital mammography (FFDM) for screening. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 12, 2018 Category: Radiology Authors: Irfanullah Haider, Matthew Morgan, Anna McGow, Matthew Stein, Maryam Rezvani, Phoebe Freer, Nan Hu, Laurie Fajardo, Nicole Winkler Tags: Original article Source Type: research

Patient-Friendly Summary of the ACR Appropriateness Criteria Iliac Artery Occlusive  Disease
Iliac artery occlusive disease is blockage of the large arteries supplying blood to the pelvis and legs. Risk factors include diabetes, high blood pressure, and smoking. This blockage is treated differently depending on whether it developed slowly (progressive) or suddenly (acute). The typical symptoms of progressive disease are pain, numbness, and tiredness in the legs when walking and standing, which worsens with time and improves with rest. Typical symptoms of acute disease are sudden leg pain and weak pulse in the groin. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 12, 2018 Category: Radiology Authors: S øren Meibom, Bruno Policeni Tags: Appropriate use criteria Source Type: research

Radiotherapy Utilization and Fractionation  Patterns During the First Course of Cancer Treatment in the United States From 2004 to 2014
This study aims to report radiotherapy utilization and fractionation patterns during the first course of cancer treatment. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 11, 2018 Category: Radiology Authors: Trevor J. Royce, Muhammad M. Qureshi, Minh Tam Truong Tags: Original article Source Type: research

Contrast Resolution Role in Medical  Imaging
Question: Why is contrast resolution important in medical imaging? What factors affect contrast resolution? (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 7, 2018 Category: Radiology Authors: Richard Morin, Mahadevappa Mahesh Tags: The medical physics consult Source Type: research

Radiologist Quality Assurance by Nonradiologists at Tumor Board
To explore the use of nonradiologists as a method to efficiently reduce bias in the assessment of radiologist performance using a hepatobiliary tumor board as a case study. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 1, 2018 Category: Radiology Authors: William R. Masch, Neehar D. Parikh, Tracy L. Licari, Mishal Mendiratta-Lala, Matthew S. Davenport Tags: Original article Source Type: research

Re: Injured Children Receive Twice the Radiation Dose at Nonpediatric Trauma Centers Compared With Pediatric Trauma Centers
We read with interest the recent article in press, “Injured Children Receive Twice the Radiation Dose at Nonpediatric Trauma Centers Compared With Pediatric Trauma Centers” [1]. We would like to recognize and applaud the effective reductions in exposure Arkansas has made with the use of a statewide image repository. Avoiding redundancy and inap propriate use of ionizing radiation should be the principal means to reduce cumulative radiation dose and associated risk. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 1, 2018 Category: Radiology Authors: M. Crockett Bone, Michael J. Schlosser, Jonathan B. Perlin Tags: Department Source Type: research

Gone Fishing
Many go fishing all their lives without knowing it is not fish they are after. —Henry David Thoreau (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 1, 2018 Category: Radiology Authors: Bruce J. Hillman Tags: Department Source Type: research

Characteristics of High-Performing Radiologists Within Medicare Quality Programs
The aim of this study was to assess radiologists ’ performance on Medicare quality measures and identify physician characteristics potentially influencing such scores. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - June 1, 2018 Category: Radiology Authors: Andrew B. Rosenkrantz, Gregory N. Nicola, Richard Duszak Tags: Original article Source Type: research

Authors ’ Reply
We appreciate the authors ’ comments on our article, “Injured Children Receive Twice the Radiation Dose at Nonpediatric Trauma Centers Compared With Pediatric Trauma Centers” [1]. The authors dispute dose optimization as the sole mechanism underlying the difference between effective radiation dose (ERD) at pediatr ic trauma centers and nonpediatric hospitals (NPHs). We acknowledge that technologists at pediatric trauma centers do not have to make an effort to change from an adult protocol to a pediatric protocol, as is necessary at NPHs, when using optimal scanning protocols. (Sou...
Source: Journal of the American College of Radiology : JACR - June 1, 2018 Category: Radiology Authors: Rosemary Nabaweesi, Raghu H. Ramakrishnaiah, Mary E. Aitken, Mallikarjuna R. Rettiganti, Chunqiao Luo, Robert T. Maxson, Charles M. Glasier, Philip J. Kenney, James M. Robbins Tags: Department Source Type: research

Key Performance Indicators and the Balanced Scorecard
How do you judge the quality of a restaurant? If you are like the average person, your opinion probably hinges on factors beyond simply whether or not your meal was delicious. It is about “the experience.” You may consider the ease of getting the reservation, friendliness of the wait staff, innovativeness of the menu, ambiance of the dining room, and price of the experience, just to name a few. Therefore, even a restaurant that uses the best ingredients to serve the best food can fail if these other important aspects of quality are ignored. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 31, 2018 Category: Radiology Authors: H. Benjamin Harvey, Susan T. Sotardi Tags: Quality in practice Source Type: research

Strengthening the Radiology Learning Environment
The learning environment is composed of the physical space, context, and culture in which students learn. The new accreditation system for residency programs introduced the Clinical Learning Environment Review program as a means to improve the environment in which physicians learn to provide safe and effective value-based care. Although a positive learning environment helps minimize burnout and is directly related to more effective learning, work satisfaction, and staff morale, creating such an environment can be challenging. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 31, 2018 Category: Radiology Authors: Priscilla J. Slanetz, Deborah Reede, Richard B. Ruchman, Tara Catanzano, Amy Oliveira, Daniel Ortiz, Debra S. Whorms, Emmanuel Carrodeguas, Lori A. Deitte Tags: Civil discourse Source Type: research

What Health Care Can Learn From  Self-Driving Vehicles
I come from a background in electrical engineering and have been with Nvidia (Santa Clara, California) for approximately 10 years. During that time, I have seen the company reinvent itself on multiple occasions. Nvidia started out as a  gaming company; 10 years ago we reinvented ourselves into a computing company, and now we are focusing on artificial intelligence (AI), which has allowed us to play an important role in making self-driving vehicles a reality. Additionally, the insights we gleaned from the process of creating self -driving vehicles are being applied to new health care initiatives, in which there ar...
Source: Journal of the American College of Radiology : JACR - May 31, 2018 Category: Radiology Authors: Kimberly Powell, Elliot K. Fishman, Karen M. Horton, Pamela T. Johnson, Steven P. Rowe Tags: Rethinking the patient experience Source Type: research

From Medical Student to Practicing Physician: Promoting Well-Being in the Learning  Continuum
Approximately 50% of US physicians are experiencing professional burnout. During the past decade, physician burnout has increased considerably and is characterized by exhaustion, cynicism, and reduced effectiveness. Physician burnout is associated with an increased risk of broken relationships, substance misuse, and suicide; burnout can also influence quality of of care and patient safety. Physician distress is  proposed as a quality indicator in health care delivery [1]. Additionally, the ACGME program requirements include a “commitment to the well-being of the students, residents, faculty members, and all memb...
Source: Journal of the American College of Radiology : JACR - May 31, 2018 Category: Radiology Authors: Lori A. Deitte, Amy E. Fleming, Madelene C. Lewis, Jessica B. Robbins, Felix S. Chew, Priscilla J. Slanetz Tags: Civil discourse Source Type: research

Delivering Humanitarian Teleradiology Services to Besieged Areas in Syria
The unique conflict in Syria has disrupted every aspect of the Syrians ’ lives. It tremendously impacted the health care system with several reports of selective targeting of medical facilities and personnel. The World Health Organization issued alarming statements regarding the continuous attacks on health care facilities and providers throughout the country reachin g a critical level of emergency. Since the beginning of the Syrian crisis in 2011, 485 medical facilities were bombed and 841 medical personnel were killed [1,2]. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 25, 2018 Category: Radiology Authors: Abdulrahman Masrani, Ihsan Mamoun, Bisher Tarabishy, Abdulrahman Tarabishy, Mohammad Arabi Tags: Case studies in leadership Source Type: research

Impact of a Commercially Available Clinical  Decision Support Program on Provider Ordering Habits
Clinical decision support (CDS) software designed around the ACR Appropriateness Criteria assists health care providers in choosing appropriate imaging studies at the time of order entry. The goal of this study was to determine the impact of commercially available CDS on the ordering habits of inpatient and emergency providers. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 25, 2018 Category: Radiology Authors: Timothy C. Huber, Arun Krishnaraj, James Patrie, Cree M. Gaskin Tags: Original article Source Type: research

Random Versus Nonrandom Peer Review: A Case for More Meaningful Peer Review
The objective of this study was to compare error cases identified through random and nonrandom peer review approaches at an academic center. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 25, 2018 Category: Radiology Authors: Jason N. Itri, Adam Donithan, Sohil H. Patel Tags: Original article Source Type: research

Comparative Analysis of Body Radiologist to Neuroradiologist Evaluation of the Spine in Trauma Settings
CT is routinely performed to evaluate trauma patients. When a radiologist misses an acute finding, there could be serious adverse consequences. In many subspecialty settings, body radiologists and neuroradiologists both interpret the thoracic and lumbar spine. RADPEER has estimated general disagreement rates between radiologists to be 2.9%, but the disagreement rate between neuroradiologists and body radiologists in trauma settings remains unknown. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 24, 2018 Category: Radiology Authors: Alice L. Zhou, Luke W. Bonham, Franco Verde Tags: Original article Source Type: research

System Redesign of a Radiology Research Clinic for Oncology Clinical Trial Patients
It is well established in the literature that a process improvement-focused culture is an essential component of success in a rapidly changing health care environment [1]. A component of this culture may include tools such as Lean Six Sigma [2]. Frequently, the issues identified are large scale and complex and require the buy-in of multiple departments for success [3,4]. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 24, 2018 Category: Radiology Authors: Lauren Gjolaj, Avantika Dang, Helen Peck, Jonathan Trent, Rosa Patricia Castillo Tags: Case studies in leadership Source Type: research

Risk Predictors for Postcontrast Acute  Kidney Injury
To evaluate risk predictors of acute kidney injury (AKI) after contrast-media procedures in a broader cohort of patients than previously reported. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 22, 2018 Category: Radiology Authors: Trudy Millard Krause, Maria Ukhanova, Frances Lee Revere, Kevin W. Finkel Tags: Original article Source Type: research

A Normal Thyroid by Any Other Name: Linguistic Analysis of Statements Describing a Normal Thyroid Gland from Noncontrast Chest CT Reports
To determine the variability and readability of language used in chest CT reports to describe a “normal” thyroid gland. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 22, 2018 Category: Radiology Authors: Ryan G. Short, Nicholas T. Befera, Jenny K. Hoang, Tina D. Tailor Tags: Original article Source Type: research

Estimated Mortality of Breast Cancer Patients Based on Stage at Diagnosis and  National Screening Guideline Categorization
To compare overall and stage I to IV mortalities of patients diagnosed with breast cancer, calculated from stage at diagnosis using the Surveillance, Epidemiology, and End Results (SEER) database stage mortality estimates, which are based on national screening guideline categorization. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 21, 2018 Category: Radiology Authors: Samir B. Patel Tags: Original article Source Type: research

Ionizing Radiation Use and Cancer Predisposition Syndromes in Children
The discovery of genetic drivers of cancer and access to genomic data have transformed the landscape of oncologic diagnosis and therapy and led to personalized treatment plans with tumor-specific immunotherapy. Treatment might be seen as the end point for personalized medicine, however, the radiologist is charged with practicing patient-centered radiology for every patient at every point in his or her disease course, including screening, diagnosis, response to therapy, and surveillance [1]. Every radiologist providing consultation and imaging recommendations should have sound knowledge of radiation sensitivity and be prepa...
Source: Journal of the American College of Radiology : JACR - May 21, 2018 Category: Radiology Authors: Janet R. Reid, Lisa J. States Tags: Radiation sensibilities Source Type: research

Good Relationships Mean Good Reimbursement
I used to tell medical students when they came to interview at my residency program that, whether they intended to or not, they were joining a service specialty. I thought of radiologists as a version of the classical “doctor’s doctor.” We help other physicians care for their patients by finding the answers to clinical questions in imaging examinations. Simple. I considered this a useful mental framework for being a radiologist. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 21, 2018 Category: Radiology Authors: Kurt Schoppe Tags: Reimbursement rounds Source Type: research

Impact of Second-Opinion Interpretation of  Breast Imaging Studies in Patients Not Currently Diagnosed With Breast Cancer
To study the impact of second-opinion interpretation of breast imaging studies submitted from outside facilities to a tertiary cancer center. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 19, 2018 Category: Radiology Authors: Lauren Q. Chang Sen, Ray C. Mayo, Michele D. Lesslie, Wei T. Yang, Jessica W.T. Leung Tags: Original article Source Type: research

Assessment of Appropriate Recovery Time After Liver Biopsy
Percutaneous liver biopsies have been a safe and effective diagnostic procedure for more than 100 years [1,2]. Liver biopsies are well tolerated, with a low complication rate ranging from 0.1% to 5.8% in adults [3-13]. The most common biopsy complications are bleeding and pain [6,10-11], mostly occurring within 24 hours of the procedure [10,12,13]. Although only a few studies have specifically addressed the length of the recovery period after biopsy, those that do  report ranges of 1 to 8 hours, with 2 to 4 hours most common [3,4,6-8,10,14]. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 19, 2018 Category: Radiology Authors: Neema J. Patel, Andrew W. Bowman Tags: Case studies in clinical practice management Source Type: research

High-Grade Serous Ovarian Cancer: Use of Machine Learning to Predict Abdominopelvic Recurrence on CT on the Basis of Serial Cancer Antigen 125 Levels
The aim of this study was to use machine learning to predict abdominal recurrence on CT on the basis of serial cancer antigen 125 (CA125) levels in patients with advanced high-grade serous ovarian cancer on surveillance. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 19, 2018 Category: Radiology Authors: Atul B. Shinagare, Patricia Balthazar, Ivan K. Ip, Ronilda Lacson, Joyce Liu, Nikhil Ramaiya, Ramin Khorasani Tags: Original article Source Type: research

My American Dream
I was born and raised in a North African country overlooking the southern European border. I came to America speaking broken English and settled in Brooklyn, New York, in pursuit of the “American dream.” Living in my adoptive melting pot, I journeyed uneventfully through my radiology training and into practice. As a young academic interventional radiologist in the Southeast, each day, for me, meant another day living the red, white, and blue dream. How sweet it was! (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Driss Raissi Tags: See one, do one, write one Source Type: research

Why Physics in Medicine?
Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Ehsan Samei, Thomas M. Grist Tags: Original article Source Type: research

Qualitative Reporting of Lesion Number: Do Radiologists and Referring Physicians Understand Each Other?
Recently, there has been growing interest in how well referring physicians understand the radiology reports they read. Specific topics that have been addressed in the literature include radiologist communication of diagnostic certainty, oncologic measurements, fracture classifications, and incidental findings [1-4]. Another topic that is vitally important, especially in oncologic imaging, is the communication of lesion number. Radiologists often use qualitative descriptors of number, such as “few,” “several,” “multiple,” or “numerous,” to give an overall impression of how man...
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Joseph R. England, Phillip M. Cheng, Miriam Romero Tags: Case studies in leadership Source Type: research

Launching a Successful Startup: An  Entrepreneur’s Field Guide
My name is Jeremy Snepar, and I have been an entrepreneur for most of my life, despite coming from a family of doctors. Although one could define entrepreneur in a number of ways, perhaps one of the most  fitting is a person who risks reputation and livelihood to pursue an unconventional or unpopular approach to solving a problem. This definition applies well to my own experience and perceptions. Being an entrepreneur is not just about starting a business. Entrepreneurs are comfortable with profe ssional discomfort. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Jeremy Snepar, Elliot K. Fishman, Karen M. Horton, Pamela T. Johnson, Steven P. Rowe Tags: Rethinking the patient experience Source Type: research

Four Grammies or Three Deanships
Appleton, Wisconsin, and inner-city Detroit are about 500 miles apart geographically, but even further apart culturally. However, in each city, there were two pairs of siblings who can teach us about creativity. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Mark E. Schweitzer Tags: Sparks of creativity Source Type: research

Geographic Variation in Gender Disparities in the US Radiologist Workforce
To assess geographic variation in gender disparities in the US radiologist workforce. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Andrew B. Rosenkrantz, Amy L. Kotsenas, Richard Duszak Tags: Original article Source Type: research

Patient Friendly Summary of the ACR Appropriateness Criteria: CT for Adult Minor  Head Trauma
A closed head injury results from hitting your head on something. Even a small minor blow to the head can be dangerous and should be evaluated by a doctor for a possible concussion, bleeding on the brain, or skull fracture. Most minor head injuries do not require imaging tests. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 18, 2018 Category: Radiology Authors: Celena Romero, Ryan Lee Tags: Appropriate use criteria Source Type: research

The Association of Program Directors in Radiology Academic Output Task Force: Assisting Today ’s Busy Radiology Educators
An important mission of the Association of Program Directors in Radiology (APDR) is to provide program directors and educators with resources to assist them with an ever changing graduate medical education (GME) climate. Today ’s program director must be ready to adapt to new policies from a host of organizations, such as the ACGME, the Liaison Committee on Medical Education, and the ABR. Trainee advocates volunteering for the APDR strive to understand new guidelines and evolving trends in residency training, often prov iding fellow educators with written recommendations in the form of published papers in the radiolo...
Source: Journal of the American College of Radiology : JACR - May 14, 2018 Category: Radiology Authors: Darel E. Heitkamp, Kamran Ali, Carolynn M. DeBenedectis, Eric England, Glenn C. Gaviola, Christopher P. Ho, Vivek Kalia, James M. Milburn, Seng Ong, Maitray D. Patel, Mary H. Scanlon, David S. Sarkany Tags: Opinion Source Type: research

Patient-Friendly Summary of the ACR Appropriateness Criteria Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer
When a patient has a confirmed diagnosis of invasive breast cancer, the patient may receive chemotherapy ahead of surgery. This is called neoadjuvant therapy and is used to shrink tumors before they are removed surgically. It also treats cancer that has spread (metastasized). Imaging tests before and during neoadjuvant treatment can help guide treatment decisions. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 11, 2018 Category: Radiology Authors: Casey Quinlan, Jennifer W. Uyeda Tags: Appropriate use criteria Source Type: research

Tailoring Radiology Resident Education Using Aggregated Missed-Cases Data
Although there has been a recent trend toward after-hours attending coverage for interpretation of imaging studies, residents at many teaching hospitals begin independent call during postgraduate year 3  after 12 months of dedicated radiology training [1,2]. Given this relatively short period to acquire the substantial amount of information necessary to safely interpret studies independently, the task of preparing radiology residents for this duty is critically important [3]. It is a daunting ta sk given the scope and variety of potential pathologies likely to be encountered during call. (Source: Journal of ...
Source: Journal of the American College of Radiology : JACR - May 11, 2018 Category: Radiology Authors: Bryce A. Merritt, Travis S. Henry, Soonmee Cha, Karen G. Ordovas, Kimberly G. Kallianos, Brett M. Elicker, Michael D. Hope, David M. Naeger Tags: Case studies in training and education Source Type: research

Artificial Intelligence and the Practice of Radiology: An Alternative View
Massive transformations often begin with deceptive slowness. The first hand-cranked digital computer in 1672 could add and subtract. The first electronic digital computer in 1946 was also able to multiply and divide. In 1956, researchers in the newly named field of artificial intelligence (AI) predicted that computers as intelligent as humans were just around the corner. But it took until 1997 for a computer to beat the best human chess player and until 2016 for a computer to win at the vastly more complicated game of Go. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 11, 2018 Category: Radiology Authors: Robert Schier Tags: Opinion Source Type: research

Democracy and Burnout: The ACR ’s Special Role
Perhaps as the most democratic of American radiology ’s major professional organizations, the ACR has an important role to play in this time of rising rates of burnout among medical professionals [1]. Two of the most important contributors to burnout are loss of autonomy and inefficacy [2]. Autonomy refers to the ability of professionals to shape th e nature of their work, while efficacy refers to the sense that what professionals say and do can enrich the professional difference they make. Both seem to be in decline. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 10, 2018 Category: Radiology Authors: Richard B. Gunderman Tags: Opinion Source Type: research

Radiology Report Readability: An Opportunity to Improve Patient Communication
Traditionally, radiology reports are written with the expectation that all readers have medical training. Consequently, they frequently contain jargon and technical terminology that render them uninterpretable by patients [1], who increasingly have access to their reports through patient portals [2]. Although perceived by some radiologists as sufficiently patient centered, mere portal access neglects issues of readability and comprehension, appraisal, and application [3]. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 10, 2018 Category: Radiology Authors: Anna Trofimova, Brianna L. Vey, Nabile M. Safdar, Richard Duszak, Nadja Kadom Tags: Case studies in leadership Source Type: research

Preoccupied With Work
As a leader, you notice that you are frequently distracted by thoughts about work, even when you are not at work. You often find yourself waking up in the middle of the night  thinking about a variety of work issues. Your family has also noticed and has complained that it is negatively affecting your relationships. How would you handle this? (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 10, 2018 Category: Radiology Authors: David Fessell, Frank J. Lexa Tags: Devilish dilemma Source Type: research

Changing Culture
You become the leader of a department in which candid feedback has not been  given or welcomed, and a strong culture has developed around this. You are noticing that many issues and problems get ignored or go unspoken. How do you solicit and encourage candid feedback for the chair and other leaders in the department? (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 10, 2018 Category: Radiology Authors: Frank J. Lexa, David Fessell Tags: Devilish dilemma Source Type: research

Understanding Why Patients No-Show: Observations of 2.9 Million Outpatient Imaging Visits Over 16 Years
To understand why patients “no-show” for imaging appointments, and to provide new insights for improving resource utilization. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 10, 2018 Category: Radiology Authors: Joshua I. Rosenbaum, Rebecca J. Mieloszyk, Christopher S. Hall, Daniel S. Hippe, Martin L. Gunn, Puneet Bhargava Tags: Original article Source Type: research

Diagnosing Happiness: Lessons From Positive Psychology
If I study, I seek only the learning that... instructs me in how to die well and live well —Michel De Montaigne (1580) (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 8, 2018 Category: Radiology Authors: Sanj Katyal Tags: Opinion Source Type: research

Modifying Institutional Guidelines Reduces the Likelihood of Oversedation During Interventional Procedures
The administration of anxiolytics and analgesia during invasive radiology procedures is standard practice. In addition to increasing patient comfort and reducing patient pain and anxiety, moderate sedation helps with the successful completion of a procedure [1-3]. Despite the general acceptance of the safety of opioids and benzodiazepines (BZDs) for sedation, there is still a potential for oversedation and related serious adverse drug events. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 8, 2018 Category: Radiology Authors: Jonathan G. Martin, Zachary L. Bercu, Lauren Becker, Morgan Whitmore, Jay Shah, Daryl Goldman, Janice Newsome Tags: Case studies in clinical practice management Source Type: research

Improving Performance by Using a Radiology Extender
Academic radiology centers challenged by reduced reimbursements have relied on a strategy of mergers, consolidations, and buyouts of nonacademic practices [1] to improve case volumes and revenue and to distribute operating costs. Our institute is a level 1 trauma center located in a large urban area and supports the region across multiple service lines. Resulting from recent mergers and acquisitions (M&A) activities, its radiology service now provides care in multiple affiliated hospitals and diagnostic imaging centers located across the region, performing over a million cases annually. (Source: Journal of the American...
Source: Journal of the American College of Radiology : JACR - May 8, 2018 Category: Radiology Authors: Arijitt Borthakur, J. Bruce Kneeland, Mitchell D. Schnall Tags: Case studies in clinical practice management Source Type: research

Pediatric CT Protocols From the American Association of Physicists in Medicine Alliance for Quality CT
In 2010, there was a lack of fundamental support for CT protocol development and frustration that patients had recently been injured from CT scans [1]. The idea for what is now called the American Association of Physicists in Medicine Alliance for Quality Computed Tomography Work Group (AQCTWG) was established during a dinner conversation between Cynthia McCollough, Dianna Cody, and William Hendee, who recognized that medical physicists had the expertise to provide that guidance. Concurrently, manufacturers were working with the US FDA to determine how to support their users and prevent accidental injury in the future. (So...
Source: Journal of the American College of Radiology : JACR - May 7, 2018 Category: Radiology Authors: Sarah E. McKenney, Cristina T. Dodge Tags: Radiation Sensibilities Source Type: research

Day of Week, Site of Service, and Patient  Complexity Differences in Venous Ultrasound Interpreted by Radiologists Versus Nonradiologists
Nationally, nonradiologists interpret an increasing proportion of lower extremity venous duplex ultrasound (LEVDU) examinations. We aimed to study day of week, site of service, and patient complexity differences in LEVDU services interpreted by radiologists versus nonradiologists. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 7, 2018 Category: Radiology Authors: Anand M. Prabhakar, Ravi V. Gottumukkala, Wenyi Wang, Danny R. Hughes, Richard Duszak Tags: Original article Source Type: research

Clinical Access and Utilization of Reports and Images in Neuroradiology
The radiology report serves as the primary means of communication between radiologist and clinician. However, the value clinicians place on imaging and reports is variable, with many images of studies or their reports never being viewed. This has implications on the perceived value of the radiologist in the imaging chain. We hypothesized that neurologists, neurosurgeons, and otolaryngologists would view neuroradiology images most frequently and neuroradiology reports least frequently of all medical specialties. (Source: Journal of the American College of Radiology : JACR)
Source: Journal of the American College of Radiology : JACR - May 7, 2018 Category: Radiology Authors: Matthew D. Alvin, Mona Shahriari, Evan Honig, Li Liu, David M. Yousem Tags: Original article Source Type: research

The Value of a Disease-Specific Template and an IT-Based Quality Tracking System in Pulmonary Embolism CT Angiography
Previously, ventilation-perfusion scans were the main modality to assess for suspected pulmonary embolism (PE) [1]. Ventilation-perfusion scans have now been largely supplanted by chest CT angiographic (CTA) examinations. CTA has the advantages of wide availability, rapid acquisition, and high positive predictive value. Moreover, chest CTA scans often detect significant non-PE findings [2-4]. PE chest CTA is among the most common cross-sectional examination types performed in our section. In a primary aim to determine if utilization rates of chest CTA scans for detection of PE were appropriate and as secondary aims to decr...
Source: Journal of the American College of Radiology : JACR - May 7, 2018 Category: Radiology Authors: Jonathan H. Chung, Luis Landeras, Kateland Haas, Peng Liu, Lili Liu, Heber MacMahon Tags: Case studies in clinical practice management Source Type: research