Interventional Radiology Care Research Articles

PRO-READ IR:Enhanced PROcedural Information READability for Patient-Centered Care in Interventional Radiology with Large Language Models

PurposeTo evaluate the extent to which GPT-4 can educate patients by generating easily understandable information about the most common Interventional Radiology(IR) procedures. Materials and methodsWe reviewed 10 IR procedures and prepared prompts for GPT-4 to provide patient educational instructions about each procedure in layman’s terms. The instructions were then evaluated by 4-clinical physicians and 9-nonclinical assessors to determine their clinical appropriateness, understandability and clarity utilizing a survey. A grade-level readability assessment was performed using validated metrics to evaluate accessibility to a wide patient population. The same procedures were also evaluated from the patient instructions available at radiologyinfo.org and compared to GPT-generated instructions utilizing a paired t-test. ResultsEvaluation by 4-clinical physicians shows that 9 GPT-generated instructions were fully appropriate, whereas arterial embolization instructions was somewhat appropriate. Evaluation by 9-nonclinical assessors shows that paracentesis, dialysis-catheter-placement, thrombectomy, ultrasound-guided-biopsy, and nephrostomy-tube instructions, were rated excellent by 57%, and good by 43%. The arterial-embolization and biliary-drain instructions were rated excellent by 28.6% and good by 71.4%. In contrast, thoracentesis, port-placement, and CT-guided-biopsy instructions received 43% excellent, 43% good, and 14% fair. The readability assessment across all procedural instructions showed a better Flesch-Kincaid mean grade of GPT-4 instructions compared to radiologyinfo.org(7.8±0.87 vs 9.6±0.83,p=0.007) indicating excellent readability at 7-8th grade level compared to 9-10th grade. Additionally there was a lower Gunning-Fog mean Index(10.4±1.2 vs. 12.7±0.93,p=0.006), and higher Flesch Reading Ease mean score (69.4±4.8 vs 51.3±3.9,p=0.0001) indicating better readability. ConclusionIR procedural instructions generated by GPT-4 can aid in improving health literacy and patient-centered care in IR by generating easily understandable explanations.

Comparison of periprocedural and procedure room times between moderate sedation and monitored anesthesia care in interventional radiology.

In recent years, there has been increased utilization of monitored anesthesia care (MAC) in interventional radiology (IR) departments. The purpose of this study was to compare pre-procedure bed, procedure room, and post-procedure bed times for IR procedures performed with either nurse-administered moderate sedation (MOSED) or MAC. An institutional review board-approved single institution retrospective review of IR procedures between January 2010 and September 2022 was performed. Procedures performed with general anesthesia or local anesthetic only, missing time stamps, or where <50 cases were performed for both MAC and MOSED were excluded from the study. Pre-procedure bed, procedure room, post-procedure bed, and total IR encounter times were compared between MAC and MOSED using the t-test. The effect size was estimated using Cohen's d statistic. 97,480 cases spanning 69 procedure codes were examined. Mean time in pre-procedure bed was 27 min longer for MAC procedures (69 vs. 42 min, P < 0.001, d = 0.95). Mean procedure room time was 11 min shorter for MAC (60 vs. 71 min, P < 0.001, d = 0.48), and mean time in post-procedure bed was 10 min longer for MAC (102 vs. 92 min, P < 0.001, d = 0.22). Total IR encounter times were on average 27 min longer for MAC cases (231 vs. 204 min, P < 0.001, d = 0.41). MAC improves the utilization of IR procedure rooms, but at the cost of increased patient time in the pre- and post-procedure areas.

Abstract No. 252 Comparison of Perioperative and Procedure Room Times Between Moderate Sedation and Monitored Anesthesia Care in Interventional Radiology

Abstract No. 252 Comparison of Perioperative and Procedure Room Times Between Moderate Sedation and Monitored Anesthesia Care in Interventional Radiology

Patient care in interventional radiology

Recent times have seen a rapid growth in the performance of day-case procedures across the breadth of surgical specialties. Aside from the obvious potential for cost-savings of avoiding overnight admission, there are demonstrable advantages in efficiency, safety, and patient experience. Interventional radiologists who have always been the standard-bearers for minimally invasive techniques have also been quick to embrace this evolution in practice. The advantages are well described in the accompanying paper by Lakshminarayan et al.

Perceptions of Futility in Interventional Radiology: A Multipractice Systematic Qualitative Analysis.

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

Implementing a Web-Based Inventory Tracking System: A Quality Improvement Initiative

Inventory control of supplies in radiology is a major contributor of time loss with potential negative effect on patient care in interventional radiology. Using Lean principles, we evaluated an outdated process and instituted an inventory control system with good results, saving time and money.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications.

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part I: Standard Post-procedural Instructions and Follow-Up Care.

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

Transitioning to the Electronic Medical Record: Its Impact on Nursing Care in Interventional Radiology

Electronic medical records (EMRs) are being integrated into the health care industry. It is widely believed that EMRs will improve the overall quality of patient care through the promotion of both patient safety and satisfaction. The introduction of EMRs at Boston Children's Hospital created a multitude of challenges for the nurses in the hospital's interventional radiology (IR) department. Despite the difficulties the new EMR presented, the IR nurses were able to safely transition their documentation to the electronic format.

Educational Exhibit Abstract No. 371 - Streamlining a vascular referral service line through the use of a portable vascular laboratory

Learning Objectives 1)The reader will learn strategies to increase efficiency in the evaluation of vascular referrals through the use of electronic medical records and a portable vascular laboratory.2)Methods and strategies utilizing a portable vascular laboratory to improve patient care, reduce healthcare costs, and increase access to care in Interventional Radiology will be discussed. Background Noninvasive vascular testing including Doppler ultrasound, segmental pressures, pulse volume recordings, and ankle brachial indices are regularly used for evaluation of peripheral vascular disease. Ultrasound is also used in evaluation of venous reflux and venous mapping. Testing can be used to screen, diagnose, and plan for vascular therapy. With the development of compact mobile noninvasive diagnostic devices, noninvasive testing has become portable. Portable vascular laboratories allow for rapid evaluation when patients are initially seen with primary care providers in office-based clinics. This technology has been utilized to increase referrals to Interventional Radiology. Clinical Findings/Procedure Details This exhibit will demonstrate how to incorporate a portable vascular laboratory into an existing vascular service line. A practical guide will be proposed which can be used to prioritize referrals based on this portable testing and the information available in the electronic medical record. Strategies to improve communication with referring clinicians and optimize treatments will be presented. Also exhibited will be the possible benefits of improving efficiency including potential cost-reduction. Methods utilizing portable devices to appropriately screen patients for referral to Interventional Radiology will be highlighted. Conclusion and/or Teaching Points Through the use of a portable noninvasive vascular laboratory and a supporting EMR, vascular referrals can be more efficiently evaluated. The potential benefits of portability and increased efficiency include cost-reduction and increased patient volume to Interventional Radiology.

For Ideal Patient Care in Interventional Radiology

For Ideal Patient Care in Interventional Radiology

Do Outcome Measures for Trauma Triage Agree?

Objective. The goal of trauma triage is to match resources to the needs of seriously injured patients. The trauma triage literature has used a variety of outcome measures to assess appropriate trauma activation. The objective of this study was to determine the agreement between procedural andnonprocedural outcome measures in a population of seriously injured patients transported to a single trauma center. Methods. Study authors reviewed all “level 2” trauma activations (January 2002–December 2003) at an American College of Surgeons (ACS) Level 1 trauma center. “Level 2” trauma activations were based on modified ACS Committee on Trauma (COT) triage criteria. Outcomes were classified as nonprocedural (Injury Severity Score [ISS] > 15 andintensive care unit [ICU] admission) andprocedural (nonorthopedic emergent surgery, emergency chest tube placement, emergency department intubation, emergency department transfusion, or emergent interventional radiology care). Results. Of 479 patients, five were transferred out of hospital. The remaining 474 were predominantly male (62%), with a mean age of 39.7 years. Their average ISS was 13.2. There were nine deaths. For all subjects, 144 (30%) were admitted to the ICU, 172 (36%) had an ISS > 15, 80 (17%) received an emergent procedure, and46 (10%) went for emergent surgery. Kappas comparing agreement of ISS > 15 with emergent resuscitation andemergent surgery were 0.31 and0.15, respectively. Kappas comparing ICU admission with emergent resuscitation andemergent surgery were 0.51 and0.26, respectively. Conclusions. We identify moderate to poor agreement between nonprocedural andprocedural outcomes of trauma triage in this population.

Clinical Care in Interventional Radiology

Clinical Care in Interventional Radiology

Patient care in interventional radiology: a perspective.

Patient care in interventional radiology: a perspective.