Strategic Studies In Radiology Research Articles

Integrative Diagnostics: The Time Is Now-A Report From the International Society for Strategic Studies in Radiology.

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the "silo" of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information. Therefore, despite great promise, diagnoses may still be incorrect, delayed, or never made. Integrative diagnostics represents a vision for the future, wherein diagnostic data, together with clinical data from the electronic health record, are aggregated and contextualized by informatics tools to direct clinical action. Integrative diagnostics has the potential to identify correct therapies more quickly, modify treatment when appropriate, and terminate treatment when not effective, ultimately decreasing morbidity, improving outcomes, and avoiding unnecessary costs. Radiology, laboratory medicine, and pathology already play major roles in medical diagnostics. Our specialties can increase the value of our examinations by taking a holistic approach to their selection, interpretation, and application to the patient's care pathway. We have the means and rationale to incorporate integrative diagnostics into our specialties and guide its implementation in clinical practice.

Integrative diagnostics: the time is now—a report from the International Society for Strategic Studies in Radiology

Enormous recent progress in diagnostic testing can enable more accurate diagnosis and improved clinical outcomes. Yet these tests are increasingly challenging and frustrating; the volume and diversity of results may overwhelm the diagnostic acumen of even the most dedicated and experienced clinician. Because they are gathered and processed within the “silo” of each diagnostic discipline, diagnostic data are fragmented, and the electronic health record does little to synthesize new and existing data into usable information. Therefore, despite great promise, diagnoses may still be incorrect, delayed, or never made. Integrative diagnostics represents a vision for the future, wherein diagnostic data, together with clinical data from the electronic health record, are aggregated and contextualized by informatics tools to direct clinical action. Integrative diagnostics has the potential to identify correct therapies more quickly, modify treatment when appropriate, and terminate treatment when not effective, ultimately decreasing morbidity, improving outcomes, and avoiding unnecessary costs. Radiology, laboratory medicine, and pathology already play major roles in medical diagnostics. Our specialties can increase the value of our examinations by taking a holistic approach to their selection, interpretation, and application to the patient’s care pathway. We have the means and rationale to incorporate integrative diagnostics into our specialties and guide its implementation in clinical practice.Graphic abstract

Integrating artificial intelligence into the clinical practice of radiology: challenges and recommendations.

Artificial intelligence (AI) has the potential to significantly disrupt the way radiology will be practiced in the near future, but several issues need to be resolved before AI can be widely implemented in daily practice. These include the role of the different stakeholders in the development of AI for imaging, the ethical development and use of AI in healthcare, the appropriate validation of each developed AI algorithm, the development of effective data sharing mechanisms, regulatory hurdles for the clearance of AI algorithms, and the development of AI educational resources for both practicing radiologists and radiology trainees. This paper details these issues and presents possible solutions based on discussions held at the 2019 meeting of the International Society for Strategic Studies in Radiology. KEY POINTS: • Radiologists should be aware of the different types of bias commonly encountered in AI studies, and understand their possible effects. • Methods for effective data sharing to train, validate, and test AI algorithms need to be developed. • It is essential for all radiologists to gain an understanding of the basic principles, potentials, and limits of AI.

William G. Bradley, Jr, MD, PhD, FACR (1942-2017).

William G. Bradley, Jr, MD, PhD, FACR (1942-2017).

External Factors That Influence the Practice of Radiology: Proceedings of the International Society for Strategic Studies in Radiology Meeting.

In both the United States and Europe, efforts to reduce soaring health care costs have led to intense scrutiny of both standard and innovative uses of imaging. Given that the United States spends a larger share of its gross domestic product on health care than any other nation and also has the most varied health care financing and delivery systems in the world, it has become an especially fertile environment for developing and testing approaches to controlling health care costs and value. This report focuses on recent reforms that have had a dampening effect on imaging use in the United States and provides a glimpse of obstacles that imaging practices may soon face or are already facing in other countries. On the basis of material presented at the 2015 meeting of the International Society for Strategic Studies in Radiology, this report outlines the effects of reforms aimed at (a) controlling imaging use, (b) controlling payer expense through changes in benefit design, and (c) controlling both costs and quality through "value-based" payment schemes. Reasons are considered for radiology practices on both sides of the Atlantic about why the emphasis needs to shift from providing a large volume of imaging services to increasing the value of imaging as manifested in clinical outcomes, patient satisfaction, and overall system savings. Options for facilitating the shift from volume to value are discussed, from the use of advanced management strategies that improve workflow to the creation of programs for patient engagement, the development of new clinical decision-making support tools, and the validation of clinically relevant imaging biomarkers. Radiologists in collaboration with industry must enhance their efforts to expand the performance of comparative effectiveness research to establish the value of these initiatives, while being mindful of the importance of minimizing conflicts of interest. © RSNA, 2017.

Imaging in the Age of Precision Medicine: Summary of the Proceedings of the 10th Biannual Symposium of the International Society for Strategic Studies in Radiology.

During the past decade, with its breakthroughs in systems biology, precision medicine (PM) has emerged as a novel health-care paradigm. Challenging reductionism and broad-based approaches in medicine, PM is an approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle. It involves integrating information from multiple sources in a holistic manner to achieve a definitive diagnosis, focused treatment, and adequate response assessment. Biomedical imaging and imaging-guided interventions, which provide multiparametric morphologic and functional information and enable focused, minimally invasive treatments, are key elements in the infrastructure needed for PM. The emerging discipline of radiogenomics, which links genotypic information to phenotypic disease manifestations at imaging, should also greatly contribute to patient-tailored care. Because of the growing volume and complexity of imaging data, decision-support algorithms will be required to help physicians apply the most essential patient data for optimal management. These innovations will challenge traditional concepts of health care and business models. Reimbursement policies and quality assurance measures will have to be reconsidered and adapted. In their 10th biannual symposium, which was held in August 2013, the members of the International Society for Strategic Studies in Radiology discussed the opportunities and challenges arising for the imaging community with the transition to PM. This article summarizes the discussions and central messages of the symposium.

A Statement about Authorship from Individual Members of the International Society for Strategic Studies in Radiology

There has been much recent discussion [1, 2] about what constitutes appropriate authorship for scientific articles. Indeed, recent exposes in the press and elsewhere about ‘gift’, ‘honorary’ and even ‘ghost’ authorship have led to law suits, other forms of litigation and the ruin of the careers of some dedicated health professionals. In many cases, improper assignment of authorship is due to naivety or oversight, but in some cases, it is undertaken knowingly and, at worst, for ultimate financial gain. The ICMJE has issued stringent guidelines for appropriate assignment of authorship and other aspects of scientific publications [3]. These guidelines also deal with issues concerning redundant publications. The International Society on Strategic Studies in Radiology unanimously endorsed the statement at their 2011 annual symposium and in addition the following IS3R members have personally underlined their support for the ICMJE criteria for authorship and are determined to ensure that colleagues in their department/institution/working group adhere to them fully. Andreas Adam, UK Ronald Arenson, US Peter Aspelin, SE Stanley Baum, US Norman J. Beauchamp, US Lorenzo Bonomo, IT William G. Bradley, US Boris Brkljacic, HR R. Nick Bryan, US Giovanni Cerri, BR Byung Ihn Choi, KR Claus D. Claussen, DE Jian-Ping Dai, CN Jorg F. Debatin, DE Adrian K. Dixon, UK Luis Donoso, ES N. Reed Dunnick, US Dieter Enzmann, US Xiaoyuan Feng, CN Guy Frija, FR Sanjiv Sam Gambhir, US Ricardo Garcia Monaco, AR Hassen A. Gharbi, TN Stephen Golding, UK Moshe Graif, IL Philippe Grenier, FR Robert I. Grossman, US Rolf W. Gunther, DE Christian J. Herold, AT Bruce Hillman, US Hedvig Hricak, US Janet E. Husband, UK Valerie Jackson, US Gilbert Jost, US Willi A. Kalender, DE Pek-Lan Khong, HK Dong-Ik Kim, KR Herbert Y. Kressel, US Gabriel P. Krestin, NL Sachio Kuribayashi, JP Denis Le Bihan, FR Jonathan S. Lewin, US Alexander Margulis, US C. Douglas Maynard, US International Society for Strategic Studies in Radiology (IS3R) Neutorgasse 9/2a, 1010 Vienna, Austria e-mail: office@is3r.org

A statement about authorship from individual members of the International Society for Strategic Studies in Radiology (IS3R)

A statement about authorship from individual members of the International Society for Strategic Studies in Radiology (IS3R)

Integrated diagnostics: proceedings from the 9th biennial symposium of the International Society for Strategic Studies in Radiology

The International Society for Strategic Studies in Radiology held its 9th biennial meeting in August 2011. The focus of the programme was integrated diagnostics and massive computing. Participants discussed the opportunities, challenges, and consequences for the discipline of radiology that will likely arise from the integration of diagnostic technologies. Diagnostic technologies are increasing in scope, including advanced imaging techniques, new molecular imaging agents, and sophisticated point-of-use devices. Advanced information technology (IT), which is increasingly influencing the practice of medicine, will aid clinical communication and the development of “population images” that represent the phenotype of particular diseases, which will aid the development of diagnostic algorithms. Integrated diagnostics offer increased operational efficiency and benefits to patients through quicker and more accurate diagnoses. As physicians with the most expertise in IT, radiologists are well placed to take the lead in introducing IT solutions and cloud computing to promote integrated diagnostics. To achieve this, radiologists must adapt to include quantitative data on biomarkers in their reports. Radiologists must also increase their role as participating physicians, collaborating with other medical specialties, not only to avoid being sidelined by other specialties but also to better prepare as leaders in the selection and sequence of diagnostic procedures. Key Points • New diagnostic technologies are yielding unprecedented amounts of diagnostic information.• Advanced IT/cloud computing will aid integration and analysis of diagnostic data.• Better diagnostic algorithms will lead to faster diagnosis and more rapid treatment.

Globalization of P4 Medicine: Predictive, Personalized, Preemptive, and Participatory—Summary of the Proceedings of the Eighth International Symposium of the International Society for Strategic Studies in Radiology, August 27–29, 2009

In August 2009, the International Society for Strategic Studies in Radiology held its eighth biennial meeting. The program focused on the globalization of predictive medicine--or P4 medicine--as it relates to the practice of radiology and radiology research. P4 medicine refers to predictive, personalized, preemptive, and participatory medicine and was the inspiration of Elias Zerhouni, MD, former director of the National Institutes of Health. This article is a summary of some of the key concepts presented at the meeting by an international group of radiologists, imaging scientists, and leaders of industry. In predictive medicine, imaging and imaging-related technologies will likely play an increasing role in the early detection of disease and, thus, the preemption of the development of advanced, hard-to-treat disease. Research into systems biology and molecular imaging promises to personalize medicine, facilitating the provision of the right care to the right patient at the right time. In participatory medicine, increasing interactions with referring physicians and patients will be helpful in raising awareness and recognition of the role of radiologists and will have a positive effect on professionalism. There is also a need to increase awareness of the vital role of radiologists as imaging and radiation safety experts who evaluate the necessity and appropriateness of examinations, monitor performance quality, and are available for postexamination consultations.

Advancing radiology through informed leadership: summary of the proceedings of the Seventh Biannual Symposium of the International Society for Strategic Studies in Radiology (IS3R), 23–25 August 2007

The International Society for Strategic Studies in Radiology (IS3R) brings together thought leaders from academia and industry from around the world to share ideas, points of view and new knowledge. This article summarizes the main concepts presented at the 2007 IS3R symposium, providing a window onto trends shaping the future of radiology. Topics addressed include new opportunities and challenges in the field of interventional radiology; emerging techniques for evaluating and improving quality and safety in radiology; and factors impeding progress in molecular imaging and nanotechnology and possible ways to overcome them. Regulatory hurdles to technical innovation and drug development are also discussed more broadly, along with proposals for addressing regulators’ concerns and streamlining the regulatory process.

Reinventing Radiology in a Digital and Molecular Age: Summary of Proceedings of the Sixth Biannual Symposium of the International Society for Strategic Studies in Radiology (ISR), August 25–27, 2005

Escalating costs and inadequate quality and safety are major concerns of health care at this time. The first, increasing cost of health care worldwide, can be attributed in part to the aging of populations, but it is also due to the successful treatment of acute illnesses and the resultant shift toward the expense of caring for the chronically ill, which now accounts for 75% of the costs (1). But with 2001 health care costs comprising 14% of the gross domestic product in the United States and with an expected increase to 18% by 2012 (2), there is considerable pressure from employers, insurance companies, and the government to limit health care spending to a sustainable amount and to make the system more accountable. Radiology is not immune to these worldwide health care concerns. In 1990, U.S. radiology costs accounted for about 3.5% of the national spending on health care (3). Overall, diagnostic radiology utilization rate increases have been modest in the United States, with a 3.1% compound annual increase for Medicare enrollees in the period 1992–2001 (4). However, utilization of high-cost radiology services increased dramatically in the past decade, as has been demonstrated for Medicare enrollees (4–9), privately insured groups (4,6,8), and within individual institutions (10,11). Data for Medicare enrollees, which are more complete than those for other populations, show a trend of double-digit annual rate increases in utilization of computed tomography (CT), magnetic resonance (MR) imaging, and nuclear imaging in the years 1992–2001 (4). The second major health care concern involves quality and safety. The rate of adverse events in medical care in the United States is 3%–4% (12,13), which may result in $28 billion in unnecessary expense and as many as 44 000–98 000 deaths per year due to provider error (14). In radiology practice, quality includes obtaining the best possible images through quality assurance programs and through the appropriate selection of modality and protocol. Safety issues include avoiding injury due to the effects of magnetic fields on metallic implants, contrast agent reactions, radiation exposure, and ensuring that there is adequate monitoring of patients for adverse events. Rapid technologic advances in radiology have increased the concerns regarding utilization, as well as quality and safety. By the end of the second millennium, computerized workstations have now become commonplace, picture archiving and communications systems (PACS) and radiology information systems (RIS) are widespread, the Internet is almost essential for the transfer of images and other information, and computer-aided detection (CAD) has been developed as a useful tool. Recent innovations in imaging suggest that radiology will be a major catalyst for transforming medicine into an age of information technology and molecular medicine.

The State of Radiology in 2006: Very High Spatial Resolution but No Visibility

The State of Radiology in 2006: Very High Spatial Resolution but No Visibility

The International Society of Strategic Studies in Radiology

HomeRadiologyVol. 236, No. 2 PreviousNext ArticlesHistorical PerspectivesThe International Society of Strategic Studies in RadiologyGary M. Glazer, Alexander R. Margulis, Karl-Jürgen Wolf, Hans G. Ringertz, Guy G. Frija, James H. Thrall, Stephen J. Golding, Gabriel P. KrestinGary M. Glazer, Alexander R. Margulis, Karl-Jürgen Wolf, Hans G. Ringertz, Guy G. Frija, James H. Thrall, Stephen J. Golding, Gabriel P. KrestinAuthor Affiliations1From the Stanford University School of Medicine, Stanford, Calif (G.M.G.); Weill Medical College, Cornell University, New York, NY (A.R.M.); Benjamin Franklin Campus, Free University of Berlin, Berlin, Germany (K.J.W.); Karolinska School of Medicine, Stockholm, Sweden (H.G.R.); Faculty of Medicine, University of Paris, Paris, France (G.G.F.); Massachusetts General Hospital, Harvard Medical School, Boston, Mass (J.H.T.); John Radcliffe Hospital, Oxford University, Oxford, England (S.J.G.); and Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands (G.P.K.). Received March 28, 2005; accepted April 8. Address correspondence to G.P.K. (e-mail: [email protected]).Gary M. GlazerAlexander R. MargulisKarl-Jürgen WolfHans G. RingertzGuy G. FrijaJames H. ThrallStephen J. GoldingGabriel P. KrestinPublished Online:Aug 1 2005https://doi.org/10.1148/radiol.2362050516MoreSectionsFull textPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In References1 Costs and benefits of radiology: an international symposium. Oxford, England. Acad Radiol 1996; 3(suppl 1):S1–S161. Crossref, Medline, Google Scholar2 Second Oxford International Symposium on the Costs and Benefits of Radiology: San Francisco, California USA—August 21-23, 1997. Acad Radiol 1998; 5(suppl 2):S255–S462. Crossref, Medline, Google Scholar3 Third International Symposium on the Costs and Benefits of Radiology: August 19–21, 1999—Berlin, Germany. Eur Radiol 2000; 10(suppl 3):S339–S446. Crossref, Medline, Google ScholarArticle HistoryPublished in print: Aug 2005 FiguresReferencesRelatedDetailsCited ByRadiologists: Physicians or Expert Image Interpreters?1C. Douglas Maynard, 1 August 2008 | Radiology, Vol. 248, No. 2Recommended Articles RadioGraphics International Team InitiativesRadioGraphics2022Volume: 42Issue: 5pp. E142-E144Increasing Opportunities for Trainees to Engage in Global Health Radiology: Radiology In TrainingRadiology2021Volume: 300Issue: 2pp. E320-E322Linda Moy, MD, Named New Editor of RadiologyRadioGraphics2022Volume: 42Issue: 2pp. E37-E38Linda Moy, MD, Named New Editor of RadiologyRadiology2022Volume: 303Issue: 1pp. 3-4Cancer Imaging Program Update: 2020Radiology: Imaging Cancer2020Volume: 2Issue: 4See More RSNA Education Exhibits Anatomy of a Deep Learning Project for Breast Cancer Prognosis Prediction: From Collecting Data to Building a PipelineDigital Posters2019Multipronged Approach to Cancer Imaging for the Next-Generation RadiologistDigital Posters2018Engaging Medical Students in Interventional Radiology: In the Era of the New Integrated IR ResidencyDigital Posters2018 RSNA Case Collection Breast density change with hormone replacement RSNA Case Collection2021Carotid WebRSNA Case Collection2020Orbital blowout fractureRSNA Case Collection2020 Vol. 236, No. 2 Metrics Downloaded 143 times Altmetric Score PDF download

Quality and Safety Revolution in Health Care

Quality and Safety Revolution in Health Care

Risk prevention, quality assurance, and the missed diagnosis conference.

HomeRadiologyVol. 145, No. 1 PreviousNext Risk prevention, quality assurance, and the missed diagnosis conference.P S WheelerP S WheelerP S WheelerPublished Online:Oct 1 1982https://doi.org/10.1148/radiology.145.1.7122886MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Article HistoryPublished in print: 1982 FiguresReferencesRelatedDetailsCited ByFundamentals of Diagnostic Error in ImagingJason N. Itri, Rafel R. Tappouni, Rachel O. McEachern, Arthur J. Pesch, Sohil H. Patel, 10 October 2018 | RadioGraphics, Vol. 38, No. 6Journal of the American College of Radiology, Vol. 9, No. 9Reinventing Radiology in a Digital and Molecular Age: Summary of Proceedings of the Sixth Biannual Symposium of the International Society for Strategic Studies in Radiology (IS3R), August 25–27, 20051Gabriel P. Krestin, , Janet C. Miller, , Stephen J. Golding, , Guy G. Frija, , Gary M. Glazer, , Hans G. Ringertz, , and James H. Thrall, 1 September 2007 | Radiology, Vol. 244, No. 3Academic Radiology, Vol. 8, No. 4Clinical Radiology, Vol. 56, No. 9The British Journal of Radiology, Vol. 70, No. 839Radiologic Clinics of North America, Vol. 21, No. 4Recommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 145, No. 1 Metrics Altmetric Score PDF download