Use Of Radiology Services Research Articles

The effect of Covid-19 pandemic on healthcare utilization in public vs private centers in Iran: a multiple group interrupted time-series analysis

BackgroundThe outbreak of Coronavirus in late 2019 and its continuation in the following years has affected all human societies, government organizations, and health systems. Access to health services is an important issue during crises. The present study aimed to investigate the effect of the Covid-19 pandemic on the consumption of health services in the public sector compared to the private sector in Iran.MethodsThe research population consisted of all insured individuals covered by Iran Health Insurance Organization in Fars province, which amounts to approximately 2,700,000 people. The required information including the utilization of laboratory, radiology, medicine, and hospitalization services was extracted on a monthly basis from February 2019 to February 2021. The Multiple Group Interrupted Time Series Analysis (MGITSA) was used for data analysis along with STATA.15 software.ResultsAccording to the findings of MGITSA, in the short-term, the utilization of private laboratory, radiology, medication, and hospital admissions had decreased by approximately 18,066, 8210, 135,445, and 1086 times, respectively (P < 0.05). In the long-run, the use of laboratory and radiology services had increased by about 2312 and 514 times (P < 0.05), respectively. The comparison between the public and private sectors showed that in the short-term, the use of radiology services decreased by about 12,525, while the use of medication increased by about 91,471 times (P < 0.05). In the long-run, the use of laboratory services decreased by about 1514 times (P = 0.076) and no change was observed in the other services utilization (in public relative to private centers).ConclusionsUtilization of health services in the public versus private centers, except for medication and hospitalization, significantly decreased in the short-term. However the utilization of most services returned to the usual trend in the long-term. The reduction in access to health services could impose a significant burden of various diseases, at least in the short-term, and increase health costs in the coming years.

Evaluating GPT as an Adjunct for Radiologic Decision Making: GPT-4 Versus GPT-3.5 in a Breast Imaging Pilot

ObjectiveDespite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT (Generative Pre-trained Transformer)-3.5 and GPT-4’s (OpenAI, San Francisco, California) capacity for clinical decision support in radiology via the identification of appropriate imaging services for two important clinical presentations: breast cancer screening and breast pain. MethodsWe compared ChatGPT’s responses to the ACR Appropriateness Criteria for breast pain and breast cancer screening. Our prompt formats included an open-ended (OE) and a select all that apply (SATA) format. Scoring criteria evaluated whether proposed imaging modalities were in accordance with ACR guidelines. Three replicate entries were conducted for each prompt, and the average of these was used to determine final scores. ResultsBoth ChatGPT-3.5 and ChatGPT-4 achieved an average OE score of 1.830 (out of 2) for breast cancer screening prompts. ChatGPT-3.5 achieved a SATA average percentage correct of 88.9%, compared with ChatGPT-4’s average percentage correct of 98.4% for breast cancer screening prompts. For breast pain, ChatGPT-3.5 achieved an average OE score of 1.125 (out of 2) and a SATA average percentage correct of 58.3%, as compared with an average OE score of 1.666 (out of 2) and a SATA average percentage correct of 77.7%. DiscussionOur results demonstrate the eventual feasibility of using large language models like ChatGPT for radiologic decision making, with the potential to improve clinical workflow and responsible use of radiology services. More use cases and greater accuracy are necessary to evaluate and implement such tools.

Radiology imaging in the hospice setting

BackgroundThere is little literature available regarding the use of radiology services within the hospice setting. St Gemma's Hospice in Leeds has a 32-bed inpatient unit with around 600 admissions per...

Rural GPs' satisfaction with radiology services to their communities: a qualitative study

Despite the acknowledged clinical importance of radiology and an awareness of issues surrounding the rural radiology workforce and access to services and equipment, there is a paucity of information assessing the adequacy of rural radiology services in Australia. Assessing the satisfaction of rural GPs with the radiology services available to them is one way of assessing the adequacy of these services. This research aimed to contribute to this important knowledge gap by identifying the factors influencing rural GPs' satisfaction with the rural radiology services available to them. We used purposive sampling from Tasmanian general practice workforce data to select rural GPs with a range of demographics from all three regions of Tasmania, Australia. We performed semi-structured interviews with these GPs, in which they discussed rural radiology services in their local area. Interviews were performed by telephone and transcribed verbatim. The transcribed interviews were analysed using an iterative and interpretive technique aimed at identifying major themes and providing insight into the issues raised by the research participants. Out of 15 GPs approached, two interviews were lost due to equipment problems and 10 interviews were successfully recorded. Major factors influencing GP satisfaction with rural radiology services included: access to service (particularly convenience for their patients and the level of direct and indirect costs to patients); the promptness and reliability of services; equipment; and access to training and skills levels. The GPs also described the added challenges that they and their communities face with dealing with problems requiring the use of radiology services after hours. These new insights into rural radiology services can help to inform policy makers, funding bodies and private radiology providers responsible for rural radiology services of issues requiring further consideration. This contribution to the creation of an evidence base is important as a platform for further research and for the development of strategies to further assess and improve radiology services for rural communities.

Trends and future needs in clinical radiology: Insights from an academic medical center

Objective Advances in technology, expanding indications and defensive medical practice, in combination with population aging, have all contributed to a substantial increase in utilization of imaging and therapeutic radiology procedures in recent years. Moreover, the integration of education, innovation and research into high-volume workflow, although challenging, is a key requirement in teaching hospitals. Therefore, identifying forthcoming demand in the use of radiology services at a referral center might be of special interest and facilitate health policy planning in this context. Methods Data regarding conventional radiographic, ultrasonographic and computed tomography (CT) investigations, radiotherapy sessions, and interventional procedures were collected for a 5-year period (2000–2004). Based on these observations, we deployed appropriate models to forecast utilization rates in 2005–2009. Results Between 2000 and 2004, ultrasound examinations increased by 31.8%, mammography by 31.6%, CT scans by 17.4%, interventions by 14.5% and radiotherapy sessions by 13.9%, while conventional investigations decreased by 42.5%. We identified significant increasing trends for ultrasound, mammography, CT and interventions (all p < 0.001 for linear component). Compared to current levels, the workload for these modalities is expected to rise in the next 5 years by 43%, 31%, 20% and 14%, respectively. Radiotherapy sessions demonstrate an unstable, non-significant increasing trend ( p = 0.189), while utilization of conventional radiography declines rapidly ( p < 0.001 for linear trend, 5-year prediction −51%). Conclusions In forthcoming years, the demand for radiology services at referral centers will increase substantially. Advances in digital technology alone will not suffice to completely alleviate the need for additional resources and well-trained personnel.

Inpatient Radiology Utilization: Trends over the Past Decade

The objective of our study was to assess patterns of use of radiology services for inpatients at our institution between 1993 and 2002. We retrospectively reviewed the administrative data about adult inpatients for fiscal years 1993-2002 in a 721-bed tertiary care institution. Examinations were coded according to imaging technique: conventional (plain films and fluoroscopy), sonography, nuclear medicine, CT, or MRI. We assessed workload trends using relative value units (RVUs). Linear regression analysis was used to assess the significance of trends for the number of examinations and RVUs per case-mix-adjusted admission (CMAA). There was a significant decrease in the total number of examinations per CMAA (p < 0.001). This was due to significant decreases in the use of conventional studies (p < 0.001) and sonograms (p < 0.001), despite significant increases in the number of nuclear medicine (p = 0.046), CT (p < 0.001), and MRI (p < 0.002) examinations per CMAA. The RVUs per CMAA increased significantly (p < 0.01) during the study period. Newer imaging technologies (nuclear medicine, CT, and MRI) are replacing older ones in the evaluation of inpatients. Despite the significant decrease in the total number of imaging examinations per CMAA, we observed a significant increase in RVUs per CMAA during the 10-year study period. Understanding the impact of this change in practice on the quality of care would be useful in justifying the increasing use of these new technologies, and decreasing their inappropriate use should be a priority in efforts that focus on controlling imaging expenditures.

Time for Change: New Emphasis on Training for Radiology Research

The field of radiology has evolved dramatically with the introduction of new modalities, the refinement of established modalities, and the development of interventional techniques. The rapid deployment of ultrasound (US), computed tomography (CT), and magnetic resonance (MR) imaging necessitated a series of reviews of the imaging features seen with these modalities and their accuracy in detecting the suspected abnormality. Such descriptive research was essential to the development and use of these new imaging tools, but it lacked validity and generalizability. Moreover, it was not the hypothesis-driven research that is typically funded by the National Institutes of Health (NIH). These new imaging modalities proved to be enormously valuable for patient care. Their success has changed the practice of medicine. Exploratory laparotomy has essentially been replaced by CT examination of the abdomen. US has become the primary modality for examining patients suspected of having cholelithiasis and is an essential monitor during pregnancy. Patients with disease of the central nervous system cannot be cared for without MR imaging, which is replacing other methods for the evaluation of the heart, vessels (MR angiography), and female pelvis. The effect of interventional procedures has been no less dramatic. The ability to affect regional blood flow with percutaneous transluminal angiographic techniques has converted treatments from surgical to radiologic procedures for a number of clinical indications. Percutaneous drainage is now the primary treatment for abdominal abscesses, and percutaneous techniques are routinely used to alleviate obstructions in the urinary tract and biliary tree. The result of these improvements has been a marked increase in demand for radiology services. Approximately 10 years ago, managed care plans were developed in an effort to control the rapidly rising cost of medical care. Such plans often included efforts to reduce the use of expensive imaging technologies, and initial implementation suggested a reduction in the use of ancillary services by as much as 30%–50%. Because of concern that there may be too many radiologists (and other subspecialists), some residency training programs were reduced in size or closed. The Health Care Financing Administration (now the Centers for Medicare and Medicaid Services [CMS]) capped the number of residents at the December 1996 institutional level. For many hospitals, the residency training program was frozen at its lowest level in years. The predicted decreases in use of radiology services were not realized, and the volume of imaging began to grow by more than 10% a year. This exploding demand came at a time when radiology could not respond by increasing the size of residency training programs. Private practice groups, hungry to expand, hired new radiologists at the completion of their residencies rather than waiting for them to gain additional expertise in a fellowship program. Fewer radiology fellows, expanded resident supervision requirements, and a shortage of available faculty put further stress on academic radiology departments to provide timely clinical service. There was little time to perform research, and fewer radiologists were trained to do it. Acad Radiol 2002; 9:695–699

Emergency department of use of radiology services at a large urban teaching hospital

Little research has explored the use of radiologic services by emergency departments and the factors that influence use. This study aimed to identify and characterize these factors. A total of 13,228 consecutive patient emergency charts from a large university emergency department were reviewed, and multiple parameters were entered into a database. The database was studied and statistical testing was done to identify significant parameters for patients who required imaging studies (X-ray group) and those who did not (non-X-ray group). Factors such as age, diagnosis, urgency of illness, and illness severe enough to require hospitalization were statistically significant in determining the need for a radiologic evaluation in the emergency setting. When these factors were equalized for the X-ray and non-X-ray groups by multivariate linear regression analysis, male sex was also found to be statistically significant. Factors such as race and presence or absence of health insurance were not statistically influential on multivariate analysis. Older age, diagnosis, and factors related to severity of illness affected the use of radiologic services in the emergency setting. Sex differences were also detected.