Time-driven cost analysis of pediatric liver biopsy completed in pediatric sedation clinic and operating room.

Background: Pediatric ultrasound (US)-guided percutaneous liver biopsy is a commonly performed procedure in children, and may be performed in a variety of clinical settings. However, there is little research on the relative costs associated with different sedation methods and locations.

Objective: This study uses time-driven activity-based costing (TDABC) to identify relevant costs associated with different biopsy sedation techniques and locations to help inform providers and patients as well as guide value-conscious care.

Patient experience surveys are vital in the twenty-first century: let's put some myths to rest.

Patient-reported data derived from surveys places patient feedback at the heart of quality improvement and health system responsiveness. Such surveys are not without critics, however, who contend that there are better ways to collect feedback. Criticisms assert that response rates are too low and measures are not robust, valid or reliable, that patient experience surveys are neither valid nor reliable for Māori and Pacific peoples and that such surveys do not contribute to improved outcomes for patients.

Comparison of chest radiograph and lung ultrasound in children with acute respiratory failure.

Purpose: Chest x-ray (CXR) is the standard imaging used to evaluate children in acute respiratory distress and failure. Our objective was to compare the lung-imaging techniques of CXR and lung ultrasound (LUS) in the evaluation of children with acute respiratory failure (ARF) to quantify agreement and to determine which technique identified a higher frequency of pulmonary abnormalities.

Methods: This was a secondary analysis of a prospective observational study evaluating the sensitivity and specificity of LUS in children with ARF from 12/2018 to 02/2020 completed at the University of Wisconsin-Madison (USA).

Cost estimation alongside a multi-regional, multi-country randomized trial of antenatal ultrasound in five low-and-middle-income countries.

Background: Improving maternal health has been a primary goal of international health agencies for many years, with the aim of reducing maternal and child deaths and improving access to antenatal care (ANC) services, particularly in low-and-middle-income countries (LMICs). Health interventions with these aims have received more attention from a clinical effectiveness perspective than for cost impact and economic efficiency.

Methods: We collected data on resource use and costs as part of a large, multi-country study assessing the use of routine antenatal screening ultrasound (US) with the aim of considering the implications for economic efficiency.

"What Program Directors Think" V: Results of the 2019 Spring Survey of the Association of Program Directors in Radiology (APDR).

Rationale And Objectives: The Association of Program Directors in Radiology (APDR) surveys its membership annually on hot topics and new developments in radiology residency training. Here we report the results of that annual survey.

Materials And Methods: A web-based survey was posed to the APDR membership in the Fall of 2018.

Cost differences between digital tomosynthesis and standard digital mammography in a breast cancer screening programme: results from the To-Be trial in Norway.

Background: Several studies in Europe and the US have shown promising results favouring digital breast tomosynthesis compared to standard digital mammography (DM). However, the costs of implementing the technology in screening programmes are not yet known.

Methods: A randomised controlled trial comparing the results from digital breast tomosynthesis including synthetic mammograms (DBT) vs.

Should Radiology Delay the Start of Fellowships? A Survey of the APDR.

Rationale And Objectives: Several major medical specialties have recently considered delaying the start date of their fellowship training programs to allow for completion of their trainees' residency obligations. Radiology program directors (PDs) have voiced the need for a similar solution, as fellowship start dates at some institutions now occur well before the end of residency training. The objectives of this study are to assess the current state of the radiology fellowship transition and understand its impact on residency programs and clinical services.

Use of ultrasound and mHealth to improve perinatal outcomes in low and middle income countries.

The explosion of mobile health and portable obstetric ultrasound interventions in low- and middle-income countries (LMIC) reflects the optimism that technology can help reduce persistently high rates of maternal and neonatal mortality and morbidity in these settings. While these technology-driven interventions have had success in improving aspects of antenatal and perinatal care, they have not clearly demonstrated reductions in mortality. The expanding synergy between mobile health (mHealth) and ultrasound technology shows promise to enhance care, but it will likely take combining these technological advances with system-wide approaches that also address referral patterns and infrastructure barriers to improve outcomes.

Including ultrasound scans in antenatal care in low-resource settings: Considering the complementarity of obstetric ultrasound screening and maternity waiting homes in strengthening referral systems in low-resource, rural settings.

Recent World Health Organization (WHO) antenatal care recommendations include an ultrasound scan as a part of routine antenatal care. The First Look Study, referenced in the WHO recommendation, subsequently shows that the routine use of ultrasound during antenatal care in rural, low-income settings did not improve maternal, fetal or neonatal mortality, nor did it increase women's use of antenatal care or the rate of hospital births. This article reviews the First Look Study, reconsidering the assumptions upon which it was built in light of these results, a supplemental descriptive study of interviews with patients and sonographers that participated in the First Look study intervention, and a review of the literature.

Comparisons of readmissions and mortality based on post-discharge ambulatory follow-up services received by stroke patients discharged home: a register-based study.

Background: Few studies have focused on post-discharge ambulatory care for stroke patients and subsequent differences in readmission and mortality rates. Identifying groups at higher risk according to services received is important when planning post-discharge follow-up in ambulatory care. According to a recent Whitepaper by the Norwegian Government, patients receiving ambulatory care should have follow-up with a general practitioner (GP) within 14 days of hospital discharge.

Factors influencing referrals for ultrasound-diagnosed complications during prenatal care in five low and middle income countries.

Background: Ultrasound during antenatal care (ANC) is proposed as a strategy for increasing hospital deliveries for complicated pregnancies and improving maternal, fetal, and neonatal outcomes. The First Look study was a cluster-randomized trial conducted in the Democratic Republic of Congo, Guatemala, Kenya, Pakistan and Zambia to evaluate the impact of ANC-ultrasound on these outcomes. An additional survey was conducted to identify factors influencing women with complicated pregnancies to attend referrals for additional care.

"What program directors think IV": Results of the 2017 Annual Survey of the Association of Program Directors in Radiology.

Rationale And Objectives: The Association of Program Directors in Radiology (APDR) regularly surveys its members to gather information regarding a broad range of topics related to radiology residency. The survey results provide insight into the opinions of residency program leadership across the country.

Materials And Methods: This is an observational cross-sectional study using a web-based survey posed to the APDR membership in the fall of 2017.

Continuity of care and its effect on readmissions for COPD patients: A comparative study of Norway and Germany.

Background: This study compares continuity of care between Germany - a social health insurance country, and Norway - a national health service country with gatekeeping and patient lists for COPD patients before and after initial hospitalization. We also investigate how subsequent readmissions are affected.

Methods: Continuity of Care Index (COCI), Usual Provider Index (UPC) and Sequential Continuity Index (SECON) were calculated using insurance claims and national register data (2009-14).

Spirometry-Assisted High Resolution Chest Computed Tomography in Children: Is it Worth the Effort?

Background: Image quality of high resolution chest computed tomographies (HRCTs) depends on adequate breath holds at end inspiration and end expiration. We hypothesized that implementation of spirometry-assisted breath holds in children undergoing HRCTs would improve image quality over that obtained with voluntary breath holds by decreasing motion artifact and atelectasis.

Methods: This is a retrospective case-control study of HRCTs obtained at a tertiary care children's hospital before and after implementation of a spirometry-assisted CT protocol, in which children ≥8 years of age are first trained in supine slow vital capacity maneuvers and then repeat the maneuvers in the CT scanner, coached by a respiratory therapist.

Evaluation of Focused Obstetric Ultrasound Examinations by Health Care Personnel in the Democratic Republic of Congo, Guatemala, Kenya, Pakistan, and Zambia.

Prior studies have suggested that obstetrical (OB) ultrasound in low- and middle-income countries has aided in detection of high-risk conditions, which in turn could improve OB management. We are participating in a cluster-randomized clinical trial of OB ultrasound, which is designed to assess the effect of basic OB ultrasound on maternal mortality, fetal mortality, neonatal mortality, and maternal near-miss in 5 low-income countries. We designed a 2-week course in basic OB ultrasound, followed by 12 weeks of oversight, to train health care professionals with no prior ultrasound experience to perform basic OB ultrasound to screen for high-risk pregnancies.

Web-Based Quality Assurance Process Drives Improvements in Obstetric Ultrasound in 5 Low- and Middle-Income Countries.

High quality is important in medical imaging, yet in many geographic areas, highly skilled sonographers are in short supply. Advances in Internet capacity along with the development of reliable portable ultrasounds have created an opportunity to provide centralized remote quality assurance (QA) for ultrasound exams performed at rural sites worldwide. We sought to harness these advances by developing a web-based tool to facilitate QA activities for newly trained sonographers who were taking part in a cluster randomized trial investigating the role of limited obstetric ultrasound to improve pregnancy outcomes in 5 low- and middle-income countries.

Reinventing the community hospital: a retrospective population-based cohort study of a natural experiment using register data.

Objectives: To investigate whether implementation of municipal acute bed units (MAUs) resulting from the Norwegian Coordination Reform (2012) was associated with reductions in hospital admissions, particularly for the elderly.

Design: A municipality-based retrospective comparative cohort study using monthly population-based registry data analysed with fixed-effects log-log regressions.

Setting: Norwegian municipalities and hospitals.

Spine Computed Tomography Radiation Dose Reduction: Protocol Refinement Based on Measurement Variation at Simulated Lower Radiation Acquisitions.

Study Design: Retrospective dose-simulation comparison.

Objective: To determine if sufficient detail for preoperative analysis of bony anatomy can be acquired at substantially lower doses than those typically used.

Summary Of Background Data: Computed tomography (CT) is a preoperative planning tool for spinal surgery.

Sedentary Behavior in the Workplace: A Potential Occupational Hazard for Radiologists.

In this study, we sought to quantify the sedentary worklife of the radiologist, a potential health risk. Radiologists of all training levels at our academic institution were surveyed to estimate the levels of at-work and out-of-work sitting. Fitbit One activity monitors were used to measure the at-work activity levels of radiology, pediatric, and internal medicine (IM) residents.