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https://www.readbyqxmd.com/read/28843944/at-most-hospitals-in-the-state-of-iowa-most-surgeons-daily-lists-of-elective-cases-include-only-1-or-2-cases-individual-surgeons-percentage-operating-room-utilization-is-a-consistently-unreliable-metric
#1
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals...
August 24, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28818305/treatment-of-the-ventral-intermediate-nucleus-for-medically-refractory-tremor-a-cost-analysis-of-stereotactic-radiosurgery-versus-deep-brain-stimulation
#2
Shearwood McClelland, Jerry J Jaboin
INTRODUCTION: Medically refractory tremor treatment has evolved over the past half-century from intraoperative thalamotomy to deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM). Within the past 15years, unilateral radiosurgical VIM thalamotomy has emerged as a comparably efficacious treatment modality. METHODS: An extensive literature search of VIM DBS series was performed; the total cost of VIM DBS was calculated from hospitals geographically representative of the entire United States using current procedural terminology and work relative value unit (RVU) codes...
August 14, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28756570/sensitivity-and-specificity-of-the-abbreviated-profile-of-hearing-aid-benefit-aphab
#3
Jan Löhler, F Gräbner, B Wollenberg, P Schlattmann, R Schönweiler
Subjective hearing loss in hearing-impaired patients can be assessed by inventory questionnaires. The abbreviated profile of hearing aid benefit (APHAB) measures subjective hearing loss in four typical hearing situations (subscales). It is used to fit hearing aids in patients with statutory insurance in Germany. In addition, the unaided APHAB (APHABu) can be used as a primary diagnostic instrument in audiology. There are no published data regarding the sensitivity and specificity of the unaided APHABu. Therefore, we investigated these parameters for detecting hearing loss of at least 25 dB at any frequency between 0...
July 29, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28655413/the-impact-of-physician-burnout-on-clinical-and-academic-productivity-of-gynecologic-oncologists-a-decision-analysis
#4
Taylor B Turner, Sarah E Dilley, Haller J Smith, Warner K Huh, Susan C Modesitt, Stephen L Rose, Laurel W Rice, Jeffrey M Fowler, J Michael Straughn
OBJECTIVE: Physician burnout is associated with mental illness, alcohol abuse, and job dissatisfaction. Our objective was to estimate the impact of burnout on productivity of gynecologic oncologists during the first half of their career. METHODS: A decision model evaluated the impact of burnout on total relative value (RVU) production during the first 15years of practice for gynecologic oncologists entering the workforce from 2011 to 2015. The SGO practice survey provided physician demographics and mean annual RVUs...
September 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28582484/comparison-of-three-methods-for-measuring-workload-in-surgical-pathology-and-cytopathology
#5
Daniel Cloetingh, Rodney A Schmidt, Christina S Kong
Objectives: Pathologist workload in the United States has traditionally been measured by relative value units (RVUs), which is often criticized for providing an inaccurate estimate of actual work. This study compares three methods for measuring workload. Methods: Surgical pathology and cytopathology workload for 1 representative month at Stanford Health Care was assessed using three different methods: RVUs, Royal College of Pathologists (RCP) point system, and University of Washington-Seattle (UW) slide count method...
July 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28579193/relativity-screens-for-misvalued-medical-services-impact-on-noninvasive-diagnostic-radiology
#6
Andrew B Rosenkrantz, Ezequiel Silva, C Matthew Hawkins
PURPOSE: In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. METHODS: Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services...
June 1, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28570413/professional-reimbursement-by-medicaid-for-cochlear-implants-and-related-services
#7
Joseph H Conduff, Daniel H Coelho
HYPOTHESIS: Medicaid reimbursement rates for cochlear implants and related services fall short of the federal benchmark set by Medicare. BACKGROUND: The financial hardships of cochlear implant centers around the United States may be a repercussion of poor Medicaid reimbursement. In time, these reimbursement discrepancies could force additional Otolaryngologists and cochlear implant centers to not provide these crucial services due to financial limitations. METHODS: Based on Medicare (MCR) claims data, current procedural terminology (CPT) codes used for cochlear implantation and related services were selected...
August 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28538612/scleral-contact-lenses-in-an-academic-oculoplastics-clinic-epidemiology-and-emerging-considerations
#8
Harinder S Chahal, Marcela Estrada, Christine W Sindt, Jacob A Boehme, Mark A Greiner, Jeffrey A Nerad, Keith D Carter, Richard C Allen, Erin M Shriver
PURPOSE: To describe the role and efficacy of scleral contact lenses (SCLs) in the treatment of progressive keratopathy in patients who have undergone periocular surgical procedures, to investigate the financial impact of these surgical interventions, and to demonstrate the role of oculoplastic surgery in improving scleral contact lens fit. METHODS: A retrospective medical record review was performed to identify patients who both received SCLs and were examined by the oculoplastics service at the University of Iowa between January 1990 and December 2015...
May 22, 2017: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28396270/structural-thermal-and-rheological-properties-of-starches-isolated-from-indian-quinoa-varieties
#9
Khan Nadiya Jan, P S Panesar, J C Rana, Sukhcharn Singh
In this study starches isolated from Indian quinoa varieties were examined for physicochemical, morphological, thermal and rheological properties. Among isolated starches V1 showed higher starch yield and lower purity (48.45% and 98.32%) than V2 (41.28 and 98.53%). The amylose content was higher for V1 (12.10%) than V2 (9.46%). Swelling powers and solubility of the starches increased with increasing temperature. Peak viscosity (386.4 RVU) was higher for V1. In contrast V2 showed higher pasting temperature (72...
September 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28373332/after-nearly-a-decade-of-rapid-growth-use-and-complexity-of-imaging-declined-2008-14
#10
David C Levin, Laurence Parker, Charles D Palit, Vijay M Rao
Imaging is an important cost driver in health care, and its use grew rapidly in the early 2000s. Several studies toward the end of the decade suggested that a leveling off was beginning to occur. In this study we examined more recent data to determine whether the slowdown had continued. Our data sources were the nationwide Medicare Part B databases for the period 2001-14. We calculated utilization rates per 1,000 enrollees for all advanced imaging modalities. We also calculated professional component relative value unit (RVU) rates per 1,000 beneficiaries for all imaging modalities, as RVU values provide a measure of complexity of imaging services and may in some ways be a better reflection of the amount of work involved in imaging...
April 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28301213/academic-radiologist-subspecialty-identification-using-a-novel-claims-based-classification-system
#11
Andrew B Rosenkrantz, Wenyi Wang, Danny R Hughes, Luke A Ginocchio, David A Rosman, Richard Duszak
OBJECTIVE: The objective of the present study is to assess the feasibility of a novel claims-based classification system for payer identification of academic radiologist subspecialties. MATERIALS AND METHODS: Using a categorization scheme based on the Neiman Imaging Types of Service (NITOS) system, we mapped the Medicare Part B services billed by all radiologists from 2012 to 2014, assigning them to the following subspecialty categories: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, nuclear medicine, interventional radiology, and neuroradiology...
June 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28265353/effects-of-pretreatments-of-banana-musa-aaa-omini-on-the-composition-rheological-properties-and-baking-quality-of-its-flour-and-composite-blends-with-wheat-flour
#12
Adegoke H Bakare, Olukemi D Ogunbowale, Mojisola O Adegunwa, Joseph O Olusanya
Effects of chemical and heat pretreatments on the protein, gluten, and alpha-amylase activity, pasting (Peak [P], Final [F] setback [S] viscosity, pasting temperature [PT] and time [T]) and alveogram (Energy [E], maximum inflation [MI], P/L, and elasticity index [EI]) properties of flour from the pretreated bananas and its composite with wheat flour (WF) were examined. The baking (water absorption [WA] and specific volume [SV]) and sensory properties of bread produced from the flour were also examined. Protein, gluten, and alpha-amylase activity ranged from 4...
March 2017: Food Science & Nutrition
https://www.readbyqxmd.com/read/28203644/optimization-of-the-functional-characteristics-pasting-and-rheological-properties-of-pearl-millet-based-composite-flour
#13
Olugbenga Olufemi Awolu
Optimisation of composite flour comprising pearl millet, kidney beans and tigernut with xanthan gum was evaluated for rheological evaluations. The functional properties of the composite flour were optimized using optimal design of response surface methodology. The optimum blends, defined as blends with overall best functional characteristics were run 3 (75.956% pearl millet, 17.692% kidney beans, 6.352% tigernut flours), run 7 (85.000% pearl millet, 10.000% kidney beans, 5.000% tigernut flours) and run 13 (75...
February 2017: Heliyon
https://www.readbyqxmd.com/read/28154988/computer-aided-reporting-of-chest-radiographs-efficient-and-effective-screening-in-the-value-based-imaging-era
#14
Michael Morris, Babak Saboury, Niketh Bandla, Christopher Toland, Christopher Meenan, Eliot Siegel, Jean Jeudy
In the post-PACS era, mammography is unique in adopting specialized ergonomic interfaces to improve efficiency in a high volume setting. Chest radiography is also a high volume area of radiology. The authors hypothesize that applying a novel interface for chest radiography interpretation and reporting could create high productivity while maintaining quality. A custom version of the ClearCanvas open source software, EzRad, was created with a workflow re-designed specifically for tuberculosis screening chest radiographs, which utilized standardized computer generated reports...
February 2, 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28121654/the-academic-rvu-ten-years-developing-a-metric-for-and-financially-incenting-academic-productivity-at-oregon-health-science-university
#15
O John Ma, Jerris R Hedges, Craig D Newgard
PURPOSE: Established metrics reward academic faculty for clinical productivity. Few data have analyzed a bonus model to measure and reward academic productivity. This study's objective was to describe development and use of a departmental academic bonus system for incenting faculty scholarly and educational productivity. METHOD: This cross-sectional study analyzed a departmental bonus system among emergency medicine academic faculty at Oregon Health & Science University, including growth from 2005 to 2015...
August 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28118038/quality-metrics-currently-used-in-academic-radiology-departments-results-of-the-qualmet-survey
#16
MULTICENTER STUDY
Eric A Walker, Jonelle M Petscavage-Thomas, Joseph S Fotos, Michael A Bruno
OBJECTIVE: We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA. METHODS: The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments. RESULTS: There was a 34...
March 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28109347/how-is-physician-work-valued
#17
REVIEW
Jeffrey P Jacobs, Stephen J Lahey, Francis C Nichols, James M Levett, George Gilbert Johnston, Richard K Freeman, James D St Louis, Julie Painter, Courtney Yohe, Cameron D Wright, Kirk R Kanter, John E Mayer, Keith S Naunheim, Jeffrey B Rich, Joseph E Bavaria
Strategies to value physician work continue to evolve. The Society of Thoracic Surgeons and The Society of Thoracic Surgeons National Database have an increasingly important role in this evolution. An understanding of the Current Procedural Terminology (CPT) system (American Medical Association [AMA], Chicago, IL) and the Relative Value Scale Update Committee (RUC) is necessary to comprehend how physician work is valued. In 1965, with the dawn of increasingly complex medical care, immense innovation, and the rollout of Medicare, the need for a common language describing medical services and procedures was recognized as being of critical importance...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28070707/value-based-assessment-of-radiology-reporting-using-radiologist-referring-physician-two-way-feedback-system-a-design-thinking-based-approach
#18
Faiq Shaikh, Kenneth Hendrata, Brian Kolowitz, Omer Awan, Rasu Shrestha, Christopher Deible
In the era of value-based healthcare, many aspects of medical care are being measured and assessed to improve quality and reduce costs. Radiology adds enormously to health care costs and is under pressure to adopt a more efficient system that incorporates essential metrics to assess its value and impact on outcomes. Most current systems tie radiologists' incentives and evaluations to RVU-based productivity metrics and peer-review-based quality metrics. In a new potential model, a radiologist's performance will have to increasingly depend on a number of parameters that define "value," beginning with peer review metrics that include referrer satisfaction and feedback from radiologists to the referring physician that evaluates the potency and validity of clinical information provided for a given study...
June 2017: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
https://www.readbyqxmd.com/read/28051222/contribution-of-ultrasound-scans-in-the-first-episode-of-urinary-tract-infection-in-children
#19
Manel Jellouli, Asma Ben Mansour, Kamel Abidi, Meriem Ferjani, Ouns Naija, Yousra Hammi, Chokri Zarrouk, Tahar Gargah
Background - Vesicoureteral reflux (VUR) is a common pediatric urologic disorder. After the first urinary tract infection (UTI), imaging studies are recommended, starting with a renal ultrasound (US) and voiding cystourethrography (VCUG). We propose to determine whether abnormalities found on US can help indicate the necessity of VCUG in children after the first urinary tract infection. Methods - A retrospective study included all children admitted with their first episode of urinary tract infection from January 2007 to December 2012...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28024653/comparison-of-2015-medicare-relative-value-units-for-gender-specific-procedures-gynecologic-and-gynecologic-oncologic-versus-urologic-cpt-coding-has-time-healed-gender-worth
#20
COMPARATIVE STUDY
M F Benoit, J F Ma, B A Upperman
BACKGROUND: In 1992, Congress implemented a relative value unit (RVU) payment system to set reimbursement for all procedures covered by Medicare. In 1997, data supported that a significant gender bias existed in reimbursement for gynecologic compared to urologic procedures. The present study was performed to compare work and total RVU's for gender specific procedures effective January 2015 and to evaluate if time has healed the gender-based RVU worth. METHODS: Using the 2015 CPT codes, we compared work and total RVU's for 50 pairs of gender specific procedures...
February 2017: Gynecologic Oncology
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