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Outpatient imaging efficiency

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https://www.readbyqxmd.com/read/29195710/health-it-and-inappropriate-utilization-of-outpatient-imaging-a-cross-sectional-study-of-u-s-hospitals
#1
Ajit Appari, M Eric Johnson, Denise L Anthony
OBJECTIVE: To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. RESEARCH DESIGN: A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using data from: Hospital Compare (2011 outpatient imaging efficiency measures), HIMSS Analytics (2009 health IT), and Health Indicator Warehouse (market characteristics)...
January 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29044295/clinical-decision-rules-for-pulmonary-embolism-in-hospitalized-patients-a-systematic-literature-review-and-meta-analysis
#2
Anne R Bass, Kara G Fields, Rie Goto, Gregory Turissini, Shirin Dey, Linda A Russell
Background Clinical decision rules (CDRs) for pulmonary embolism (PE) have been validated in outpatients, but their performance in hospitalized patients is not well characterized. Objectives The goal of this systematic literature review was to assess the performance of CDRs for PE in hospitalized patients. Methods We performed a structured literature search using Medline, EMBASE and the Cochrane library for articles published on or before January 18, 2017. Two authors reviewed all titles, abstracts and full texts...
November 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29030346/diagnostic-accuracy-of-the-aortic-dissection-detection-risk-score-plus-d-dimer-for-acute-aortic-syndromes-the-advised-prospective-multicenter-study
#3
Peiman Nazerian, Christian Mueller, Alexandre de Matos Soeiro, Bernd A Leidel, Sibilla Anna Teresa Salvadeo, Francesca Giachino, Simone Vanni, Karin Grimm, Múcio T Oliveira, Emanuele E Pivetta, Enrico Lupia, Stefano Grifoni, Fulvio Morello
Background -Acute aortic syndromes (AAS) are rare and severe cardiovascular emergencies with unspecific symptoms. For AAS, both misdiagnosis and over-testing are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS, but is inadequate as a standalone test. Integration of pre-test probability assessment (PPA) with D-dimer (DD) testing is feasible, but the safety and efficiency of such diagnostic strategy are currently unknown...
October 13, 2017: Circulation
https://www.readbyqxmd.com/read/29029689/implementation-of-a-cloud-based-electronic-medical-record-exchange-system-in-compliance-with-the-integrating-healthcare-enterprise-s-cross-enterprise-document-sharing-integration-profile
#4
Chien Hua Wu, Ruey Kei Chiu, Hong Mo Yeh, Da Wei Wang
In 2011, the Ministry of Health and Welfare of Taiwan established the National Electronic Medical Record Exchange Center (EEC) to permit the sharing of medical resources among hospitals. This system can presently exchange electronic medical records (EMRs) among hospitals, in the form of medical imaging reports, laboratory test reports, discharge summaries, outpatient records, and outpatient medication records. Hospitals can send or retrieve EMRs over the virtual private network by connecting to the EEC through a gateway...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28864165/public-reporting-of-mri-of-the-lumbar-spine-for-low-back-pain-and-changes-in%C3%A2-clinical-documentation
#5
Jonathan A Flug, Kimberly E Lind
OBJECTIVE: OP-8 is the Medicare imaging efficiency metric for MRI of the lumbar spine for low back pain in the outpatient hospital. We studied trends in exclusion criteria coding over time by site of service after implementation of OP-8 to evaluate provider's response to public reporting. MATERIALS AND METHODS: We conducted a secondary data analysis using the Medicare Limited Data Set 5% sample for beneficiaries with MRI lumbar spine and lower back pain during 2009 to 2014...
August 30, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28520668/structural-connectivity-related-to-persistent-symptoms-after-mild-tbi-in-adolescents-and-response-to-aerobic-training-preliminary-investigation
#6
Weihong Yuan, Shari L Wade, Catherine Quatman-Yates, Jason A Hugentobler, Paul J Gubanich, Brad G Kurowski
OBJECTIVE: To quantify structural connectivity abnormalities in adolescents with mild traumatic brain injury (mTBI) and to investigate connectivity changes following aerobic training using graph theory and diffusion tensor imaging tractography. SETTING: Outpatient research setting. PARTICIPANTS: Twenty-two children (age: 15.83 ± 1.77 years, 10 females) with 4 to 16 weeks of persistent symptoms after mTBI and a matched healthy comparison group...
November 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28467520/transdiagnostic-associations-between-functional-brain-network-integrity-and-cognition
#7
Julia M Sheffield, Sridhar Kandala, Carol A Tamminga, Godfrey D Pearlson, Matcheri S Keshavan, John A Sweeney, Brett A Clementz, Dov B Lerman-Sinkoff, S Kristian Hill, Deanna M Barch
Importance: Cognitive impairment occurs across the psychosis spectrum and is associated with functional outcome. However, it is unknown whether these shared manifestations of cognitive dysfunction across diagnostic categories also reflect shared neurobiological mechanisms or whether the source of impairment differs. Objective: To examine whether the general cognitive deficit observed across psychotic disorders is similarly associated with functional integrity of 2 brain networks widely implicated in supporting many cognitive domains...
June 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28445191/evaluation-of-horner-syndrome-in-the-mri-era
#8
Ama Sadaka, Samantha L Schockman, Karl C Golnik
BACKGROUND: To identify the etiologies of adult Horner syndrome (HS) in the MRI era using a targeted evaluation approach and to assess the value and yield of targeted imaging. METHODS: A retrospective chart review was performed of 200 adult outpatients with HS, confirmed with cocaine eyedrop testing. Patients were divided into subgroups based on the presence or absence of symptoms and those who did or did not receive additional testing with hydroxyamphetamine drops...
September 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28437802/surveillance-after-resection-of-pancreatic-ductal-adenocarcinoma-with-curative-intent-a-multicenter-survey-in-germany-and-review-of-the-literature
#9
Thomas J Ettrich, Lucas A Schulte, Natalie Eitel, Kristin Ettrich, Andreas W Berger, Lukas Perkhofer, Thomas Seufferlein
Background Pancreatic ductal adenocarcinoma (PDAC) is one of the most lethal cancers with high risk of relapse even after curative-intended resection. There are no evidence-based recommendations for surveillance in actual guidelines. Given this situation and as a basis for prospective studies, we wanted to determine the current practice of surveillance after pancreatic cancer resection in German institutions. Methods A web-based questionnaire was sent in 2015 to 300 German institutions (hospitals, outpatient clinics, and private practices) experienced in the care of patients with PDAC...
July 2017: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/28427416/shoulder-ultrasonography-performed-by-orthopedic-surgeons-increases-efficiency-in-diagnosis-of-rotator-cuff-tears
#10
Chih-Hao Chiu, Poyu Chen, Alvin Chao-Yu Chen, Kuo-Yao Hsu, Shih-Sheng Chang, Yi-Sheng Chan, Yeung-Jen Chen
BACKGROUND: Rotator cuff tears are very common and their incidence increases with age. Shoulder ultrasonography has recently gained popularity in detecting rotator cuff tears because of its efficiency, cost-effectiveness, time-saving, and real-time nature of the procedure. Well-trained orthopedic surgeons may utilize shoulder ultrasonography to diagnose rotator cuff tears. The wait time of patients planned to have shoulder MRI (magnetic resonance imaging) to rule in rotator cuff tears may decrease after orthopedic surgeon start doing shoulder ultrasonography as a screening tool for that...
April 20, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28375914/low-back-pain
#11
Jinny O Tavee, Kerry H Levin
PURPOSE OF REVIEW: This article provides an overview of evaluating and treating low back pain in the outpatient setting. RECENT FINDINGS: As most cases of acute low back pain have a favorable prognosis, current guidelines on imaging studies recommend conservative treatment for 6 weeks prior to obtaining an MRI if no red flags are present. Of these red flags, a prior history of cancer is the strongest risk factor for a malignant etiology and requires urgent evaluation with MRI...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28375910/dizziness-in-the-outpatient-care-setting
#12
Terry D Fife
PURPOSE OF REVIEW: This article summarizes an approach to evaluating dizziness for the general neurologist and reviews common and important causes of dizziness and vertigo. RECENT FINDINGS: Improved methods of diagnosing patients with vertigo and dizziness have been evolving, including additional diagnostic criteria and characterization of some common conditions that cause dizziness (eg, vestibular migraine, benign paroxysmal positional vertigo, chronic subjective dizziness)...
April 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28327977/the-ethics-of-choosing-wisely-the-use-of-neuroimaging-for-uncomplicated-headache
#13
David J Cote, Edward R Laws
The use of magnetic resonance imaging (MRI) for evaluation of headache remains excessive among physicians across many specialties according to both the American Headache Society and the American College of Radiology, despite recent attempts at limiting overuse of imaging and procedures. As part of the Choosing Wisely campaign, both of these organizations have explicitly recommended against imaging in patients with uncomplicated or typical migraine headaches. Yet, the practice nevertheless remains prevalent, with estimates ranging from 12...
May 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28254445/new-device-for-intermittent-emptying-of-the-bladder-in-female-children-and-adolescents-a-pilot-study
#14
Salvador V C Lima, Fábio O Vilar, Eugênio S Lustosa, Daniel C C Aragão, Fernanda C F S Calisto, Flávia C M Pinto
INTRODUCTION: Urinary incontinence (UI) is a challenging problem for the urological community. Clean intermittent catheterization (CIC) is the most commonly used method to restore bladder emptying to the state close to the physiological condition. This procedure can cause negative aspects such as pain and possible urethral injury. In addition, there is a negative impact on self-image and decline in quality of patient's life. The aim of the present study was to evaluate the safety and efficacy of a new intraurethral self-retaining device (ISRD), in female children and adolescents, as an attractive alternative to CIC...
October 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27795820/cost-of-illness-among-patients-with-diabetic-foot-ulcer-in-turkey
#15
Ergun Oksuz, Simten Malhan, Bilge Sonmez, Rukiye Numanoglu Tekin
AIM: To evaluate the annual cost of patients with Wagner grade 3-4-5 diabetic foot ulcer (DFU) from the public payer's perspective in Turkey. METHODS: This study was conducted focused on a time frame of one year from the public payer's perspective. Cost-of-illness (COI) methodology, which was developed by the World Health Organization, was used in the generation of cost data. By following a clinical path with the COI method, the main total expenses were reached by multiplying the number of uses of each expense item, the percentage of cases that used them and unit costs...
October 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/27782870/factors-associated-with-the-decision-of-the-rheumatologist-to-order-sacroiliac-joints-magnetic-resonance-imaging-si-mri-or-hla-b27-testing-in-the-diagnostic-work-up-of-patients-with-spondyloarthritis-in-clinical-practice
#16
Wilson Bautista-Molano, Robert B M Landewé, Cesar Serna, Rafael Valle-Oñate, Désirée van der Heijde
OBJECTIVES: To evaluate the patients' characteristics associated with the clinical decision to request SI-MRI and/or HLA-B27 in patients with SpA in daily practice. METHODS: Patients referred to a rheumatology outpatient-clinic in a national referral-centre were selected. Patients with a clinical diagnosis of SpA according to the rheumatologist were included. SI-MRI and HLA-B27 was available for patients in whom the rheumatologists had ordered these tests. Characteristics associated with ordering SI-MRI or HLA-B27 were identified with univariable analyses...
January 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27686648/telehealth-interventions-for-reducing-waiting-lists-and-waiting-times-for-specialist-outpatient-services-a-scoping-review
#17
REVIEW
Liam J Caffery, Mutaz Farjian, Anthony C Smith
We undertook a scoping review of the published literature to identify and summarise key findings on the telehealth interventions that influence waiting times or waiting lists for specialist outpatient services. Searches were conducted to identify relevant articles. Articles were included if the telehealth intervention restructured or made the referral process more efficient. We excluded studies that simply increased capacity. Two categories of interventions were identified - electronic consultations and image-based triage...
December 2016: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/27557630/strategies-for-assessing-renal-function-prior-to-outpatient-contrast-enhanced-ct-a-uk-survey
#18
MULTICENTER STUDY
Martine Ann Harris, Beverly Snaith, Ruth Clarke
OBJECTIVE: To identify current UK screening practices prior to contrast-enhanced CT. To determine the patient management strategies to minimize the risk of contrast-induced acute kidney injury (CI-AKI) risk in outpatients. METHODS: An invitation to complete an electronic survey was distributed to the CT managers of 174 UK adult National Health Service hospital trusts. The survey included questions related to local protocols and national guidance on which these are based...
November 2016: British Journal of Radiology
https://www.readbyqxmd.com/read/27504650/the-mini-c-arm-adds-quality-and-efficiency-to-the-pediatric-orthopedic-outpatient-clinic
#19
Matthew G Fanelli, William L Hennrikus, Jennifer M Slough Hill, Douglas G Armstrong, Steven H King
The mini C-arm has become increasingly popular in the practice of orthopedics. To the authors' knowledge, its use in the pediatric orthopedic outpatient clinic has not been reported. The purpose of this study was to evaluate the practice efficiency and radiation exposure to the patient when the mini C-arm was used in the pediatric orthopedic outpatient clinic. One hundred consecutive midshaft and distal forearm fractures were evaluated by one orthopedic surgeon in follow-up using a mini C-arm. For each case, the radiation physicist calculated the amount of skin exposure in milligray (mGy)...
November 1, 2016: Orthopedics
https://www.readbyqxmd.com/read/27493745/improving-the-safety-and-efficiency-of-outpatient-lumbar-puncture-service
#20
Mark Sweeney, Adam Al-Diwani, Robert Hadden
Lumbar puncture (LP) is a commonly performed procedure in diagnosis and management of neurological conditions. LP is generally safe, however there are a number of potentially serious complications, including epidural haematoma and cerebral herniation. The risks of these should be considered and minimised prior to undertaking LP. Our regional neuroscience centre provides an outpatient LP service for patients throughout southeast England. Referrals from distant hospitals meant there was frequently no access to important clinical information, including indication for LP, past medical history, or medication history until the day of the procedure, and no access to results of investigations such as coagulation profile, platelet count, or intracranial imaging...
2016: BMJ Quality Improvement Reports
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