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Effect of home terminal use on radiology report approval time
POSTERS P-53 Effect of Home Terminal Use on Radiology Report Approval Time J. Kevin Smith, M.D., Ph.D., Philip Kenney, M.D. University of Alabama.
Purpose: The purpose of this study was to determine whether a single specific intervention, providing home terminals for radiologists, would signifieandy speed radiologists' performance in the task of approving and electronically signing radiology reports.
Methods: Prompt reporting of radiologic study results is a critical part,of radiologists' contribution to patient care, as well as being a requirement for meeting the standards of the American College of Radiology. A total quality management approach combined with several specific interventions including the use of home terminals has recently been shown to significantly accelerate report signing. While computer equipment and high speed modems are readily available, the cost ($1,000-1,500 per mdiologis0 is not insignificant. This study evaluates the single specific intervention of providing home terminals for report correction and approval. Five radiologists in the department have had home terminals set up within the last year; five additional radiologists with similar clinical schedules and workloads were selected to serve as controls. The radiology information system (SD&G Images 3000) was used to provide times from transcription to report approval for the ten selected radiologists for a one month period. Results: Radiologists with home terminals averaged 787 _+ 198 minutes (mean + standard error) compared to 972 + 200 minutes for the control group (p=0.20) during the study period.
eel. 2, No. 12, December 1995
P-54 CT-Guided Needle Localization of Non-Palpable Breast Lesions: Review of 23 Cases Robert M. Spillane, M.D., G. Whitman, M.D., D.B. Kopans, M.D. Massachusetts General Hospital.
Objective: The purpose of this project was to review the role of CT in breast imaging, especially in needle-localization procedures. Materials & Methods: We reviewed our institutions' breast imaging data base from 1978-1994 for procedures performed using CT. Twenty-four CT-guided needle procedures were identified. Medical records, mammograms, CT scans, and pathology reports were reviewed. Results: Twenty-four CT-guided procedures (23 nemale loealizations, 1 core biopsy) were performed on 22 female patients (mean age 59 years). The average size of the lesions localized was 11 ram. The most common reason for referral to CT was the inability to image a suspicious density by conventional mammography in two orthogonal views. Nine malignant and fourteen benign lesions were localized under CT guidance. CT failed to identify one lesion and CT averted the need for one biopsy. No complications
OCCUlTed. Conclusion: CT is a simple and reliable technique to define and triangulate selected breast lesions not visible by conventional 2-view mammography.
Conclusion: Radiologists with home computer terminals for approving reports had shorter average report approval times than controls by more than three hours, but the difference was not statistically significant, possibly due to the small sample size and large variability within the sample. Further study is underway with additional radiologists over a longer lime period. These radiologists will serve as their own controls before and after home terminal provision which will allow more stringent statistical evaluation.
P-55 Magnetic Resonance Imaging of the Elbow Sean Tutton, M.D., S.W. Fitzgerald, M.D., A.H. Sonin, M.D., F.L. Hoff, M.D., J.S. Donaldson, M.D. Northwestern Memorial Hospital, Children's Memorial Hospital.
Purpose: T o d e m o n s t r a t e a t a i l o r e d a p p r o a c h t o M R i m a g i n g o f t h e elbow.
Methods: O v e r 2 5 0 M R e x a m i n a t i o n s o f t h e e l b o w h a v e b e e n p e r f o r m e d at our institution. Imaging parameters were varied based on knowledg~ of normal anatomy, and recognized patterns of disease. MR protocols including patient positioning, imaging planes, sequence selection, and gadolinium enhancement will be discussed. Results: A b r o a d s p e c t r u m o f p a t h o l o g y w i t h i n a n d a b o u t t h e e l b o w w i l l be demonstrated including osseous, intra-articular and ligamentous injuries; loose bodies and osteochondritis; over-use syndromes; soft tissue masses, and pediatric disorders. Emphasis will be placed on the advantages of the tailored approach. Conclusions: M R i m a g i n g o f t h e e l b o w c a n b e a v a l u a b l e d i a g n o s t i c t o o l with an understanding of relevant normal anatomy and the use of appropriate imaging strategies.
P-56 Accuracy of the Screening Mammogram in the Dense Breast Bonnie C. Yankaskas, Ph.D., Dawn A. Jones, B.A., Etta D. Pisano, M.D., Robert McLelland, M.D., M. Patricia Braening, M.D. University of North Carolina.
Objective: The purpose of this study was to estimate accuracy of screening mammogrephy in women with dense breasts, compared to women with fatty breasts. Metheds: All women having a screening mammogram were identified from the Mammography Dataintsc, which has registration, demographic, and mammographic data on all women seen in four practices. All films were interpreted by the 4 radiologists at UNC-CH who specialize in mammography. A screening mammogram was defined as being performed in an asymptom~ic women who had no hiStol7 of b~ast cancer, and no abnormal mmm~gram within the past year. Thedatabase was used to gather information on medical breast history, family history, mammographieinterpretativefindings,recommended follow-up time, procedures and pathologic outcome. All breast pathologyis routinely received for the database from the hospital pathology department, Annually, the database links with the NC Central Cancer Registry to locate any cancers that may have been diagnosed outside our hospital. Woman were categorized by breast density into dense, mixed, and fatty groups. The outcomes from the screening marnmogram was determined by pa~nchymal density, age and race. Results: There wox~ 1094 mammograms of fatty breasts, and 3099 of mostly dense or fully dense breasts over this time period. The incidenceof cancer in the two groups was 1.4/1000 in the dense marnmograms, and 0.5/1000 in the fatty breasts. This reflects that younger women getting screzning mammograms are at higher risk for breast cancer, and tend to have a higher percent of immediate recall as a result of the screening mammogram. The sensitivityof the screening mammogram is very dependent on the definitions used to define a positive or negative mammogram, and the follow-up parameters. The varied possible definitions and the resulting accuracies will be discussed. Conclusions: Accuracyin the dense breast is different, and perhaps higher than accuracy in the fatty breast, based on the screening mammogram. The actual value is very dependent on the definitions applied.
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Purpose: The purpose of this study was to determine whether a single specific intervention, providing home terminals for radiologists, would signifieandy speed radiologists' performance in the task of approving and electronically signing radiology reports.
Methods: Prompt reporting of radiologic study results is a critical part,of radiologists' contribution to patient care, as well as being a requirement for meeting the standards of the American College of Radiology. A total quality management approach combined with several specific interventions including the use of home terminals has recently been shown to significantly accelerate report signing. While computer equipment and high speed modems are readily available, the cost ($1,000-1,500 per mdiologis0 is not insignificant. This study evaluates the single specific intervention of providing home terminals for report correction and approval. Five radiologists in the department have had home terminals set up within the last year; five additional radiologists with similar clinical schedules and workloads were selected to serve as controls. The radiology information system (SD&G Images 3000) was used to provide times from transcription to report approval for the ten selected radiologists for a one month period. Results: Radiologists with home terminals averaged 787 _+ 198 minutes (mean + standard error) compared to 972 + 200 minutes for the control group (p=0.20) during the study period.
eel. 2, No. 12, December 1995
P-54 CT-Guided Needle Localization of Non-Palpable Breast Lesions: Review of 23 Cases Robert M. Spillane, M.D., G. Whitman, M.D., D.B. Kopans, M.D. Massachusetts General Hospital.
Objective: The purpose of this project was to review the role of CT in breast imaging, especially in needle-localization procedures. Materials & Methods: We reviewed our institutions' breast imaging data base from 1978-1994 for procedures performed using CT. Twenty-four CT-guided needle procedures were identified. Medical records, mammograms, CT scans, and pathology reports were reviewed. Results: Twenty-four CT-guided procedures (23 nemale loealizations, 1 core biopsy) were performed on 22 female patients (mean age 59 years). The average size of the lesions localized was 11 ram. The most common reason for referral to CT was the inability to image a suspicious density by conventional mammography in two orthogonal views. Nine malignant and fourteen benign lesions were localized under CT guidance. CT failed to identify one lesion and CT averted the need for one biopsy. No complications
OCCUlTed. Conclusion: CT is a simple and reliable technique to define and triangulate selected breast lesions not visible by conventional 2-view mammography.
Conclusion: Radiologists with home computer terminals for approving reports had shorter average report approval times than controls by more than three hours, but the difference was not statistically significant, possibly due to the small sample size and large variability within the sample. Further study is underway with additional radiologists over a longer lime period. These radiologists will serve as their own controls before and after home terminal provision which will allow more stringent statistical evaluation.
P-55 Magnetic Resonance Imaging of the Elbow Sean Tutton, M.D., S.W. Fitzgerald, M.D., A.H. Sonin, M.D., F.L. Hoff, M.D., J.S. Donaldson, M.D. Northwestern Memorial Hospital, Children's Memorial Hospital.
Purpose: T o d e m o n s t r a t e a t a i l o r e d a p p r o a c h t o M R i m a g i n g o f t h e elbow.
Methods: O v e r 2 5 0 M R e x a m i n a t i o n s o f t h e e l b o w h a v e b e e n p e r f o r m e d at our institution. Imaging parameters were varied based on knowledg~ of normal anatomy, and recognized patterns of disease. MR protocols including patient positioning, imaging planes, sequence selection, and gadolinium enhancement will be discussed. Results: A b r o a d s p e c t r u m o f p a t h o l o g y w i t h i n a n d a b o u t t h e e l b o w w i l l be demonstrated including osseous, intra-articular and ligamentous injuries; loose bodies and osteochondritis; over-use syndromes; soft tissue masses, and pediatric disorders. Emphasis will be placed on the advantages of the tailored approach. Conclusions: M R i m a g i n g o f t h e e l b o w c a n b e a v a l u a b l e d i a g n o s t i c t o o l with an understanding of relevant normal anatomy and the use of appropriate imaging strategies.
P-56 Accuracy of the Screening Mammogram in the Dense Breast Bonnie C. Yankaskas, Ph.D., Dawn A. Jones, B.A., Etta D. Pisano, M.D., Robert McLelland, M.D., M. Patricia Braening, M.D. University of North Carolina.
Objective: The purpose of this study was to estimate accuracy of screening mammogrephy in women with dense breasts, compared to women with fatty breasts. Metheds: All women having a screening mammogram were identified from the Mammography Dataintsc, which has registration, demographic, and mammographic data on all women seen in four practices. All films were interpreted by the 4 radiologists at UNC-CH who specialize in mammography. A screening mammogram was defined as being performed in an asymptom~ic women who had no hiStol7 of b~ast cancer, and no abnormal mmm~gram within the past year. Thedatabase was used to gather information on medical breast history, family history, mammographieinterpretativefindings,recommended follow-up time, procedures and pathologic outcome. All breast pathologyis routinely received for the database from the hospital pathology department, Annually, the database links with the NC Central Cancer Registry to locate any cancers that may have been diagnosed outside our hospital. Woman were categorized by breast density into dense, mixed, and fatty groups. The outcomes from the screening marnmogram was determined by pa~nchymal density, age and race. Results: There wox~ 1094 mammograms of fatty breasts, and 3099 of mostly dense or fully dense breasts over this time period. The incidenceof cancer in the two groups was 1.4/1000 in the dense marnmograms, and 0.5/1000 in the fatty breasts. This reflects that younger women getting screzning mammograms are at higher risk for breast cancer, and tend to have a higher percent of immediate recall as a result of the screening mammogram. The sensitivityof the screening mammogram is very dependent on the definitions used to define a positive or negative mammogram, and the follow-up parameters. The varied possible definitions and the resulting accuracies will be discussed. Conclusions: Accuracyin the dense breast is different, and perhaps higher than accuracy in the fatty breast, based on the screening mammogram. The actual value is very dependent on the definitions applied.
1168