Breast exam use during the protracted COVID-19 pandemic, by age, race, and geography.

In this study we analyzed data collected from the onset of the COVID-19 pandemic through March 31, 2022, to identify temporal shifts in breast exam volume. Screening mammography volume stabilized toward the end of the study period, and diagnostic exam volume varied over time and by age. Older women experienced a decline in diagnostic exam volume between August 2020 and April 2021 that was not observed among women aged younger than 50 years (50-69 years: monthly percentage change [MPC] = -6.5%; and 70 years and older: MPC = -15.7%). With respect to breast biopsy volume, women aged younger than 70 years had increased exam volume beginning in April 2020 and June 2020, whereas a corresponding increase among older women was delayed until April 2021 (70 years and older: MPC = 9.3%). Findings from our study suggest a temporal shift in the use of breast exams that could result in differential detection of breast cancer by age.

Radiology Dictation Errors with COVID-19 Protective Equipment: Does Wearing a Surgical Mask Increase the Dictation Error Rate?

Our aim was to determine the effect of wearing a surgical mask on the number and type of dictation errors in unedited radiology reports. IRB review was waived for this prospective matched-pairs study in which no patient data was used. Model radiology reports (n = 40) simulated those typical for an academic medical center. Six randomized radiologists dictated using speech-recognition software with and without a surgical mask. Dictations were compared to model reports and errors were classified according to type and severity. A statistical model was used to demonstrate that error rates for all types of errors were greater when masks are worn compared to when they are not (unmasked: 21.7 ± 4.9 errors per 1000 words, masked: 27.1 ± 2.2 errors per 1000 words; adjusted p < 0.0001). A sensitivity analysis was performed, excluding a reader with a large number of errors. The sensitivity analysis found a similar difference in error rates for all types of errors, although significance was attenuated (unmasked: 16.9 ± 1.9 errors per 1000 words, masked: 20.1 ± 2.2 errors per 1000 words; adjusted p = 0.054). We conclude that wearing a mask results in a near-significant increase in the rate of dictation errors in unedited radiology reports created with speech-recognition, although this difference may be accentuated in some groups of radiologists. Additionally, we find that most errors are minor single incorrect words and are unlikely to result in a medically relevant misunderstanding.

Self-Care and Storytelling for Radiologists: A Feasibility Study.

RATIONALE AND OBJECTIVES: Physician wellness and burnout mitigation strategies have become priority practices in recent years. Despite these efforts, however, physicians living with the psychological effects of the current COVID-19 global pandemic, political stressors, and social injustices, face ever increasing threats to their personal and professional well-being. This manuscript investigates the process of storytelling as a self-care practice for radiologists. MATERIALS AND METHODS: The AUR Well Being Ad-Hoc Committee introduced and approved Storytelling Geek Week, a virtual workshop held by The Moth, a Peabody award-winning storytelling nonprofit group. Nineteen AUR members applied and were selected for participation in the workshop which occurred over 5 days in November 2020. Anonymous electronic surveys were sent to participants before and after the workshop to gather feedback on their experience. RESULTS: Of the 19 AUR member participants, 12 (63%) completed the pre-workshop survey and 8 (42%) completed the post-workshop survey. Participant current state of well-being was found to be increased between the pre- and post-course surveys, with a statistically significant adjusted P-value of 0.017. All 8 post-workshop respondents reported that they would recommend the workshop to others. With regard to how participation in the workshop impacted their wellbeing, representative free text responses include, "helped with processing emotions," and "felt more connected to strangers." Regarding shifts in perspective as a result of workshop participation, representative free text responses include, "more empathetic" and "started focusing on hope and gratitude rather than sadness and anxiety." CONCLUSION: Participants in a storytelling workshop reported a positive impact on their perceived sense of well-being. Respondents also reports shifts in their sense of empathy and connectedness to others. This type of intervention may help to mitigate burnout and build community during challenging times.

Population-level impact of coronavirus disease 2019 on breast cancer screening and diagnostic procedures.

BACKGROUND: To understand how health care delays may affect breast cancer detection, the authors quantified changes in breast-related preventive and diagnostic care during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Eligible women (N = 39,444) were aged ≥18 years and received a screening mammogram, diagnostic mammogram, or breast biopsy between January 1, 2019 and September 30, 2020, at 7 academic and community breast imaging facilities in North Carolina. Changes in the number of mammography or breast biopsy examinations after March 3, 2020 (the first COVID-19 diagnosis in North Carolina) were evaluated and compared with the expected numbers based on trends between January 1, 2019 and March 2, 2020. Changes in the predicted mean monthly number of examinations were estimated using interrupted time series models. Differences in patient characteristics were tested using least squares means regression. RESULTS: Fewer examinations than expected were received after the pandemic's onset. Maximum reductions occurred in March 2020 for screening mammography (-85.1%; 95% CI, -100.0%, -70.0%) and diagnostic mammography (-48.9%; 95% CI, -71.7%, -26.2%) and in May 2020 for biopsies (-40.9%; 95% CI, -57.6%, -24.3%). The deficit decreased gradually, with no significant difference between observed and expected numbers by July 2020 (diagnostic mammography) and August 2020 (screening mammography and biopsy). Several months after the pandemic's onset, women who were receiving care had higher predicted breast cancer risk (screening mammography, P < .001) and more commonly lacked insurance (diagnostic mammography, P < .001; biopsy, P < .001) compared with the prepandemic population. CONCLUSIONS: Pandemic-associated deficits in the number of breast examinations decreased over time. Utilization differed by breast cancer risk and insurance status, but not by age or race/ethnicity. Long-term studies are needed to clarify the contribution of these trends to breast cancer disparities.

Radiology Medical Student Education 2020: Surveys of the Alliance of Medical Student Educators in Radiology and Medical Students.

RATIONALE AND OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant changes to medical student education by disrupting clinical rotations, licensing exams, and residency applications. To evaluate the pandemic's impact and required modifications of radiology medical student courses, the authors developed and administered surveys to Alliance of Medical Student Educators in Radiology (AMSER) faculty and enrolled medical students. The surveys requested feedback and insight about respondents' experiences and innovations. MATERIALS AND METHODS: Anonymous twenty-question and seventeen-question surveys about the pandemic's impact on medical student education were distributed via email to AMSER members and medical students. The surveys consisted of multiple choice, ranking, Likert scale, and open-ended questions. Differences in the Likert score agreement was performed using one-sided Wilcoxon-Mann-Whitney tests. Survey data were collected using SurveyMonkey (San Mateo, California). This study was IRB exempt. RESULTS: The AMSER survey indicated 96% of institutions cancelled medical student courses and 92% resumed with virtual courses, typically general radiology. A total of 64% of faculty enjoyed online teaching, although 82% preferred on-site courses. A total of 62% of students felt an online radiology course was an excellent alternative to an on-site rotation, although 27% disagreed. A total of 69% of students who completed both on-site and online courses preferred the on-site format. Survey-reported innovations and free response comments have been collated as educational resources. CONCLUSION: Faculty were able to adapt radiology courses to the online environment utilizing interactive lectures, self-directed learning, flipped classroom sessions, and virtual readouts, which were effective for student respondents. Hybrid rotations with on-site and online elements may offer the best of both worlds.