Detecting Technical Image Quality in Radiology Reports.

Image interpretation accuracy is critical to ensure optimal care, yet many diagnostic reports contain expressions of uncertainty often due to shortcomings in technical quality among other factors. While radiologists will usually attempt to interpret images and render a diagnosis even if the imaging quality is suboptimal, often the details related to any quality concerns are dictated into the report. Despite imaging exam quality being an import factor for accurate image interpretation, there is a significant knowledge gap in terms of understanding the nature and frequency of technical limitations mentioned in radiology reports. To address some of these limitations, in this research we developed algorithms to automatically detect a broad spectrum of acquisition-related quality concerns using a dataset containing 1,210,858 exams. There was some type of a quality concern mentioned in 2.4% of exams with motion being the most frequent.

Using hip measures to avoid misdiagnosing early rapid onset osteoarthritis for osteonecrosis.

In the early phases, subchondral insufficiency fractures and rapidly destructive osteoarthritis of the hip are often mistaken for osteonecrosis of the hip. Three hip measures were used comparing combined subchondral insufficiency fractures and rapidly destructive 18 osteoarthritis patients to 18 osteonecrosis patients. Due to the rarity of these conditions there was no statistical power. Initial diagnoses for the osteoarthritis patients were recorded. The osteoarthritis group had significantly higher means for Tönnis angle (P < 0.001), lateral center edge angle (P = 0.006), and acetabular extrusion index (P = 0.014). Only 7 of the 18 patients were initially diagnosed without reservation as subchondral insufficiency fracture or rapidly destructive osteoarthritis. Using hip measures will reduce the misdiagnosis of rapid onset osteoarthritis of the hip for osteonecrosis.

A single, global patient-centered measure from the SF-36 instrument to assess surgical outcomes and quality of life: a pilot study.

BACKGROUND: Many quality of life (QoL) and patient-reported outcomes (PRO) measures have been developed to assess the effects of disease processes and treatments. Although these instruments are valuable, the process is hampered because of their number and lack of interchangeability. METHODS: We identified a cohort of patients across a variety of operations within 3-12 months postoperatively. Patients completed the SF-36, measuring eight domains of QoL (physical functioning, role-physical, role-emotional, bodily pain, vitality, mental health, social functioning, and general health), plus a health transition item: Compared to one year ago, how would you rate your health in general now?. (1) Much better now than one year ago. (2) Somewhat better now than one year ago. (3) About the same as one year ago. (4) Somewhat worse than one year ago. (5) Much worse than one year ago. Additional data included improvement of preoperative symptoms, the occurrence of any postoperative symptoms, and the occurrence of any postoperative complications. RESULTS: Of 217 patients, 28 % were much better, 28 % somewhat better, 27 % unchanged, 13 % somewhat worse, and 3 % much worse. The health transition results were associated with all SF-36 domains, preoperative symptom change (p = 0.03) and persistent or new postoperative symptoms (p = 0.001), but not postoperative complications. Patients with persistent or new symptoms postoperatively had worse scores in the role-emotional (p = 0.01), bodily pain (p = 0.05), social functioning (p = 0.02), and mental health (p = 0.009) domains of the SF-36. CONCLUSIONS: This single, global assessment of health transition may be a promising practical alternative to assess postoperative patient-centered outcomes. Improved patients had better QoL scores, preoperative symptoms elimination, and no operation-related symptoms, but the occurrence of complications did not affect improvement.