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4.
Radiology ; 273(3): 948, 2014 Dec.
Article in English | MEDLINE | ID: mdl-25420172
7.
Ann Emerg Med ; 63(1): 25-32, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24134958

ABSTRACT

Availability, reliability, and technical improvements have led to continued expansion of computed tomography (CT) imaging. During a CT scan, there is substantially more exposure to ionizing radiation than with conventional radiography. This has led to questions and critical conclusions about whether the continuous growth of CT scans should be subjected to review and potentially restraints or, at a minimum, closer investigation. This is particularly pertinent to populations in emergency departments, such as children and patients who receive repeated CT scans for benign diagnoses. During the last several decades, among national medical specialty organizations, the American College of Emergency Physicians and the American College of Radiology have each formed membership working groups to consider value, access, and expedience and to promote broad acceptance of CT protocols and procedures within their disciplines. Those efforts have had positive effects on the use criteria for CT by other physician groups, health insurance carriers, regulators, and legislators.


Subject(s)
Emergency Service, Hospital/standards , Practice Guidelines as Topic , Tomography, X-Ray Computed/standards , Brain Injuries/diagnostic imaging , Defensive Medicine/standards , Emergency Service, Hospital/statistics & numerical data , Humans , Tomography, X-Ray Computed/adverse effects , Tomography, X-Ray Computed/statistics & numerical data , United States
8.
J Am Coll Radiol ; 11(1): 36-44, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24135540

ABSTRACT

Availability, reliability, and technical improvements have led to continued expansion of computed tomography (CT) imaging. During a CT scan, there is substantially more exposure to ionizing radiation than with conventional radiography. This has led to questions and critical conclusions about whether the continuous growth of CT scans should be subjected to review and potentially restraints or, at a minimum, closer investigation. This is particularly pertinent to populations in emergency departments, such as children and patients who receive repeated CT scans for benign diagnoses. During the last several decades, among national medical specialty organizations, the American College of Emergency Physicians and the American College of Radiology have each formed membership working groups to consider value, access, and expedience and to promote broad acceptance of CT protocols and procedures within their disciplines. Those efforts have had positive effects on the use criteria for CT by other physician groups, health insurance carriers, regulators, and legislators.


Subject(s)
Emergency Medical Services/standards , Emergency Medicine/standards , Practice Guidelines as Topic , Radiation Protection/standards , Radiology/standards , Tomography, X-Ray Computed/standards , Guideline Adherence , United States
9.
Acad Radiol ; 20(12): 1613-4, 2013 Dec.
Article in English | MEDLINE | ID: mdl-24200491
10.
Acad Radiol ; 20(11): 1473, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24119363
12.
Acad Radiol ; 20(6): 791, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23664406
13.
Acad Radiol ; 19(5): 640, 2012 May.
Article in English | MEDLINE | ID: mdl-22463963
18.
Acad Radiol ; 11(8): 843-56, 2004 Aug.
Article in English | MEDLINE | ID: mdl-15354304

ABSTRACT

RATIONALE AND OBJECTIVES: The purpose of this study was to determine if chest radiographic interpretations by physicians retained by attorneys representing persons alleging respiratory changes from occupational exposure to asbestos would be confirmed by independent consultant readers. MATERIALS AND METHODS: For 551 chest radiographs read as positive for lung changes by initial "B" readers retained by plaintiffs' attorneys, 492 matching interpretative reports were made available to the authors. Six consultants in chest radiology, also B readers, agreed to re-interpret the radiographs independently without knowledge of their provenance. The film source, patient name, and other identifiers on each film were masked. The International Labor Office 1980 Classification of Chest Radiographs(ILO 80) was used with forms designed by the US National Institute of Occupational Safety and Health to record the consult-ants' findings. The results were compared with initial readings for film quality, complete negativity, parenchymal abnormalities,small opacities profusion, and pleural abnormalities using chi-square tests and kappa statistics.Results. Initial readers interpreted study radiographs as positive for parenchymal abnormalities (ILO small opacity profusion category of 1/0 or higher) in 95.9% of 492 cases. Six consultants classified the films as 1/0 or higher in 4.5% of 2,952 readings. Statistical tests of these and other comparable data from the study showed highly significant differences between the interpretations of the initial readers and the findings of the consultants. CONCLUSION: The magnitude of the differences between the interpretations by initial readers and the six consultants is too great to be attributed to interobserver variability. There is no support in the literature on x-ray studies of workers exposed to asbestos and other mineral dusts for the high level of positive findings recorded by the initial readers in this report.


Subject(s)
Asbestosis/diagnostic imaging , Expert Testimony/legislation & jurisprudence , Lung/diagnostic imaging , Radiology/legislation & jurisprudence , Chi-Square Distribution , Consultants , Forensic Medicine/legislation & jurisprudence , Humans , National Institute for Occupational Safety and Health, U.S. , Observer Variation , Pleura/diagnostic imaging , Radiography, Thoracic/classification , Radiography, Thoracic/standards , United States
20.
World health ; 48(3): 4-1995-05.
Article in English | WHO IRIS | ID: who-330111
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