Combined task activation display as an effective method to teach introductory fMRI users.

RATIONALE AND OBJECTIVES: Interpreting functional magnetic resonance imaging (fMRI) can be an overwhelming and challenging task for trainees, particularly when post processing, synthesizing and interpreting data from multiple language paradigms. Currently, there is no established best method for teaching fMRI interpretation to new trainees. The purpose of our study is to compare the use of combined task activation display (CTAD) and conventional display of fMRI language paradigms as an effective method to teach fMRI to the introductory learner. MATERIALS AND METHODS: Following IRB approval, 43 unique cases (with 10 repeat cases to assess intra-reader variability) were identified based on the inclusion/exclusion criteria. Eight radiology trainees, without prior exposure to fMRI, were asked to determine language lateralization based on activation of Wernicke's area, Broca's area, and the pre-supplementary motor area. Prior to trainee interpretation, a 15-minute training session was conducted to describe the expected anatomic locations of the language centers. Trainees were asked to determine language dominance using either the CTAD or conventional methods. Following a 6-week washout period, the same eight trainees were asked to interpret the cases using the opposite interpretation approach. RESULTS: Interpreting fMRI with the CTAD method significantly increased trainee accuracy (85.4% vs 70.9% p < 0.001) and trainee confidence (4.3 vs 3.6 p < 0.001), while decreasing time to interpretation (mean difference of 29 min), and intra-reader variability when compared to the conventional approach. CONCLUSION: Combined task activation display is an effective method to teach fMRI to introductory learners.

The growing geriatric otolaryngology patient population: a study of 131,700 new patient encounters.

OBJECTIVES/HYPOTHESIS: To establish the effects the changing population demographics in the United States are having on the general practice otolaryngologists. STUDY DESIGN: Retrospective analysis of 131,070 consecutive new patient visits at a large private practice otolaryngology group from 2004 to 2010. METHODS: Billing records for new patient visits from 2004 to 2010 were reviewed. Analysis of patient age, diagnosis, and year of presentation was completed to determine changes in patient demographics and frequencies of diagnoses stratified by age groups. Predictive analysis was performed to determine future trends in patient demographics. RESULTS: Geriatric patients showed a statistically significant increase from 14.3% of the patient population in 2004 to 17.9% in 2010. Predictive analysis shows that at the current rate, almost 30% of all patients seen by 2030 would be over the age of 65 years. The most common pathologies seen in geriatric patients were also different than that of other age groups, with the five most common geriatric diagnoses being otologic in nature. Geriatric patients also have an overall increased proportion of otologic diagnoses, with 73% of all geriatric diagnoses being otologic, compared to just 32% of those aged 18 to 45 years. CONCLUSIONS: Our data show that the changing population is causing the frequency and type of disease seen by general otolaryngologists to change. This information may be useful in structuring both residency training curricula as well as licensing and recertification exams to ensure otolaryngologists are properly prepared to care for their future patient population.