Leveraging Emergency Department Encounters to Improve Cancer Screening Adherence.

OBJECTIVE: We aimed to estimate the proportion of patients visiting the emergency department (ED) who were not up to date with cancer screening guidelines to assess the scope of need and potential impact of ED-based cancer screening interventions. METHODS: Adult participants from the 2015 National Health Interview Survey were included. Among patients nonadherent to national breast, colorectal, or lung cancer screening guidelines, the proportion of patients reporting an ED visit within the last year was estimated, accounting for complex survey sampling design features. Multiple variable logistic regression analyses were then conducted to evaluate the association between sociodemographic characteristics and screening adherence. RESULTS: Of screening eligible respondents, 17.2% of women nonadherent to mammography screening, 16.9% of patients nonadherent to colorectal cancer screening, and 25.0% of patients nonadherent to lung cancer screening reported at least one ED visit in the preceding year. Patients visiting the ED with postsecondary school education were more likely to be up to date with mammography screening than those without advanced education (odds ratio [OR] 1.45; 95% confidence interval [CI]: 1.21-1.74; P = .01). Patients without insurance were less likely than those with insurance to report being up to date with both mammography screening (OR 0.31; 95% CI: 0.21-0.48; P = .01) and colorectal cancer screening (OR 0.56; 95% CI: 0.34-0.93; P = .03). DISCUSSION: Opportunities to improve cancer screening adherence exist through ED-based preventative care interventions, which leverage multidisciplinary partnerships, including radiologists, to reach large volumes of patients who are not engaged in cancer screening.

Patient-Centered and Specialty-Specific Case Work-Up: An Effective Method for Teaching Appropriateness of Imaging to Medical Students.

RATIONALE AND OBJECTIVES: Our institution has developed a mini-course program within the diagnostic radiology elective curriculum that promotes active learning, using patient cases specifically tailored to students' future specialties. The purpose of this study is to evaluate the effectiveness of this mini-course on medical student knowledge of imaging appropriateness and attitude toward radiologist consultation. MATERIALS AND METHODS: During each month-long radiology elective course, students were divided into teams of up to four students based on their specialty interest and assigned recent patient cases with imaging findings relevant to their specialties. The students researched their customized patient cases, integrated pertinent clinical and imaging findings, and presented their findings in a final preceptor-led session. A five-point Likert-type item preprogram and postprogram survey assessing knowledge of imaging appropriateness and attitude toward radiologist consultation was sent to the enrolled medical students. RESULTS: Out of 36 medical students, 33 (92%) completed the preprogram survey and 31 (86%) completed the postprogram survey. Students reported improved confidence in knowledge of imaging appropriateness, such as indications for intravenous contrast (p < 0.0005) and oral contrast (p < 0.0005). Furthermore, students reported an improved understanding of how to utilize radiologists (p < 0.005) and how to provide pertinent clinical historical information when requesting a radiology exam (p < 0.0005). Students reported that researching the patient's historical and clinical information in conjunction with the radiology images made them more invested in the case. CONCLUSION: Assigning customized patient cases to medical students on diagnostic radiology elective, tailored to their future specialties, is an effective and active way to teach imaging appropriateness and to improve attitudes toward radiologist consultation.

Unusual Focal Muscle FDG Activity Related to Altered Biomechanics.

A 20 year old man suffered severe right knee pain, especially when his right foot touched ground. The MRI findings suggested periosteal osteosarcoma, which led to a staging FDG PET/CT. The images showed not only a hypermetabolic right knee lesion but also focally elevated activity in select muscles, which was attributed to altered biomechanics. The resected lesion was pathologically proven as periosteal chondrosarcoma instead of periosteal osteosarcoma. In a follow-up period of 4 years after the surgery, there was no recurrent disease, nor any abnormality in the muscles which showed focal FDG activity on the initial FDG PET/CT.