Search

Rationale and Objectives: The purpose of this paper is to describe the integration of a commercial chest CT computer-aided detection (CAD) system into the clinical radiology reporting workflow and perform an initial investigation of its impact on radiologist efficiency. It seeks to complement research into CAD sensitivity and specificity of stand-alone systems, by focusing on report generation time when the CAD is integrated into the clinical workflow., Materials and Methods: A commercial chest CT CAD software that provides automated detection and measurement of lung nodules, ascending and descending aorta, and pleural effusion was integrated with a commercial radiology report dictation application. The CAD system automatically prepopulated a radiology report template, thus offering the potential for increased efficiency. The integrated system was evaluated using 40 scans from a publicly available lung nodule database. Each scan was read using two methods: (1) without CAD analytics, i.e., manually populated report with measurements using electronic calipers, and (2) with CAD analytics to prepopulate the report for reader review and editing. Three radiologists participated as readers in this study., Results: CAD assistance reduced reading times by 7%-44%, relative to the conventional manual method, for the three radiologists from opening of the case to signing of the final report., Conclusion: This study provides an investigation of the impact of CAD and measurement on chest CTs within a clinical reporting workflow. Prepopulation of a report with automated nodule and aorta measurements yielded substantial time savings relative to manual measurement and entry., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: In the newest revision of the Accreditation Council for Graduate Medical Education Common Program Requirements, substantial changes were made to section VI now entitled "The Learning and Working Environment." The Accreditation Council for Graduate Medical Education expanded section VI to include patient safety, quality improvement, supervision, accountability, well-being, and fatigue mitigation realizing work hours represent only one part of the work environment., Materials and Methods: These new requirements prompted us to evaluate our current curriculum, including our current tools for meeting program requirements such as the didactic lecture series and tracking resident progress in our Clinical Competency Committee, and identified areas of our curriculum that were lacking or could be improved upon., Results: This assessment leads to incorporation of innovative and novel strategies to not only satisfy the requirements but also to engage our trainees throughout the process., Conclusion: Our model can be used as an example for other residency programs looking for ways to fulfill these new requirements., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Efficiency is central to current radiology practice. Knowledge of report generation timing is essential for workload optimization and departmental staffing decisions. Yet little research evaluates the distribution of activities performed by neuroradiologists in daily work., Materials and Methods: This observational study tracked radiologists interpreting 358 brain magnetic resonance imaging (MRI) in an academic practice over 9 months. We measured the total duration from study opening to report signing and times for five activities performed during this period: image viewing, report transcription, obtaining clinical data, education, and other. Attendings, fellows, and residents reading studies independently and attendings over-reading trainee-previewed studies were observed., Results: Ten attendings, 12 fellows, and 13 residents spent a mean of 11, 18, and 16 minutes reading brain MRIs independently. Mean duration was significantly different comparing attendings in all assignments to fellows (18.36 ± 1.05 minutes, p = 0.0001) or residents (16.31 ± 1.11 minutes, p = 0.001) but not between fellows/residents. Mean duration among attendings reading independently versus over-reading trainees was not statistically different. Attendings spent the same time on image viewing (4.07-5.33 minutes) with or without trainees. Attending transcription time was shortest when over-reading trainees (2.24 minutes) and longest when reading independently (4.20 minutes), demonstrating benefit of the draft report. Fellows and Residents spent longer on image viewing (7.14 minutes and 8.06 minutes, respectively) and transcription (7.02 minutes and 5.40 minutes, respectively) than attendings reading independently., Conclusion: Neuroradiologist time/activity distributions for reading brain MRI studies were measured, setting the stage to establish a benchmark for future reference and suggesting opportunities for greater efficiency. Furthermore, report production time can be decreased when a draft report is available., (Copyright © 2018. Published by Elsevier Inc.)

Rationale and Objectives: The objective of this study was to evaluate the association of communication practices with timely follow-up of screening mammograms read as Breast Imaging Reporting and Data Systems (BI-RADS) 0 in the Population-based Research Optimizing Screening through Personalized Regimens (PROSPR) consortium., Materials and Methods: A radiology facility survey was conducted in 2015 with responses linked to screening mammograms obtained in 2011-2014. We considered timely follow-up to be within 15 days of the screening mammogram. Generalized estimating equation models were used to evaluate the association between modes of communication with patients and providers and timely follow-up, adjusting for PROSPR site, patient age, and race and ethnicity., Results: The analysis included 34,680 mammography examinations with a BI-RADS 0 assessment among 28 facilities. Across facilities, 85.6% of examinations had a follow-up within 15 days. Patients in a facility where routine practice was to contact the patient by phone if follow-up imaging was recommended were more likely to have timely follow-up (odds ratio [OR] 4.63, 95% confidence interval [CI] 2.76-7.76), whereas standard use of mail was associated with reduced timely follow-up (OR 0.47, 95% CI 0.30-0.75). Facilities that had standard use of electronic medical records to report the need for follow-up imaging to a provider had less timely follow-up (OR 0.56, 95% CI 0.35-0.90). Facilities that routinely contacted patients by mail if they missed a follow-up imaging visit were more likely to have timely follow-up (OR 1.65, 95% CI 1.02-2.69)., Conclusions: Our findings support the value of telephone communication to patients in relation to timely follow-up. Future research is needed to evaluate the role of communication in completing the breast cancer screening episode., (Copyright © 2018. Published by Elsevier Inc.)

Rationale and Objectives: Women make up half of American medical school graduates, but remain underrepresented among radiologists. This study sought to determine whether workforce gender disparities exist in other countries, and to identify any country-specific indices associated with increased female representation., Materials and Methods: In this cross-sectional study, 95 professional radiology organizations in 75 countries were contacted via email to provide membership statistics, including proportion of female members, female members aged 35 or under, and women in society leadership positions. Country-specific metrics collected included gross domestic product, Gini index, percent female medical school enrollment, and Gender Development Index for the purposes of univariate multiple regression analysis., Results: Twenty-nine organizations provided data on 184,888 radiologists, representing 26 countries from Europe (n = 12), North America (n = 2), Central/South America (n = 6), Oceania (n = 2), Asia (n = 3), and Africa (n = 1) for a response rate of 34.7% (26/75). Globally, 33.5% of radiologists are female. Women constitute a higher proportion of younger radiologists, with 48.5% of radiologists aged 35 or under being female. Female representation in radiology is lowest in the United States (27.2%), highest in Thailand (85.0%), and most variable in Europe (mean 40.1%, range 28.8%-68.9%). The proportion of female radiologists was positively associated with a country's Gender Development Index (P = .006), percent female medical student enrollment (P = .001), and Gini index (P = .002), and negatively associated with gross domestic product (P = .03)., Conclusions: Women are underrepresented in radiology globally, most notably in the United States. Countries with greater representation of women had higher gender equality and percent female medical school enrollment, suggesting these factors may play a role in the gender gap., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Given increasing volume and workflow interruptions in radiology, we sought to identify and characterize radiology call assistant triage (RCAT) programs among US radiology residency programs., Materials and Methods: A survey was created using Qualtrics survey software and emailed to all members of the Association of Program Directors in Radiology listserv. A total of 296 active members belong to this listserv, including program directors and assistant program directors. The survey included questions about the existence and specifics of a call triage assistant program., Results: Data were obtained from 88 active members of the Association of Program Directors in Radiology (30% response rate). Of those, 20 programs (23%) have an RCAT program. Triage assistant staffing includes nonmedical or clerical staff (60%), medical students (30%), first-year radiology residents (5%), and technologists (5%). All respondents with RCAT programs report satisfaction with their program and plan to continue. A significant majority (75%) have no plans to change, whereas the remaining 25% are considering program expansion and pay increases. Among residency programs without RCAT programs, none reported termination of their triage program. The most common reasons for not having triage assistants include cost, lack of awareness, differing opinions on utility, and the presence of 24/7 attending coverage., Conclusion: Twenty US radiology residency programs report having an RCAT program. All report satisfaction with their program despite different staffing models. RCAT programs may represent an effective measure in limiting interruptions and potentially decreasing interpretative errors made by residents on call., (Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: The study aimed to assess perceptions of reading room workflow and the impact separating image-interpretive and nonimage-interpretive task workflows can have on radiologist perceptions of workplace disruptions, workload, and overall satisfaction., Materials and Methods: A 14-question survey instrument was developed to measure radiologist perceptions of workplace interruptions, satisfaction, and workload prior to and following implementation of separate image-interpretive and nonimage-interpretive reading room workflows. The results were collected over 2 weeks preceding the intervention and 2 weeks following the end of the intervention. The results were anonymized and analyzed using univariate analysis., Results: A total of 18 people responded to the preintervention survey: 6 neuroradiology fellows and 12 attending neuroradiologists. Fifteen people who were then present for the 1-month intervention period responded to the postintervention survey. Perceptions of workplace disruptions, image interpretation, quality of trainee education, ability to perform nonimage-interpretive tasks, and quality of consultations (P < 0.0001) all improved following the intervention. Mental effort and workload also improved across all assessment domains, as did satisfaction with quality of image interpretation and consultative work., Conclusion: Implementation of parallel dedicated image-interpretive and nonimage-interpretive workflows may improve markers of radiologist perceptions of workplace satisfaction., (Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

With the US healthcare system on an unsustainable course, change is inevitable. Changes in the healthcare landscape impacting radiology include changing payment models, rapid adoption of digital technology, changes in radiology resident certifying exams, and the rise of consumerism in health care. Academic Radiology will be part of that change with none of its missions spared. What matters is not that change is coming but how Academic Radiology responds to change. Do we ignore, adapt, adopt others' practices, or lead change? Change management or transformation is a management skill set that can be learned and developed. Transformational leadership is a leadership style defined by the relationships between the leaders and the followers and the results they are able to achieve together to meet organizational goals. In this paper, we provide a review of key change management theories, as well as practical advice for self-reflection and development of leadership behaviors that promote effective change management and organizational transformation, particularly in a complex industry like Academic Radiology., (Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: The newly formed Alliance of Directors and Vice Chairs of Education in Radiology (ADVICER), a group within the Alliance for Clinician Educators in Radiology, identified an acute need for a generic job description template for Vice Chairs of Education in Radiology, a role that is being developed in many academic Departments of Radiology. Eighty-three percent of current members who responded to a survey had no detailed job description, and over half had no job description at all. Having a comprehensive and detailed job description is vital to developing this key position., Materials and Methods: Using the results of a survey sent to ADVICER members and seven Education Vice Chair job descriptions provided by members, the authors developed a detailed job description encompassing all potential elements of this position., Results: Only 17% of survey respondents had a detailed job description. The role of an Education Vice Chair varies significantly between institutions in its scope and level of responsibilities. The resultant generic job description that was devised is intended to provide a template that would be modified by the candidate or the Department Chair. It is unlikely that any one individual would perform all the described activities., Conclusions: ADVICER has developed a comprehensive, flexible job description for Vice Chair of Education in Radiology that can be adapted by institutions as appropriate. It can be downloaded from http://aur.org/ADVICER/., (Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.)

Radiologists are increasingly recognizing their role as direct service providers to patients and seeking to offer an exceptional patient experience as part of high-quality service delivery. Patients' perceptions of service delivery are derived from the chain of numerous individual real-time encounters that occur throughout their visit. These so-called "moments of truth" define the overall experience and form the lasting impression of the given practice in their mind. Providing excellent service can be difficult to achieve in practice given its intangible nature as well as the heterogeneity and unpredictability of the large number of patients, frontline staff, and environmental circumstances that define the patient experience. Thus, broad commitment and team effort among all members of a radiology practice are required. This article explores important areas to be considered by a radiology practice to ensure positive and meaningful patient experiences. Specific ways in which every member within the practice, including schedulers, receptionists, technologists, nurses, and radiologists, can contribute to achieving high-quality patient service are discussed. Examples of patient-oriented language that may be useful in particular scenarios in radiology practice are given. The role of the practice's physical facility, including all aspects of its aesthetics and amenities, as well as of Internet services, in shaping the patient experience is also described. Throughout this work, a proactive approach to promoting a service-oriented organizational culture is provided. By improving the patient experience, these strategies may serve to enhance patients' perceptions of radiology and radiologists., (Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.)

Online social networking services have changed the way we interact as a society and offer many opportunities to improve the way we practice radiology and medicine in general. This article begins with an introduction to social networking. Next, the latest advances in online social networking are reviewed, and areas where radiologists and clinicians may benefit from these new tools are discussed. This article concludes with several steps that the interested reader can take to become more involved in online social networking., (Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Innovation and entrepreneurship in health care can help solve the current health care crisis by creating products and services that improve quality and convenience while reducing costs., Materials and Methods: To effectively drive innovation and entrepreneurship within the current health care delivery environment, academic institutions will need to provide education, promote networking across disciplines, align incentives, and adapt institutional cultures. This article provides a general review of entrepreneurship and commercialization from the perspective of academic radiology departments, drawing on information sources in several disciplines including radiology, medicine, law, and business., Conclusions: Our review will discuss the role of universities in supporting academic entrepreneurship, identify drivers of entrepreneurship, detail opportunities for academic radiologists, and outline key strategies that foster greater involvement of radiologists in entrepreneurial efforts and encourage leadership to embrace and support entrepreneurship., (Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Radiology residents must acquire dictation and reporting skills to meet Accreditation Council for Graduate Medical Examination requirements and provide optimal patient care. Historically, these skills have been taught informally and vary between institutions and among radiologists. A structured curriculum improves resident report quality when using a quantitative grading scheme. This study describes the implementation of such a curriculum and evaluates its utility in tracking resident progress., Materials and Methods: We implemented a three-stage reporting curriculum in our diagnostic radiology residency program in 2009. Stages 1 and 2 involve instruction and formative feedback composed of suggestions for improvement in a 360° format from faculty, peers, and others within the resident's sphere of influence. The third stage involves individual, biannual, written feedback with scored reports specifically assessing four categories: succinctness, spelling/grammar, clarity, and responsible referral. Biannual scores were collected from 2009 to 2013, sorted by year of residency training (R1 to R4), and average training level scores were statistically compared., Results: Review of 1500 reports over a 4-year period yielded a total of 153 scores: 54, 36, 29, and 34 from R1, R2, R3, and R4 residents, respectively. The mean (standard deviation) scores for R1, R2, R3, and R4 residents were 10.20 (1.06), 10.25 (0.81), 10.5 (0.74), and 10.75 (0.69), respectively. Post hoc analysis identified significant differences between R1 and R4 residents (P = .012) and R2 and R4 residents (P = .009)., Conclusions: Residents' reporting scores showed significant improvement over the course of their residency training. This indicates that there may be a benefit in using an organized reporting curriculum to track resident progress in producing reports that may improve patient care., (Copyright © 2014 AUR. Published by Elsevier Inc. All rights reserved.)

The three missions of academic radiology compete with one another for time and funding. Revenue for the clinical mission often subsidizes education and research. Given the internal and external drivers/pressures on health care and, more particularly, on academic health centers, the current model is unsustainable. Trends seen in other industries are entering academic health care. The radiology department of the future will need to be more efficient with increasingly fewer resources while meeting its missions at higher levels of expectation., (Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.)

The Patient Protection and Affordable Care Act (ACA) generated significant media attention since its inception. When the law was approved in 2010, the U.S. health care system began facing multiple changes to adapt and to incorporate measures to meet the new requirements. These mandatory changes will be challenging for academic radiology departments (ARDs) since they will need to promote a shift from a volume-focused to a value-focused practice. This will affect all components of the mission of ARDs, including clinical practice, education, and research. A unique key element to success in this transition is to focus on both quality and safety, thus improving the value of radiology in the post-ACA era. Given the changes ARDs will face during the implementation of ACA, suggestions are provided on how to adapt ARDs to this new environment., (Copyright © 2013. Published by Elsevier Inc.)

There are rapid changes occurring in the health care environment. Radiologists face new challenges but also new opportunities. The purpose of this report is to review how new informatics tools and developments can help the radiologist respond to the drive for safety, quality, and efficiency. These tools will be of assistance in conducting research and education. They not only provide greater efficiency in traditional operations but also open new pathways for the delivery of new services and imaging technologies. Our future as a specialty is dependent on integrating these informatics solutions into our daily practice., (Copyright © 2013. Published by Elsevier Inc.)

Rationale and Objectives: To better prepare radiology residents for providing care within the context of the larger health care system, this study evaluated the feasibility and impact of a curriculum to enhance radiology residents' understanding and ability to apply concepts from medical management and industrial and operational engineering to systems-based practice problems in radiology practice., Materials and Methods: A multiprofessional team including radiology, medical education, and industrial and operational engineering professionals collaborated in developing a seven-module curriculum, including didactic lectures, interactive large-group analysis, and small-group discussions with case-based radiology examples, which illustrated real-life management issues and the roles physicians held. Residents and faculty participated in topic selection. Pre- and post-instruction formative assessments were administered, and results were shared with residents during teaching sessions., Results: Attendance and participation in case-based scenario resolutions indicate the feasibility and impact of the interactive curriculum on residents' interest and ability to apply curricular concepts to systems-based practice in radiology. Paired t test analyses (P < .05) and effect sizes showed residents significantly increased their knowledge and ability to apply concepts to systems-based practice issues in radiology., Conclusions: Our iterative curriculum development and implementation process demonstrated need and support for a multiprofessional team approach to teach management and operational engineering concepts. Curriculum topics are congruent with Accreditation Council for Graduate Medical Education requirements for systems-based practice. The case-based curriculum using a mixed educational format of didactic lectures and small-group discussion and problem analysis could be adopted for other radiology programs, for both residents and continuing medical education applications., (Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.)

The authors describe our experience in planning, organizing, and running a radiology CME conference at a hotel (rather than at a stand-alone conference or convention center). Much of the information described should also be useful for other medical and nonmedical conferences. This experience should provide new conference organizers with useful information to ensure a more efficient and successful conference, so there are fewer "If I knew then what I know now" moments over the years., (Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: At the authors' institutions, faculty members and trainees work at multiple sites scattered miles apart, making it difficult to physically attend weekly teaching conferences. As a possible solution, a weekly online musculoskeletal teaching conference was undertaken. This quickly grew to include multiple other sites around North America. The authors share their experiences to assist other radiologists in organizing similar educational conferences., Materials and Methods: The conferences are run using the Citrix GoToMeeting online meeting system. It runs on multiple platforms, including Mac, PC, iPhone, iPad, and Android. Attendees use a wide variety of microphones, sound cards, powered speakers, and webcams. Most users have fast institutional Internet connections, though several attend via slower connections, such as 3G., Results: The conference has run successfully for 2 years, with participants logging in from 24 different sites in 18 states, two Canadian provinces, and three countries. About 48 sessions are held each year, with 10 to 15 sites joining the conferences each week and about 10 to 15 cases seen each week. Most attendees are from university medical centers, though several private practice radiologists attend regularly. Screen-sharing quality is superb, with no discernible difference between local and remote slide quality. Audio quality is usually quite good, particularly for those using computer audio. Audio feedback is an occasional problem, but this issue is now more easily addressed. No single time is equally convenient for participants scattered among four to six time zones. However, some sites find the conferences sufficiently valuable to rearrange their afternoon procedure schedules to reduce conflicts with the conferences. The social aspect of visiting weekly with friends and colleagues from afar is highly valued, as are seeing the wide range of pathology from other institutions and the ability to confer with colleagues on difficult cases. The conferences have also spawned several collaborative educational projects, such as an online journal club, a published book of conference cases, and an online musculoskeletal hardware atlas., Conclusions: The weekly online musculoskeletal conference described in this report has matured over 2 years from a peculiar experiment to a very popular conference. Cases not seen locally provide enrichment, and attendees gain educational opportunities not otherwise available. Other radiology groups should be able to create and maintain similar conferences., (Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Managing and supervising the complex imaging examinations performed for clinical research in an academic medical center can be a daunting task. Coordinating with both radiology and research staff to ensure that the necessary imaging is performed, analyzed, and delivered in accordance with the research protocol is nontrivial. The purpose of this communication is to report on the establishment of a new Human Imaging Research Office (HIRO) at our institution that provides a dedicated infrastructure to assist with these issues and improve collaborations between radiology and research staff., Materials and Methods: The HIRO was created with three primary responsibilities: 1) coordinate the acquisition of images for clinical research per the study protocol, 2) facilitate reliable and consistent assessment of disease response for clinical research, and 3) manage and distribute clinical research images in a compliant manner., Results: The HIRO currently provides assistance for 191 clinical research studies from 14 sections and departments within our medical center and performs quality assessment of image-based measurements for six clinical research studies. The HIRO has fulfilled 1806 requests for medical images, delivering 81,712 imaging examinations (more than 44.1 million images) and related reports to investigators for research purposes., Conclusions: The ultimate goal of the HIRO is to increase the level of satisfaction and interaction among investigators, research subjects, radiologists, and other imaging professionals. Clinical research studies that use the HIRO benefit from a more efficient and accurate imaging process. The HIRO model could be adopted by other academic medical centers to support their clinical research activities; the details of implementation may differ among institutions, but the need to support imaging in clinical research through a dedicated, centralized initiative should apply to most academic medical centers., (Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: The aim of this study was to evaluate the feasibility of partnering with engineering students and critically examining the merit of the problem identification and analyses students generated in identifying sources impeding effective turnaround in a large university department of diagnostic radiology. Turnaround involves the time and activities beginning when a patient enters the magnetic resonance scanner room until the patient leaves, minus the time the scanner is conducting the protocol., Materials and Methods: A prospective observational study was conducted, in which four senior undergraduate industrial and operations engineering students interviewed magnetic resonance staff members and observed all shifts. On the basis of 150 hours of observation, the engineering students identified 11 process steps (eg, changing coils). They charted machine use for all shifts, providing a breakdown of turnaround time between appropriate process and non-value-added time. To evaluate the processes occurring in the scanning room, the students used a work-sampling schedule in which a beeper sounded 2.5 times per hour, signaling the technologist to identify which of 11 process steps was occurring. This generated 2147 random observations over a 3-week period., Results: The breakdown of machine use over 105 individual studies showed that non-value-added time accounted for 62% of turnaround time. Analysis of 2147 random samples of work showed that scanners were empty and waiting for patients 15% of the total time. Analyses showed that poor communication delayed the arrival of patients and that no one had responsibility for communicating when scanning was done., Conclusions: Engineering students used rigorous study design and sampling methods to conduct interviews and observations. This led to data-driven definition of problems and potential solutions to guide systems-based improvement., (Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: Among the various medical disciplines, the radiology residency faces unique challenges when balancing clinical service and education, which have not been explored in the literature., Materials and Methods: The authors present a summary of material generated during collaborative sessions at the 56th Annual Meeting of the Association of University Radiologists in Seattle, Washington, in March 2008, including strategies on maintaining an appropriate emphasis on education in the face of increasing service obligations, with a review of the pertinent literature., Results: Although the topic of service and education has been explored in the medical and surgical literature, little has been published in the radiology literature. The portability of radiology and the relative lack of patient contact can lead to the redistribution of residents as a matter of convenience to fill service gaps, often at the expense of the educational goals of training programs. Residents and faculty members alike must take part in both service and educational obligations without compromising patient care. Physician extenders, call schedule optimization, and other strategies and resources can help ensure that a proper balance is maintained., Conclusion: The radiology residency presents unique challenges to the service and education balance. The authors highlight several strategies to address these challenges.

Informatics methods and systems in support of clinical care are well established in the health care enterprise. The new paradigm of patient-centered radiology creates new requirements and challenges that can be enabled by informatics. In particular, computer support can help referring physicians tailor their imaging requests to those procedures that would be most helpful for their patients'clinical context. Informatics methods can assist radiologists in recognizing important findings in images as well as helping them decide the best course of action for patients given the radiologic imaging results and other clinical data. Finally, informatics methods can help engage patients in their care by providing information about their imaging procedures and results. All of these informatics technologies share in common the ability to bring together critical knowledge filtered according to the specific requirements of patients undergoing radiologic imaging, a key component of patient-centered radiology. The goals of this article are to review the opportunities for informatics in supporting patient-centered radiology, to demonstrate the potential utility of these methods, and to point radiologists to the ways that informatics will help them provide care that is tailored to each patient.

To date, technology transfer from academia to industry has been strongest in the biotechnology and pharmaceutical sector. The medical imaging and medical device industries have traditionally been smaller players and, as a result, some, perhaps many, investigators in radiology are unaware of the potential value of technology transfer and the opportunity to receive sponsorship for research from medical imaging companies. Many investigators are also unaware of opportunities to introduce important academic discoveries into clinical practice through licensing and technology transfer. These untapped opportunities are not only valuable, but also are becoming more and more important in light of the ever-increasing difficulties associated with sustaining and receiving new government funding. The goal of this article is to provide academic scientists in the field of radiology with insights about the key aspects of the technology transfer process, including observations about inventions, intellectual property, and industry-sponsored research.

Clinical decision rules to guide physicians in the appropriate use of diagnostic imaging studies need to be developed, in part, to control the overutilization of imaging studies. These rules need to be evidence based. Randomized control trials can be designed to assess the value of imaging studies and interventional procedures at levels five and six, patient outcome and societal efficacies, in Fryback and Thornbury's hierarchical model of efficacy. Results of these trials can be used to develop clinical decision rules. However, the efficacy of most diagnostic imaging studies can be assessed better at levels three and four, diagnostic thinking and therapeutic efficacies. Studies can be designed to determine clinical situations in which imaging studies will be of no value or to determine clinical criteria for the use of imaging studies. Systematic reviews of the literature and other techniques of analysis of evidence, such as decision trees, also can be used to develop evidence-based clinical decision rules for the use of diagnostic imaging procedures.

The Radiology Alliance for Health Services Research sponsored a symposium at the 2005 Annual Meeting of the Association of University Radiologists, which focused on the issue of aligning mentor and mentee expectations to foster successful mentoring relationships. This article presents a summary of the informal discussion of the panelists' individual experiences, common themes, and insights gained from the panel participants.

Rationale and Objectives: The authors performed this study to compare self-reported estimates of the time radiology members spend performing various activities between reporting methods and academic years., Materials and Methods: For 3 consecutive academic years, the percentage of time each faculty member reported spending on clinical, teaching, research, and service and/or administrative activities was noted on each of three separate reports: a quarterly report to department administration, an annual report to university administration, and the annual review with his or her department supervisor. For each activity, the means were compared between methods and between years., Results: In general, the year-to-year changes in mean percentage for each activity and method were not statistically significant (34 of 36 comparisons). Nineteen of 36 comparisons, however, showed significant differences between reporting methods for a particular activity. For example, the mean percentages obtained with the three methods from 1999 to 2000 varied from 49% to 66% (clinical), 14% to 34% (teaching), 8% to 15% (research), and 3% to 11% (service and/or administrative)., Conclusion: Current methods used to quantify faculty time distribution yield significantly different results despite internal consistency from year to year for each method. New and clearer methods for determining faculty time distribution are needed.

Regular meetings of residency program teaching faculty are required by the ACGME and support the educational mission of the department. The education committee should be viewed by the department chair and other members of the faculty as being equally important as the departmental research, operations, and finance committees. An education committee that is dedicated to promoting excellence in education and supports the educational mission of the department will enhance the department's local, regional, and national reputation.