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To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2008.11.004 Byline: Bruce I. Reiner, Eliot L. Siegel Keywords: Quality assurance; commoditization; pay for performance Abstract: The current focus on the economic bottom line in health care creates the potential for radiology to become a commodity, devoid of qualitative differentiation. This trend toward commoditization has been accelerated by the globalization of imaging services (teleradiology), increased information exchange (eg, Digital Imaging and Communications in Medicine, Integrating the Healthcare Enterprise), and new technology development (eg, picture archiving and communication systems, computer-aided diagnosis). The optimum strategy for avoiding commoditization is the creation of objective quality metrics and standards throughout the medical imaging practice, which will provide a reproducible and objective means with which to differentiate imaging service deliverables on the basis of quality and clinical outcomes. These quality measures can in turn be directly tied to economic incentives (pay for performance), providing further incentive for proactive quality assurance, qualitative differentiation, and technology development centered on quality. Author Affiliation: Department of Diagnostic Imaging, Baltimore VA Medical Center, Baltimore, Maryland

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2007.01.015 Byline: Bruce I. Reiner (a), Nancy Knight (b), Eliot L. Siegel (a)(b) Keywords: Radiology reporting; structured reporting; quality assurance; pay for performance Abstract: Although imaging technologies have undergone dramatic evolution over the past century, radiology reporting has remained largely static, in both content and structure. Existing free-text (prose) reports have been criticized for a number of inherent deficiencies, including inconsistencies in content, structure, organization, and nomenclature. A number of new initiatives and technologies now present the radiology community with the unique opportunity to fundamentally change the radiology report from free to structured text. These new developments include a standardized nomenclature (RadLex), automated information technologies (picture archiving and communications systems and electronic medical records), and automated data tracking and analysis software (natural-language processing). Despite the increasing availability of these tools and technologies for revolutionizing reporting, clinical, psychologic, legal, and economic challenges have collectively limited structured reporting to mammography. These challenges are most evident in the current environment of heightened expectations for improved quality, timeliness, and communication, along with increasing stress, fatigue, and malpractice concerns. In conclusion, the authors present an alternative to traditional reporting that attempts to address some of these diverse challenges while incorporating the aforementioned initiatives and technologic developments. This approach uses a graphical symbol language that is directly mapped to a standardized lexicon (RadLex) and is automatically converted into a structured hierarchical text report, which can then be much more easily searched and analyzed. Author Affiliation: (a) Baltimore Veterans Affairs Medical Center, Baltimore, Md. (b) University of Maryland School of Medicine, Baltimore, Md.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jacr.2006.02.024 Byline: Khan M. Siddiqui (a), Stacy Chia (b), Nancy Knight (c), Eliot L. Siegel (a) Keywords: Reading room design; digital imaging; ergonomics Abstract: Planning and executing the redesign of a traditional institutional radiology reading room to conform to the radically different requirements of digital imaging are reviewed, with examples drawn from the authors' experience and from the growing body of literature on this subject. Included are best-practice recommendations and real-life examples on initial design and planning, stakeholder involvement, identifying and hiring consultants, architectural planning, the designation of a radiology point person, rethinking room and workstation design, the selection of ergonomic furniture and fittings, identifying optimal environmental elements, fine tuning and lessons learned, and going digital. Author Affiliation: (a) Department of Radiology, VA Maryland Health Care System, University of Maryland School of Medicine, Baltimore, Md. (b) Department of Radiology, VA Maryland Health Care System, Baltimore, Md. (c) Department of Radiology, University of Maryland School of Medicine, Baltimore, Md.

Research indicates that muscle volume response is not affected by either gender or age in whole-body strength training. Data were obtained from men and women from 20 to 30 years of age, and 65 to 75 years of age, measuring quadriceps and thigh muscles.

In an acute trauma patient with unrecognized scimitar syndrome, physiologic measurements used in patient management decisions were misleading due to the anatomic and physiologic anomalies of the syndrome. Pulmonary artery [...]

Research points out that selection of a 3.1 centimeter between axial magnetic resonance imaging sections is ideal in the quadriceps measurement for muscle volume. Data indicate that the procedure yields adequate precision and detects small changes in the muscle volume.