Journal of the American College of Radiology : JACR
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There is contention within the medical community surrounding imaging self-referral, in which providers refer patients to imaging facilities from which they receive financial returns. Controversy surrounds the assertion that self-referral leads to overutilization, or the application of imaging resources and services in situations in which patients are unlikely to benefit. ⋯ The 4 core principles of medical ethics--autonomy, nonmaleficence, beneficence, and justice--represent a useful and well-established paradigm. This review article addresses the question of whether self-referral upholds these 4 principles and thus whether it is an ethical practice.
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Image-based radiation treatment planning and localization have contributed to better targeting of the prostate and sparing of normal tissues. Guidelines are needed to address radiation dose delivery, including patient setup and immobilization, target volume definition, treatment planning, treatment delivery methods, and target localization. Guidelines for external-beam radiation treatment planning have been updated and are presented here. ⋯ The ACR Appropriateness Criteria(®) are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.
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The aim of this study was to document the current state of administrative structure in US diagnostic radiology (DR) residency program leadership. A secondary objective was to assess for correlation(s), if any, with DR residency programs that equipped positions such as assistant, associate, and emeritus program director (PD) with respect to residency size and region of the country. ⋯ The majority of US DR residency programs used some form of additional DR leadership position. In the majority of cases, this was in the form of an assistant or associate PD. Nearly one-fifth of programs studied had more than one such position. This is a positive model for the depth and breadth of management of US residency programs, serving both as a template for matrixed leadership and as a source of leadership succession planning.