Journal of the American College of Radiology : JACR
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The aim of this report is to provide a detailed description of a program employing medical students to assist with triaging off-hour diagnostic imaging studies at a major academic medical center. ⋯ The employment of medical student triage assistants provides in-depth exposure to clinical radiology relatively early in medical school, while providing an effective system to help streamline the off-hour workflow for attending radiologists, residents, technicians, and support staff members.
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A survey of academic radiology departments shows that the prevalence of emergency room physician-performed ultrasound examinations is high and that providing a 24/7 attending radiology service leads to no significant reduction in physician activity.
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Stroke is the sudden onset of focal neurologic symptoms due to ischemia or hemorrhage in the brain. Current FDA-approved clinical treatment of acute ischemic stroke involves the use of the intravenous thrombolytic agent recombinant tissue plasminogen activator given <3 hours after symptom onset, following the exclusion of intracerebral hemorrhage by a noncontrast CT scan. Advanced MRI, CT, and other techniques may confirm the stroke diagnosis and subtype, demonstrate lesion location, identify vascular occlusion, and guide other management decisions but, within the first 3 hours after ictus, should not delay or be used to withhold recombinant tissue plasminogen activator therapy after the exclusion of acute hemorrhage on noncontrast CT scans. ⋯ 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 ACGME recognizes radiology's neuroradiology fellowship programs as the pathway to neuroradiology expertise. Members of the American Society of Neuroimaging have called for the expansion of neuroradiology fellowships for neurologists with informal accreditation through the United Council for Neurologic Subspecialties. The aim of this study was to investigate the number of neuroradiologic studies read by neurologists to assess their capacity to support fellowship positions at ACGME training criteria. ⋯ Radiologists are responsible for interpreting the vast majority (98.3%) of neuroradiologic studies. Neurologists have a limited exposure to neuroradiologic CT and MR and could support only 12 fellowship positions by ACGME criteria on the basis of reading available 1996 to 2008 Medicare cases.