Journal of the American College of Radiology : JACR
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To study growth trends in the ownership of magnetic resonance imaging (MRI) examinations by nonradiologist physicians who either own the equipment outright or are involved in scan leasing arrangements. ⋯ In the private-office setting in 2005, radiologists performed most MRI examinations. However, the growth rate from 2000 to 2005 among nonradiologist physicians was far higher, 254% compared with 83% among radiologists. Because scans performed by nonradiologists through ownership or leasing are subject to self-referral, the much more rapid growth among those physicians should be of concern to policymakers and payers.
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To study trends in the utilization of the various noncardiac thoracic imaging modalities in the Medicare population in recent years and to compare the roles of radiologists and nonradiologist physicians. ⋯ The overall utilization rate of noncardiac chest imaging in recent years has increased only minimally. Within the various categories, there has been a decline in CXR utilization and a substantial decline in radionuclide scan utilization. However, there has been a considerable increase in the utilization of chest CT/CTA. Radiologists strongly predominate in all aspects of noncardiac thoracic imaging. This seems to be a pattern in which the use of a newer and better technology, CT or CTA, gradually replaces older ones and overall utilization rates remain relatively flat. One reason for this seems to be the lack of major involvement by nonradiologist physicians who might be in a position to self-refer. It is in contradistinction to cardiac imaging, in which the utilization of radionuclide scans and echocardiography has sharply increased among cardiologists. These data suggest that utilization rates in imaging might be kept under control by eliminating the opportunity for self-referral.
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The technical nature of radiotherapy requires different data collection strategies for outcomes reporting than those required for most other disciplines in clinical medicine. To correlate advances in radiotherapy technology with treatment outcomes, it is necessary to integrate a given radiotherapy outcomes-study database with the record-and-verify database and with the global hospital database. ⋯ This bioinformatics database was successfully queried in a manner that allowed streamlining data flow of relevance to radiotherapy outcomes studies. Future directions of the application of this integration are discussed.