Academic radiology
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Expensive and steadily rising health care costs without a concomitant increase in quality have generated a search for solutions to fund health care in the United States. Recent health care reforms and proposals on the agenda have spurred debate about alternative payment plans for health care. Much of the talk centers on imaging, which is a fast-growing and expensive component of health care. ⋯ A corollary of pay-for-performance initiatives in which physician incentives are aligned with evidence-based medical practices, VBID seeks to increase patient incentives to comply with evidence-based health care consumption. We previously reviewed the principles of VBID and provided examples of VBID in practice using diabetes management as a model, as well as suggested some areas in diagnostic testing that lend themselves to VBID benefit design. In this article, we summarize the barriers to implementation and outline potential solutions, with particular regard to radiology.
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To detect whether the efficacy of microwave ablation (MWA) could be improved by preinjected fluids in an ex vivo porcine liver model. ⋯ In an ex vivo porcine liver, preinjected fluids do not benefit microwave ablation as those in radiofrequency ablation.
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Comparative Study
Comparison of CT perfusion and digital subtraction angiography in the evaluation of delayed cerebral ischemia.
Delayed cerebral ischemia (DCI) is a devastating condition that occurs secondary to aneurysmal subarachnoid hemorrhage (A-SAH). The purpose is to compare computed tomography perfusion (CTP) and digital subtraction angiography (DSA) for determining DCI in A-SAH. ⋯ CTP and DSA have similar test characteristics and Bayesian analysis for determining DCI in A-SAH patients.
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Comparative Study
MR spectroscopy using normalized and non-normalized metabolite ratios for differentiating recurrent brain tumor from radiation injury.
To compare the ability of normalized versus non-normalized metabolite ratios to differentiate recurrent brain tumor from radiation injury using magnetic resonance spectroscopy (MRS) in previously treated patients. ⋯ Cho/NAA and NAA/Cr were the two ratios with the best discriminating ability and both had better discriminating ability than their corresponding normalized ratios (Area under the curve = 0.92 versus 0.77, AUC= 0.85 vs. 0.66), respectively.