14 research outputs found
What Patients Want to Know about Imaging Examinations: A Multiinstitutional U.S. Survey in Adult and Pediatric Teaching Hospitals on Patient Preferences for Receiving Information before Radiologic Examinations
Purpose
To identify what information patients and parents or caregivers found useful before an imaging examination, from whom they preferred to receive information, and how those preferences related to patient-specific variables including demographics and prior radiologic examinations.
Materials and Methods
A 24-item survey was distributed at three pediatric and three adult hospitals between January and May 2015. The χ2 or Fisher exact test (categorical variables) and one-way analysis of variance or two-sample t test (continuous variables) were used for comparisons. Multivariate logistic regression was used to determine associations between responses and demographics.
Results
Of 1742 surveys, 1542 (89%) were returned (381 partial, 1161 completed). Mean respondent age was 46.2 years ± 16.8 (standard deviation), with respondents more frequently female (1025 of 1506, 68%) and Caucasian (1132 of 1504, 75%). Overall, 78% (1117 of 1438) reported receiving information about their examination most commonly from the ordering provider (824 of 1292, 64%), who was also the most preferred source (1005 of 1388, 72%). Scheduled magnetic resonance (MR) imaging or nuclear medicine examinations (P < .001 vs other examination types) and increasing education (P = .008) were associated with higher rates of receiving information. Half of respondents (757 of 1452, 52%) sought information themselves. The highest importance scores for pre-examination information (Likert scale ≥4) was most frequently assigned to information on examination preparation and least frequently assigned to whether an alternative radiation-free examination could be used (74% vs 54%; P < .001).
Conclusion
Delivery of pre-examination information for radiologic examinations is suboptimal, with half of all patients and caregivers seeking information on their own. Ordering providers are the predominant and preferred source of examination-related information, with respondents placing highest importance on information related to examination preparation
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The “Differential Diagnosis” for Multiple Diseases: Comparison with the Binary-Truth State Experiment in Two Empirical Studies
In practice readers must often choose between multiple diagnoses. For assessing reader accuracy in these settings, Obuchowski et al have proposed the “differential diagnosis” method, which derives all pairwise estimates of accuracy for the various diagnoses, along with summary measures of accuracy. The current study assessed the correspondence between the differential diagnosis method and conventional binary-truth state experiments.
Two empirical studies were conducted at two institutions with different readers and diagnostic tests. Readers used the differential diagnosis format to interpret a set of cases. In subsequent readings they interpreted the cases in binary-truth state experiments. Spearman rank correlation coefficients and the percentages of agreement in scores were computed, and the areas under the receiver operating characteristic curves were estimated and compared.
The between-format Spearman rank correlation coefficients were 0.697–0.718 and 0.750–0.780 for the two studies; the between-reader correlations were 0.417 and 0.792, respectively. The percentages of agreement between formats for the two studies were 50.0%–51.7% and 72.9%–78.8%; the percentages of agreement between readers were 45.0% and 80%, respectively. In the first study there were several significant differences in the areas under receiver operating characteristic curves; in the second study these differences were small.
The differences observed between the two formats can be attributed to within-reader variability and inherent differences in the questions posed to readers in the multiple-diagnoses versus binary-truth state reading sessions. The differential diagnosis format is useful for estimating accuracy when there are multiple possible diagnoses
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The image gently in dentistry campaign: partnering with parents to promote the responsible use of x-rays in pediatric dentistry.
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