Beauty Is in the AI of the Beholder: Are We Ready for the Clinical Integration of Artificial Intelligence in Radiography? An Exploratory Analysis of Perceived AI Knowledge, Skills, Confidence, and Education Perspectives of UK Radiographers

Introduction: The use of artificial intelligence (AI) in medical imaging and radiotherapy has been met with both scepticism and excitement. However, clinical integration of AI is already well-underway. Many authors have recently reported on the AI knowledge and perceptions of radiologists/medical staff and students however there is a paucity of information regarding radiographers. Published literature agrees that AI is likely to have significant impact on radiology practice. As radiographers are at the forefront of radiology service delivery, an awareness of the current level of their perceived knowledge, skills, and confidence in AI is essential to identify any educational needs necessary for successful adoption into practice.Aim: The aim of this survey was to determine the perceived knowledge, skills, and confidence in AI amongst UK radiographers and highlight priorities for educational provisions to support a digital healthcare ecosystem.Methods: A survey was created on Qualtrics® and promoted via social media (Twitter®/LinkedIn®). This survey was open to all UK radiographers, including students and retired radiographers. Participants were recruited by convenience, snowball sampling. Demographic information was gathered as well as data on the perceived, self-reported, knowledge, skills, and confidence in AI of respondents. Insight into what the participants understand by the term “AI” was gained by means of a free text response. Quantitative analysis was performed using SPSS® and qualitative thematic analysis was performed on NVivo®.Results: Four hundred and eleven responses were collected (80% from diagnostic radiography and 20% from a radiotherapy background), broadly representative of the workforce distribution in the UK. Although many respondents stated that they understood the concept of AI in general (78.7% for diagnostic and 52.1% for therapeutic radiography respondents, respectively) there was a notable lack of sufficient knowledge of AI principles, understanding of AI terminology, skills, and confidence in the use of AI technology. Many participants, 57% of diagnostic and 49% radiotherapy respondents, do not feel adequately trained to implement AI in the clinical setting. Furthermore 52% and 64%, respectively, said they have not developed any skill in AI whilst 62% and 55%, respectively, stated that there is not enough AI training for radiographers. The majority of the respondents indicate that there is an urgent need for further education (77.4% of diagnostic and 73.9% of therapeutic radiographers feeling they have not had adequate training in AI), with many respondents stating that they had to educate themselves to gain some basic AI skills. Notable correlations between confidence in working with AI and gender, age, and highest qualification were reported.Conclusion: Knowledge of AI terminology, principles, and applications by healthcare practitioners is necessary for adoption and integration of AI applications. The results of this survey highlight the perceived lack of knowledge, skills, and confidence for radiographers in applying AI solutions but also underline the need for formalised education on AI to prepare the current and prospective workforce for the upcoming clinical integration of AI in healthcare, to safely and efficiently navigate a digital future. Focus should be given on different needs of learners depending on age, gender, and highest qualification to ensure optimal integration.

Optimising access and provision of interventional radiology service to patients by utilising a new referral system

Objective: Implementing a streamlined interventional radiology (IR) service in the UK has been a challenge. This study aims to review a set of changes introduced in IR at a tertiary centre, including a new referral process and the designation of IR clinical nurse specialists. Methods: A new process of referring patients to IR using a single generic referral pathway was implemented, replacing an order dropdown-based system. A qualitative survey was designed and distributed as a single-use web link in order to assess the satisfaction and impact of this new process. Responses were based on Likert scale and pertained to perceived qualities of the new referral process. Data analysis was performed to identify specialty and grade-specific trends and possible differences amongst groups. Results: Findings from 98 respondents revealed a strong overall satisfaction with the new referral method and support for its continuation. Subgroup analysis by specialty, concluded medical specialties rated the new referral system more favourably than surgical specialties across all aspects: time efficiency, ease of use, periprocedural support and overall user experience. The new system also increased departmental productivity with an increase in the number of patients treated by 11.2%. Conclusion: Micropolicy changes within individual IR departments such as the replacement of a request-based referral system to one which puts IR in control of vetting and patient flow is one of many changes that reinforce the transformational phase of this specialty. Advances in knowledge: Micropolicy changes within IR departments are key in the progression and widespread recognition of the specialty.

EP.FRI.1036 Provision of 7 Day Radiology Service: Are we compliant against standards

Aim The audit aimed to retrospectively look into reporting times for investigations for acute surgical inpatients and determine if we were able to meet standards as set in NHS 7 day service provision standards which aims to provide 7day radiological service for hospital inpatients from commission to reporting. Method A prospective audit is undertaken to collect waiting times for investigations for all acute admissions requiring radiological investigations over one month. Investigations were categorized into ‘critical’, ‘urgent’ and ‘non-urgent’ according to guidelines set by Royal College of Surgeons. The results were tabulated in Excel and analyzed to determine level of compliance. Results Collected data shows that off the total 119 investigations performed, 34% were USG, 63% were CT scans and 2.5% were MRI. Standards were met for a total of 67% of the investigations. Only 20% of critical, 67% of urgent and 76% of non-urgent scans were done within the standard time while by modality, CT scans had the highest rate of compliance. 60% of investigations requested over weekends met standards with highest compliance for USG and for non-urgent scans. Average reporting time was approximately 50 minutes. Conclusion The audit outcome highlighted that 1 out of 3 investigations did not meet standards. Within its limitations of no numerical parameters to guide urgency, the audit was able give an idea of the radiology service offered by the hospital and highlighted clear areas for improvements which can be suggested to improve compliance such as documenting ‘operative catergory’ of requested investigations on request forms.

Computational Radiological Screening of Patients with COVID-19 Using Chest X-ray Images from Portable Devices

This work presents a fully automatic system for the screening of chest X-ray images from portable devices under the analysis of three different clinical categories: normal, pathological cases of pulmonary diseases with findings similar to those of COVID-19, and COVID-19 cases. Our methodology was validated using a dataset retrieved specifically for this study, which was provided by the Radiology Service of the Complexo Hospitalario Universitario A Coruña (CHUAC). Despite the poor quality conditions of chest X-ray images acquired by portable devices, satisfactory results were obtained, demonstrating the robustness and great potential of the proposed system to help front-line clinicians in the diagnosis and treatment of patients with COVID-19.

The importance of continuing education in the radiology service: a successful practice at the University Hospital of the Federal University of Maranhão

The concept of permanent education is materialized in the possibility of exchanging knowledge after initial training. This theme is of great importance to society and needs to be explored to provide a reflection on the reality of health services. This study presents permanent education for radiology services in accordance with current legislation and the project implemented at the University Hospital of the Federal University of Maranhão. The aim is to build a knowledge of continuing education in the health field, identifying the practice of this project and also contributing to the enrichment and theoretical dissemination aimed at diagnostic imaging services that make use of technologies with ionizing and non-ionizing radiation. Thus, improving the assistance and safety to radiology professionals and their users, through a gradual and appropriate knowledge.

Dynamic capacity allocation in a radiology service considering different types of patients, individual no-show probabilities, and overbooking

Background We propose a mathematical model formulated as a finite-horizon Markov Decision Process (MDP) to allocate capacity in a radiology department that serves different types of patients. To the best of our knowledge, this is the first attempt at considering radiology resources with different capacities and individual no-show probabilities of ambulatory patients in an MDP model. To mitigate the negative impacts of no-show, overbooking rules are also investigated. Methods The model’s main objective is to identify an optimal policy for allocating the available capacity such that waiting, overtime, and penalty costs are minimized. Optimization is carried out using traditional dynamic programming (DP). The model was applied to real data from a radiology department of a large Brazilian public hospital. The optimal policy is compared with five alternative policies, one of which resembles the one currently used by the department. We identify among alternative policies the one that performs closest to the optimal. Results The optimal policy presented the best performance (smallest total daily cost) in the majority of analyzed scenarios (212 out of 216). Numerical analyses allowed us to recommend the use of the optimal policy for capacity allocation with a double overbooking rule and two resources available in overtime periods. An alternative policy in which outpatients are prioritized for service (rather than inpatients) displayed results closest to the optimal policy, being also recommended due to its easy implementation. Conclusions Based on such recommendation and observing the state of the system at any given period (representing the number of patients waiting for service), radiology department managers should be able to make a decision (i.e., define number and type of patients) that should be selected for service such that the system’s cost is minimized.

Availability of interventional-radiological revascularization procedures in Germany – an analysis of the DeGIR Registry Data 2018/19

Purpose Peripheral artery disease (PAD) is a common condition with high socio-economic relevance. Therefore, qualified nationwide provision of interventional treatments of PAD is important for maintaining a high quality medical service in Germany. Materials and Methods All data on revascularization procedures from the quality management system of the German interventional radiological society (DeGIR) for the years 2018 and 2019 were retrospectively analysed. Number and distribution of DeGIR certified endovascular specialists and treatment centres was mapped. Documented procedures were broken down to the level of administrative districts. Absolute number of revascularization procedures and normalized number per one million inhabitants were computed. Results In 2019 there were 57 732 revascularization procedures from 228 participating centres performed by DeGIR certified interventional radiologists. A median of 62 recanalization procedures were documented per centre. 36 centres were considered to be high volume centres, with more than 500 procedures each. On a regional level in the years 2018 and 2019 combined a median (range) of 2324 (323–12 518) revascularization procedures per administrative district were performed by DeGIR certified interventional radiologist. Conclusion There is a comprehensive nationwide high quality interventional-radiology service for the provision of revascularization procedures available in Germany. Key points: Citation Format

Analisa Performance Instalasi Radiologi Dalam Upaya Pemenuhan Standar Pelayanan Minimal (Spm) Di Rumah Sakit Condong Catur Yogyakarta

Radiology services are an integrated part of overall health services. Radiology is a supporting examination to establish disease diagnosis and provide prompt and appropriate therapy for patients. Analysis of the results of radiology at the Condong Catur Hospital found that an average of 74 (86.80%) files from patients were in accordance with the standards and 12 files from patients (13.20%) were not in accordance with predetermined standards. These problems will interfere with the service quality and performance of the hospital. The purpose of this study was to evaluate the implementation of the Minimum Service Standards or Standar Pelayanan Minimal (SPM) Policy of the radiology unit at the Condong Catur Hospital Yogyakarta. This type of research is qualitative with a case study design. The key informants were radiographers, medical doctor of radiology specialists, and chief medical officer. Data collection methods consisted of observation methods, in-depth interviews and documentaries. This research shows that the policies and commitments have been formed, but the resources are only sufficient for the minimum requirement. The application has referred to the radiology service policy, bureaucratic structure, compliance with clinical practice guidelines and standard operating procedures. Process components that support the success of radiology services are the disposition (attitude) and communication patterns between top management and staff in implementing SPM for radiology services that have been running quite well, but some have not reached the target. The suggestion of this research is that the management always socializes minimum service standards policy and standard operating procedures radiology to improve radiology services.

Impact of a Hospitalist-Run Procedure Service on Time to Paracentesis and Length of Stay

Hospitals are establishing procedure services to address resident training and patient safety. We examined whether a hospitalist procedure service affects a patient’s hospital length of stay (LOS) and the time from admission to paracentesis (A2P). We queried our electronic medical records for all inpatient peritoneal fluid samples from July 1, 2016, to May 31, 2019. LOS and A2P time were compared among patients who had paracentesis by the procedure service, by residents, or by radiology. Of the 1,321 procedures, 509 (38.5%) were performed by the procedure service. In the adjusted analysis, as compared with procedure service, the group that underwent paracentesis by the radiology service had a 27% longer LOS (95% CI, 2%-58%) and 40% longer A2P time (95% CI, 5%-87%). The resident group had shorter A2P (–19%; 95% CI, –33% to 0.2%; P = .05) than the procedure service group but similar LOS. To our knowledge, this is the first study that suggests patient-centered benefits of a hospitalist procedure service.