The Association of University Radiologists held their 62rd Annual Meeting in Baltimore, April 1–4, 2014. Many exciting posters, abstracts, and courses were presented at the meeting ( https://www.aur.org/2014AnnualMeeting/ ). In addition to the formal meeting program, the networking and hallway discussions resulted in an amazing educational experience. We have collected some of these activities as well as ongoing radiology research and insights from thought leaders into the 2016 Radiology Alliance of Health Service Researchers edition of Academic Radiology.
As a new generation of radiology researchers, educators, and leaders take their places at the decision-making table, there is opportunity for reflection on what health service research tools they will need. In a high-tech field that is tightly linked to informatics and change management, some elements for success can be identified.
First and foremost, radiology leaders will need to be professional. The definition of professionalism has evolved overtime and remains in flux. Dr Kelly’s paper “The evolution of professionalism in medicine and radiology” outlines how the concept of professionalism has evolved from ancient to modern times. Her research was supported by an Education Scholar Grant from Radiological Society of North America. In educational perspectives, Dr. Gunderman offers further insight in what it means to be a professional. In his first article , he discusses the role of communication, cognition, and conduct in organizational culture. He also acknowledges the difficulty in capturing some of the critical elements of culture in metrics. This is reminiscent of Albert Einstein’s quote, “Not everything that can be counted counts, and not everything that counts can be counted. His second article relays the story of a journal into improvisational training including collaborative communication and its impact on physician perspectives and practices. This raises the question of how we teach professionalism and how we pass our culture onto the next generation of radiologists.
Another essential skill will be for radiologists to be able to report and assess evidence for clinical practices. “Review of research reporting guidelines for radiology researchers” is a continuation of a series of articles on standards for reporting and reviewing research by Cronin and Rawson and describes internationally accepted guidelines for how research is to be reported. In addition to being helpful to researchers, these guidelines are important for journal reviewers and those who would assess new research. As resources continue to be contract in healthcare, the field of comparative effectiveness research will assess the value proposition between choices. Carol et al. demonstrates a systematic evaluation of the literature to date around a clinical complex topic using standard tools of assessment in “Systematic review and CER of imaging intestinal obstruction” . Thus, this type of review and analysis will be essential in determining what changes would be better as new evidence is produced. It also highlights evidence gaps, thus identifying potential high-impact future areas of research. Research could compare changes in imaging techniques as Masch et al. did in their study to optimize the difference between recurrent neoplasm and radiation necrosis using diffusion tensor imaging in magnetic resonance imaging . As the incidence of chronic diseases continue to rise, our research questions will become more complicated and focus on well-defined subpopulations. We will need to look at imaging in populations with chronic diseases superimposed on other illness. Petrou looked for correlation between gray matter loss on imaging and cognitive function in patients with Parkinson disease who also have diabetes . Another area of focus will be determining the impact of radiology examinations on the patient outcome further downstream in the patient’s care. With support from the Harvey L. Neiman Health Policy Institute, Chan studied the impact of whole body computed tomography in blunt trauma on the length of stay in hospitalized trauma patients . While their analysis found whole body computed tomography expedited patient transfer out of the emergency department, it did not shorten the hospital length of stay in this subpopulation. As we move into an era of population health, identifying where changes in imaging strategies in a subpopulation will result in better outcomes will be essential.
Once new practices are evaluated and it is determined that a change in clinical practice is needed, the radiologist will need to understand the principles of leadership and change management. Research may involve changing the behavior and clinical practices of radiologists as well as other healthcare professionals. Burton et al. describe an attempt to change the ordering patterns of emergency medicine physicians in “The impact of a pre-authorization policy on the after-hours utilization of emergency department computed tomography imaging” . In times of great change, our profession will need leaders who are transformational. In “Transformation and transformational leadership: a review of the current and relevant literature for academic radiologists” , Thomson et al. review models of change management.
Although radiology has seen much change over the past decades, there has not always been organized change. Moving forward, successful radiology leaders will be change agents. In addition to excellent clinical skills, radiologists will need additional skills to bring continued value to patients. This issue of Academic Radiology highlights health services research skills as part of the radiologist tool kit.
References
1. Kelly A.M., Mullan P.B., Gruppen L.D.: The evolution of professionalism in medicine and radiology. Acad Radiol 2016; in press
2. Gunderman R.B.: Education in professionalism: metrics or culture?. Acad Radiol 2016; in press
3. Gunderman R.B.: Education in professionalism: improvisation. Acad Radiol 2016; in press
4. Cronin P., Rawson J.V.: Review of research reporting guidelines for radiology researchers. Acad Radiol 2016; in press
5. Pandharipande P.V., Gazelle G.S.: Comparative effectiveness research: what it means for radiology. Radiology 2009; 253: pp. 600-605.
6. Rawson J.V.: Comparative effectiveness research in radiology: patients, physicians and policy makers. Acad Radiol 2011; 18: pp. 1067-1071.
7. Carol A.G., Kavanagh R.G., Ni Leidhin C., et. al.: Comparative effectiveness of imaging modalities for the diagnosis of intestinal obstruction in neonates and infants: a critically appraised topic. Acad Radiol 2016; in press
8. Masch W.R., Wang P.I., Chenevert T.L., et. al.: Comparison of diffusion tensor imaging and magnetic resonance perfusion imaging in differentiating recurrent brain neoplasm from radiation necrosis. Acad Radiol 2016; in press
9. Petrou M.: Diabetes, gray matter loss and cognition in the setting of Parkinson disease. Acad Radiol 2016; in press
10. Chan J.: Measuring the impact of whole body computed tomography on hospital length of stay in blunt trauma. Acad Radiol 2016; in press
11. Burton K.B., Lawlor R.L., Dhanoa D.: The impact of a pre-authorization policy on the after-hours utilization of emergency department computed tomography imaging. Acad Radiol 2016; in press
12. Thomson N.B., Rawson J.V., Bledsoe M., et. al.: Transformation and transformational leadership: a review of the current and relevant literature for academic radiologists. Acad Radiol 2016; in press