Abdominal Imaging and Intervention Section, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA.
Abdominal Imaging and Intervention Section, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA.
Acad Radiol. 2021 Sep;28(9):1219-1224. doi: 10.1016/j.acra.2020.05.036. Epub 2020 Jul 1.
Radiology participation is necessary in oncology multidisciplinary conferences (MDCs), but the resources required to do so are often unaccounted for. In this prospective study we provide an analysis of resource utilization as a function of outcomes for all MDCs covered by an entire radiology section and provide a time-based cost estimate.
Following institutional review board approval, prospective data on all MDCs covered by abdominal radiologists at a single tertiary care academic center were obtained over nine weeks. A predefined questionnaire was used by a single observer who attended every imaging review and recorded the total time spent by the radiologists and several outcome measures. The total time recorded was used to provide a time-based cost estimate using a national salary survey.
Six radiologists participated in a total of 57 MDCs, with 577 cases reviewed and discussed. 181 (31%) cases were performed at outside facilities requiring full reinterpretation. Clinically significant revisions to original reports were recorded in 107 (18.5%) cases. Radiologist input directly resulted in alteration of cancer staging in 65 (11%) patients and specific recommendations for follow-up diagnostic workup in 280 (48%) of cases. The mean total time devoted by the staff radiologist per week to MDCs was 18.7 hours/week, nearly a half of full-time effort, or 8% of total effort per radiologist. The total annual projected cost of radiology coverage for each weekly MDC was $26,920.
Section-wide radiologist participation in MDCs directly resulted in change in clinical management in nearly half of reviewed cases. This was achieved at a notable time cost, highlighting the need for efficient integration of radiology MDC participation into radiologist workflow and compensation models.
肿瘤多学科诊疗会议(MDC)中需要放射科的参与,但相关资源往往没有得到充分考虑。在本前瞻性研究中,我们对整个放射科涵盖的所有 MDC 进行了资源利用分析,并提供了基于时间的成本估算。
在获得机构审查委员会批准后,前瞻性地收集了在单一三级学术中心工作的腹部放射科医生涵盖的所有 MDC 的数据,为期 9 周。一名观察者使用预定义的问卷出席了每次影像学审查,并记录了放射科医生的总时间以及几个结果指标。使用全国薪资调查,根据记录的总时间提供基于时间的成本估算。
共有 6 名放射科医生参与了总共 57 次 MDC,共审查和讨论了 577 例病例。其中 181 例(31%)在外部机构进行,需要全面重新解读。记录了 107 例(18.5%)原始报告的临床意义重大修订。放射科医生的建议直接导致 65 例(11%)患者的癌症分期改变,以及 280 例(48%)患者的后续诊断性检查的具体建议。每周用于 MDC 的工作人员放射科医生的平均总时间为 18.7 小时/周,接近全职工作的一半,或每位放射科医生的总工作量的 8%。每周一次 MDC 的放射科覆盖的年度总预计成本为 26920 美元。
放射科的全面参与直接导致了近一半审查病例的临床管理改变。这需要付出大量的时间成本,这突显了需要有效地将放射科 MDC 参与融入放射科医生的工作流程和薪酬模式。