Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

https://www.medpagetoday.com/upload/2011/4/4/Clin%20Infect%20Dis.-2002-O'Grady-1281-307.pdf

Guidelines for the Prevention of Intravascular Catheter-related Infections

https://www.medpagetoday.com/upload/2008/3/6/CRC.pdf

Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology.

Naomi P. O'Grady, M.D., Mary Alexander, R.N. Lillian A. Burns, M.T., M.P.H., C.I.C. E. Patchen Dellinger, M.D. Jeffery Garland, M.D., S.M. Stephen O. Heard, M.D. Pamela A. Lipsett, M.D. Henry Masur, M.D. Leonard A. Mermel, D.O., Sc.M. Michele L. Pearson, M.D. Issam I. Raad, M.D. Adrienne Randolph, M.D., M.Sc. Mark E. Rupp, M.D. Sanjay Saint, M.D., M.P.H. and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

/pdf/guidelines-for-the-prevention-of-intravascular-catheter-4xarsoczlz.pdf

Guidelines for the prevention of intravascular catheter-related infections, 2011

Cost Effectiveness in Health and Medicine.

Purpose The aim of this study was to characterize out-of-pocket patient costs for advanced imaging across the US private insurance marketplace. Methods Using the 2017 CMS Health Insurance Marketplace Benefits and Cost Sharing Public Use File, which details coverage policies for qualified health plans on federally facilitated marketplaces, measures of out-of-pocket costs for advanced imaging and other essential health benefits were analyzed for all 18,429 plans. Results Independent of deductibles, 48.0% of plans required coinsurance (percentage fees) for advanced imaging, 9.7% required copayments (flat fees), and 8.0% required both; 34.3% required neither. For out-of-network services, 91.5% required coinsurance, 0.1% copayments, and 1.0% both; only 7.4% required neither. In the presence of deductibles, patient coinsurance burdens for advanced imaging in and out of network were 27.7% and 47.7%, respectively, and average in- and out-of-network copayments were $319 and $630, respectively. In the presence of deductibles, patients' average coinsurance ranged from 10.0% to 40.9% in network and from 29.1% to 75.0% out of network by state; these tended to be higher in lower income states ( r  = −0.332). For no-deductible policies, patients' average out-of-network coinsurance burden for advanced imaging was 99.9%. Among assessed benefits, advanced imaging had the highest in-network and second highest out-of-network copayments. Conclusions In the US private insurance marketplace, patients very commonly pay coinsurance when undergoing advanced imaging, both in and out of network. But out-of-network services usually involve drastically higher patient financial responsibilities (potentially 100% of examination cost). To more effectively engage patients in shared decision making and mitigate the hardships of surprise balance billing, radiologists should facilitate transparent communication of advanced imaging costs with patients.

Out-of-Pocket Costs for Advanced Imaging Across the US Private Insurance Marketplace.

PurposeThe study sought to identify and characterise barriers to research for Canadian diagnostic radiology residents and suggest potential solutions to enhance future research success.MethodsInsti...

Barriers to Resident Research in Radiology: A Canadian Perspective.

Using decision support algorithms, referring physicians will usually choose theappropriate examinationtypes,and many will be aware of the need for appropriate imaging protocols (eg, contrast-enhanced imaging in malignant disease), but they cannot be expected to know the gamut of complex protocols available to radiologists. Ultimately, it is up to radiologists to dictate which protocol is most suitable for a particular patient in a particular situation. But therein lies a problem. Contemporary equipment and the number of available parameters for protocoldesignhavebecome sodiverse and complicated that even many subspecialty radiologists are not always aware of the ideal protocol for ag iven patient with a given disease at a particular time. Furthermore, with the advent and increasing deployment of precision medicine, whereby patient care is rapidly becoming driven and delivered according to unique biomarkerdataandpatientpreferences, it is now too overwhelming for most radiologists to optimally and uniquely tailoreachexamination.Consequently, many departments are unable to uniformly design and deliver optimal protocols for every circumstance. For example,morethan50%ofabdominal CT protocols do not currently adhere to the ACR Appropriateness Criteria � concerning anatomic coverage [1]. Further exacerbating the issue, suffi

http://www.massgeneralimaging.org/thercg/pdf/boland_article_5.pdf

Protocol Design and Optimization

Medicare Utilization of CT Angiography from 2001 through 2014: Continued Growth by Radiologists.

The numbers of nurse practitioners and physician assistants are increasing throughout the entire health care enterprise, and a similar expansion continues within radiology. Some practices have instead embraced radiologist assistants. The increased volume of services rendered by this growing nonphysician provider subset of the health care workforce within and outside of radiology departments warrants closer review. The authors evaluate the recent literature and offer recommendations to radiology practices regarding both regulatory and scope-of-practice issues related to these professionals. Additionally, billing and compliance issues for care provided by nurse practitioners, physician assistants, and radiologist assistants are detailed. An analysis of the integration of these professionals into interventional and diagnostic radiology practices, as well as potential implications for medical education, is provided in the second part of this series.

Richard Duszak

Papers

Out-of-Pocket Costs for Advanced Imaging Across the US Private Insurance Marketplace.

Barriers to Resident Research in Radiology: A Canadian Perspective.

Protocol Design and Optimization

Medicare Utilization of CT Angiography from 2001 through 2014: Continued Growth by Radiologists.

The impact of nonphysician providers on diagnostic and interventional radiology practices: regulatory, billing, and compliance perspectives.