In all ex-smokers, ADC values were significantly elevated in regions of PRM gas trapping, and VDP was quantitatively and spatially related to both PRM gas trapping and PRM emphysema. In patients with mild to moderate COPD, VDP was related to PRM gas trapping, whereas in patients with severe COPD, VDP correlated with both PRM gas trapping and PRM emphysema.
Purpose Physician burnout is on the rise compared to the average population, and radiology burnout rates are ranked high compared to other specialties. We aim to assess radiologist and radiology trainee burnout in Canada. Methods A survey using the abbreviated 7-item Maslach Burnout Inventory that characterizes burnout symptoms into personal accomplishment, emotional exhaustion, and depersonalization was sent to all eligible members of the Canadian Association of Radiologists in January 2018. The anonymous survey was hosted on SurveyMonkey for 1 month. A reminder e-mail was sent halfway through the survey period. Results Overall, 262 of 1401 invited radiology trainees and radiologists completed the survey (response rate 18.7%). With regards to personal accomplishment, we observed that (1) burnout in this domain improved with increased years worked and (2) milder symptoms were observed in community radiologists compared with their academic counterparts. In comparison with other studies of radiologist burnout, we found mild burnout symptoms in personal accomplishment, but severe symptoms in the burnout domains of both emotional exhaustion and depersonalization. Conclusions Canadian radiologists and radiology trainees reported above average burnout symptoms with regard to both emotional exhaustion and depersonalization. Future research directions include exploring etiologies of burnout and implementation of treatment strategies based on these identified problem areas.
Background Our objective was to perform a systematic review and meta-analysis comparing the breast cancer detection rate (CDR), invasive CDR, recall rate, and positive predictive value 1 (PPV1) of digital mammography (DM) alone, combined digital breast tomosynthesis (DBT) and DM, combined DBT and synthetic 2-dimensional mammography (S2D), and DBT alone. Methods MEDLINE and Embase were searched until April 2020 to identify comparative design studies reporting on patients undergoing routine breast cancer screening. Random effects model proportional meta-analyses estimated CDR, invasive CDR, recall rate, and PPV1. Meta-regression modeling was used to compare imaging modalities. All statistical tests were 2-sided. Results Forty-two studies reporting on 2 606 296 patients (13 003 breast cancer cases) were included. CDR was highest in combined DBT and DM (6.36 per 1000 screened, 95% confidence interval [CI] = 5.62 to 7.14, P < .001), and combined DBT and S2D (7.40 per 1000 screened, 95% CI = 6.49 to 8.37, P < .001) compared with DM alone (4.68 per 1000 screened, 95% CI = 4.28 to 5.11). Invasive CDR was highest in combined DBT and DM (4.53 per 1000 screened, 95% CI = 3.97 to 5.12, P = .003) and combined DBT and S2D (5.68 per 1000 screened, 95% CI = 4.43 to 7.09, P < .001) compared with DM alone (3.42 per 1000 screened, 95% CI = 3.02 to 3.83). Recall rate was lowest in combined DBT and S2D (42.3 per 1000 screened, 95% CI = 37.4 to 60.4, P<.001). PPV1 was highest in combined DBT and DM (10.0%, 95% CI = 8.0% to 12.0%, P = .004), and combined DBT and S2D (16.0%, 95% CI = 10.0% to 23.0%, P < .001), whereas no difference was detected for DBT alone (7.0%, 95% CI = 6.0% to 8.0%, P = .75) compared with DM alone (7.0%, 95.0% CI = 5.0% to 8.0%). Conclusions Our findings provide evidence on key performance metrics for DM, DBT alone, combined DBT and DM, and combined DBT and S2D, which may inform optimal application of these modalities for breast cancer screening.
Purpose: There is worsening of burnout symptoms experienced by radiologists and trainees. We explored potential factors that exacerbate burnout symptoms observed in the Canadian radiological community and currently available protective factors as next steps for establishing viable solutions for burnout. Methods: An 11-question electronic survey was distributed to Canadian radiologists and trainees through the Canadian Association of Radiologists (CAR). Approval from a local ethics board and the CAR were obtained. The survey contained demographics-related questions as well as questions based on common risk factors for burnout. Qualitative and quantitative analyses were performed. Results: The survey was distributed to 2200 CAR members, and a response rate of 23.3% was achieved. Most radiologists experienced frequent unexpected high workload with no statistically significant difference by the type of practice. Trainees experienced a statistically significantly ( P < .0001) higher frequency of on-call shifts compared to staff radiologists. A statistically significant difference ( P < .0001) was observed for perceived threats to career longevity dependent on length of career. Although support mechanisms for radiology were perceived as available, survey commentary suggested inefficiency in their usage and lack of prioritization, which was a trend observed across all types of practice. Conclusions: While there is awareness for radiology needs, changes are required at the workplace level to reduce burnout symptoms at their source. Communication between radiologists and hospital administration, as well as among radiology group members, is key to prioritize radiology needs in our imaging-driven era of health care.
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