JACR® March Highlights

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The Impact of Breast Density Reporting Laws on Women’s Awareness of Density-Associated Risks and Conversations Regarding Supplemental Screening With Providers

Sensitivity of mammography is decreased in women with dense breasts, but supplemental screening tools may help counteract this phenomenon. However, many women are unaware of their own breast density, and how it may affect their screening. Many states have implemented legislation requiring notification and education of patients regarding their breast density. Investigators in this study conducted a national survey to assess the impact of these breast density reporting laws. A total of 300 women responded to the survey, and were categorized based on presence and language of their state’s breast density regulations. Results demonstrated that women from states with breast density laws were significantly more likely to have learned their breast density type and, more importantly, discussed the need for supplemental screening with their physicians.

Access to IR Services in Small Hospitals and Rural Communities: An ACR Membership Intercommission Survey

The ACR’s Commission for General, Small, Emergency, and/or Rural Practice and the Commission on IR and Cardiovascular Radiology collaborated to create a survey reviewing staffing, recruitment, and retention of IRs in the United States. Specifically, the survey was intended to evaluate for differences in small hospital and rural communities compared to other practice settings. Over 1,000 radiologists responded to the 22-question survey, which demonstrated a statistical significance in staffing and retention between rural and non-rural practices. The most frequently reported reason for difficulty with IR physician recruitment was that interventionalists “do not want to do diagnostic work.” Lack of complex cases and volume of cases were both cited as contributing to struggles with retention.

The Cost-Estimation Department: A Step Toward Cost Transparency in Radiology

Even with recent CMS regulations requiring hospitals to post chargemaster prices online, healthcare prices can be a constant source of confusion for both patients and physicians. Even the concept of price transparency itself can be controversial, particularly if intended only to stimulate price-based competition, as there is the possibility of incentivizing poor quality care. The authors’ institution created a patient cost-estimation department to assist patients facing large out-of-pocket expenses. For the entire year, the department provided 878 cost-estimate counseling sessions, which ultimately led to a 63 percent decrease in the amount of self-pay adjustments. 85 percent of families responded positively to these discussions.

The Role of the FDA in Ensuring the Safety and Efficacy of Artificial Intelligence Software and Devices 

The FDA ensures the safety and efficacy of a wide variety of medical products and technology, including medical devices and instruments. However, as software and AI become more essential to medical devices and services, the FDA has initiated multiple programs to assist in bringing these products to market while ensuring patient safety. These include the Medical Device Development Tools program, to qualify tools medical device sponsors can use while developing and evaluating medical devices. Another program, the National Evaluation System for Health Technology (NEST) is intended to provide robust postmarket surveillance, while fast-tracking products to the market. NEST Coordinating Center has chosen Lung-RADS™ Assist, sponsored by the ACR Data Science Institute™, as one of its early demonstration projects for AI algorithms. An additional program is the Software Precertification Program, designed to evaluate a developer’s capability to respond to real-world performance. For approved developers, this could provide a more efficient premarket pathway for certain applications.

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