Writing a Competitive Grant Proposal
January 30–31, 2009
RSNA Headquarters, Oak Brook, Ill.
Application Deadline—December 15
Registrations are being accepted for the second Writing a Competitive Grant Proposal program, designed for researchers in radiology, radiation oncology, nuclear medicine and related sciences who are interested in actively pursuing federal funding.
A limited number of slots are available for this 1½-day intermediate-level program. The course combines didactic and small group interactive sessions to help radiologic researchers understand and apply the key components of writing a competitive grant proposal. Topics to be covered include the NIH grant review process, developing specific aims and funding opportunities.
Guided by a faculty of leading researchers with extensive experience in all aspects of grant applications and funding, the program will focus on developing realistic expectations and provide tools for getting started. Faculty includes G. Scott Gazelle, M.D., Ph.D., of Massachusetts General Hospital in Boston and King C. Li, M.D., of Methodist Hospital in Houston.
The course fee is $175. Registration forms can be found online. Contact Fiona Miller at 1-630-590-7741 or fmiller@rsna.org for more information.
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Leading the News
Computer-Aided Mammogram Reading Effective
Computer-aided detection (CAD) for screening mammography displays similar detection rates to mammograms read by two different radiologists, according to research conducted by University of Aberdeen professor of radiology Dr. Fiona Gilbert and her colleagues. They randomly assigned more than 31,000 women to undergo a routine mammography read by two radiologists or by CAD and one radiologist. CAD and a single reading detected 87.2 percent of cancers compared to two readings, which detected 87.7 percent of cancers. In light of these findings, Gilbert maintains "CAD could increase the cancer detection rate of a single reader in breast screening centers currently using single reading alone." Full results of the study were posted early online and can be found in the Oct. 16 issue of the New England Journal of Medicine.
From "Computer-Aided Mammogram Reading Effective"
U.S. News & World Report (10/01/08)
Research
Bedside Chest Radiographs Can Accurately Detect Intraatrial Central Venous Catheter Position
M. Wirsing and colleagues at Friedrich-Schiller University recently conducted an investigation comparing the accuracy of bedside chest radiographs (CXRs) to transesophageal echocardiography (TEE) to detect intraatrial central venous catheter position. The researchers randomized 213 patients scheduled for cardiothoracic surgery to right or left internal jugular vein cauterization. One senior radiologist and two radiologists in training then read the patients CXRs to determine proper positioning of the catheter. These readings were then compared to TEE findings. Results of the study, published in Chest, led researchers to believe that CXR can be used to identify valid markers for catheter positioning.
From "New Findings From Friedrich-Schiller University in the Area of Central Venous Catheter Published"
Surgery Litigation & Law Weekly (10/03/08)
MR Imaging Aids in Diagnosis of Foot and Ankle Trauma
A study by Gerald T. Kuwada, of the Ankle and Foot Clinic of Renton, Wash., indicates that magnetic resonance imaging (MRI) can be a valuable tool in diagnosing and detecting trauma to large tendons and collateral ligaments of the foot and ankle. In the study, six radiologists retrospectively studied the MRI results of 28 patients who had undergone preoperative MRI and then surgery for tendon and ligament repair in the foot and ankle. Sensitivity was computed as a percentage of MRI interpretation correlated with surgical confirmation, and specificity was based on a percentage of errors of MRI interpretations that were confirmed surgically. According to the findings, MRI readings were confirmed 83 percent of the time for tears of tendons and ligaments of the foot and ankle. The study noted that larger tendons, such as the Achilles or posterior tibial tendon, have 94 percent sensitivity and 6 percent specificity. There was 73 percent sensitivity for collateral ligament and high ankle sprains, and 57 percent sensitivity for peroneus brevis and longus ruptures. According to Kuwada, differences between this study and others may depend on the training and experience of the radiologists, the positioning of the patient, and anatomical differences in the feet and ankles of the patients that influenced imaging and diagnosis. He notes that the findings support "the notion that MRI is a valuable diagnostic tool and as technology and accuracy improve, MRIs may prove to be superior to other diagnostic modalities for trauma of the foot and ankle."
From "Surgical Correlation of Preoperative MRI Findings of Trauma to Tendons and Ligaments of the Foot and Ankle"
Journal of the American Podiatric Medical Association (10/01/08) Vol. 98, No. 5, P. 370; Kuwada, Gerald T.
Exposure to Low-Dose Ionizing Radiation May Increase Risk of Cataract
A group of researchers led by a team from the National Institutes of Health recently concluded a 20-year study of radiologic technologists. Over 35,000 technologists between the ages of 24 years old and 44 years old were followed to determine if exposure to ionizing radiation increased the risk of cataract. Researchers reported that technologists who were exposed to x-rays to the face and neck had a hazard ratio of 1.25 for cataracts. Workers who were exposed to the highest levels of radiation had an adjusted hazard ratio of 1.18. These findings challenge the National Council on Radiation Protection and International Commission on Radiological Protection's beliefs that the lowest dose of radiation to the lens of the eye that can produce a cataract is around 2 Gy.
From "Risk of Cataract After Exposure to Low Doses of Ionizing Radiation"
American Journal of Epidemiology (07/29/08) Chodick, Gabriel; Bekiroglu, Nural; Hauptmann, Michael
Most Radiation Oncology Patients Do Not Use Analgesics
A new study, led by Dr. Charles Simone of the National Cancer Institute's Radiation Oncology Branch, found that 80 percent of cancer patients undergoing radiation therapy do not use medications to combat pain. Simone and his colleagues collected data from 106 patients using an Internet-based questionnaire. The results of their research, reported in the International Journal of Radiation Oncology, Biology, Physics, found that 46 percent of patients had cancer-related pain and 58 percent experienced treatment-related pain. Common factors cited for not using analgesics to combat pain included fear of addiction and inability to pay for medication.
From "Most Radiation Oncology Patients Do Not Use Analgesics"
Reuters Health Information Services (09/29/08)
Technology
Nanomagnets Inside Red Blood Cells Will Bring MRI Scans Into Sharp Focus
Magnetic nanoparticles injected into the bloodstream can enhance magnetic resonance imaging (MRI); however, the particles tend to get removed from the body too quickly to be of much use. University of Urbino Prof. Mauro Magnani may have solved this problem in a recent study, published in the Journal of Nanoscience and Nanotechnology. Magnani and his team were able to get the nanoparticles to stay in the bloodstream for approximately four months by inserting them into living blood cells. During that time Magnani was able to use the magnetic blood cells to gain detailed images of the hearts of mice.
From "Nanomagnets Inside Red Blood Cells Will Bring MRI Scans Into Sharp Focus"
New Scientist (10/04/08) Vol. 200, No. 2676, P. 26
Better Healthcare IT Empowers Patients
Purdue University College of Science Dean Jeffrey Vitter, who oversees the Center for Education and Research in Information Assurance and Security, says many patients are frustrated with the current healthcare system because it is always evolving and is consistently hard to "navigate." Vitter suggests using information technology to make healthcare data available to patients in a secure way can foster greater understanding of healthcare treatments, improve patients' healthcare decision-making, and generate healthcare ownership among patients. Personalized medicine, according to Vitter, can be accomplished through greater information technology use; but without additional education, many patients will misinterpret available data. Patients need control over their own medical data, and providers across the country need access to that data. However, Vitter says, "This is an enormous challenge because there is no universal computer network for healthcare in the country."
From "Better Healthcare IT Will Empower Patients, Says Purdue Expert"
Healthcare IT News (07/01/08) Monegain, Bernie
Medical-Legal Issues
FDA Issues a Class I Recall of Nebion HLX-8 Magnetic Resonance Device
The FDA has issued a Class I Recall of the Nebion HLX-8 Magnetic Resonance Device. According to the recall, the device's manufacturer marketed it without gaining FDA approval or submitting any safety and effectiveness data to the agency. Promotional materials for the device reportedly claim it could be used to treat many different medical conditions, including several types of cancer, carpal tunnel syndrome, migraines, rheumatoid arthritis, ruptured disks, sports injuries, and sprains. Additionally, the device was not manufactured using current good manufacturing practices.
From "Nebion HLX-8 Magnetic Resonance Device"
Medwatch (10/03/2008)
Clinical Practice
Staying Attuned to Employee Needs Can Lower Turnover
Physicians whose practices have high turnover rates should not immediately offer pay increases, as salary is not the only issue that prompts workers to leave their jobs. Experts highlight the importance of exit interviews to determine exactly why workers are leaving, but they also should look for signs of unhappiness before their departure, such as numerous absences, lower productivity, negativity, an unwillingness to accept new responsibilities, and the absence of a team mentality. To retain quality employees, physicians should ensure that employees receive the necessary training to do their jobs effectively and praise employees when they do a good job. They also should offer incentives and opportunities for advancement, hold office parties, and make sure salaries and benefits are in line with competitors.
From "Staying Attuned to Employee Needs Can Lower Turnover"
American Medical News (09/29/08) Schechter, Karen S.
Goodwill Value of Practice Important in Variety of Transactions
Physicians need to be concerned about their practice's goodwill when they plan to sell, but goodwill also comes into play when structuring physician partnership agreements, cashing out retired physicians, valuing the practice during legal proceedings, or changing the practice's ownership structure. Goodwill centers on intangible assets, such as patient base, accounts receivable, reputation, location, size, specialty, and payer mix. According to The Health Care Group Inc. CEO Sandra McGraw, "People are still paying a premium to join the right practice. If you're in the middle of nowhere with no real barrier to entry, no one is inclined to pay a premium for your practice. They can just set up their own practice and compete with you. But if you want to join an ophthalmologist practice in Manhattan, generally you will be willing to pay goodwill. It would be difficult financially to start on your own." Practices that command no goodwill are worthless, as potential buyers increasingly are concerned about lower reimbursements and decreased patient loyalty. In areas like rural Maine, Maine Medical Association general counsel Andrew MacLean says, "Hospitals continue to buy primary care and specialty practices, but they aren't paying goodwill." Medical Business Advisors CEO David Marcinko says practices that sold for upwards of five times their gross annual revenue in the 1990s are selling for about two times gross annual revenue today.
From "Goodwill Hunting: What's Your Practice Worth?"
American Medical News (09/15/08) Caffarini, Karen
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