Retrospective data mining has tremendous potential in research but is time and labor intensive. C... more Retrospective data mining has tremendous potential in research but is time and labor intensive. Current data mining software contains many advanced search features but is limited in its ability to identify patients who meet multiple complex independent search criteria. Simple keyword and Boolean search techniques are ineffective when more complex searches are required, or when a search for multiple mutually inclusive variables becomes important. This is particularly true when trying to identify patients with a set of specific radiologic findings or proximity in time across multiple different imaging modalities. Another challenge that arises in retrospective data mining is that much variation still exists in how image findings are described in radiology reports. We present an algorithmic approach to solve this problem and describe a specific use case scenario in which we applied our technique to a real-world data set in order to identify patients who matched several independent variables in our institution's picture archiving and communication systems (PACS) database.
PURPOSE/AIM The purpose of this exhibit is: (1) To review common and uncommon cystic masses that ... more PURPOSE/AIM The purpose of this exhibit is: (1) To review common and uncommon cystic masses that develop in the fetal abdomen and pelvis (2) To describe the imaging findings of fetal cystic masses with antenatal and postnatal MRI, US, CT and CR (3) To understand how the imaging findings are used to determine maternal-fetal management CONTENT ORGANIZATION (1) Pathophysiology of fetal abdominal and pelvic cystic masses by anatomic system: hepatobiliary, gastrointestinal, genitourinary/retroperitoneum, mesentery/omentum, and miscellaneous (2) Review antenatal fetal imaging findings of cystic masses with US and Fetal MRI (3) Review postnatal and neonatal imaging findings of cystic masses with Ultrasound, CT, MRI, and CR (4) Correlate imaging findings and differential diagnoses with surgical findings and pathological diagnoses SUMMARY The major teaching points of this exhibit are: (1) To understand the etiology and pathophysiology of cystic masses of the fetal abdomen and pelvis (2) To d...
LEARNING OBJECTIVES 1) Understand the different methods of communication offered by Facebook and ... more LEARNING OBJECTIVES 1) Understand the different methods of communication offered by Facebook and Twitter. 2) Be able to establish active accounts/profiles on basic, mainstream social media platforms. ABSTRACT
Radiology's core assets include t... more Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices.
Journal of the American College of Radiology, 2015
To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR ... more To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR Appropriateness Criteria (AC) into an inpatient computerized provider order entry (CPOE) system for advanced imaging requests. Over 12 months, inpatient CPOE requests for nuclear medicine, CT, and MRI were processed by CDS to generate an AC score using provider-selected data from pull-down menus. During the second 6-month period, AC scores were displayed to ordering providers, and acknowledgement was required to finalize a request. Request AC scores and percentages of requests not scored by CDS were compared among primary care providers (PCPs) and specialists, and by years in practice of the responsible physician of record. CDS prospectively generated a score for 26.0% and 30.3% of baseline and intervention requests, respectively. The average AC score increased slightly for all requests (7.2 ± 1.6 versus 7.4 ± 1.5; P < .001), for PCPs (6.9 ± 1.9 versus 7.4 ± 1.6; P < .001), and minimally for specialists (7.3 ± 1.6 versus 7.4 ± 1.5; P < .001). The percentage of requests lacking sufficient structured clinical information to generate an AC score decreased for all requests (73.1% versus 68.9%; P < .001), for PCPs (78.0% versus 71.7%; P < .001), and for specialists (72.9% versus 69.1%; P < .001). Integrating CDS into inpatient CPOE slightly increased the overall AC score of advanced imaging requests as well as the provision of sufficient structured data to automatically generate AC scores. Both effects were more pronounced in PCPs compared with specialists.
Journal of the American College of Radiology, 2014
With the promotion and incentivization of electronic health records and computerized order entry ... more With the promotion and incentivization of electronic health records and computerized order entry by CMS, there is a unique opportunity to catalyze the use of evidence-based guidelines with the inclusion of clinical decision support (CDS) tools. Imaging CDS tools have evolved from static paper algorithms, checklists, and scores to interactive systems that provide feedback and recommendations with the intent of directing health care providers to deliver best practices. Some of the major limitations of first generation imaging CDS tools include a lack of comprehensive evidence-based guidelines, limited ability to input detailed patient conditions and symptoms, and time-intensive user interfaces. Next-generation imaging CDS tools will attempt to close the information and interface gaps to provide more meaningful guidance to health care providers and improve the delivery of best practices to patients.
Diagnostic imaging is often the first step in evaluating patients with back pain and likely funct... more Diagnostic imaging is often the first step in evaluating patients with back pain and likely functions as a "gateway" to a subsequent cascade of interventions. However, lumbar spine imaging frequently reveals incidental findings among normal, pain-free individuals suggesting that treatment of these "abnormalities" may not be warranted. Our prior work suggested that inserting the prevalence of imaging findings in patients without back pain into spine imaging reports may reduce subsequent interventions. We are now conducting a pragmatic cluster randomized clinical trial to test the hypothesis that inserting this prevalence data into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. We are using a stepped wedge design that sequentially randomizes 100 primary care clinics at four health systems to receive either standard lumbar spine imaging reports, or reports containing prevalence data for ...
Retrospective data mining has tremendous potential in research but is time and labor intensive. C... more Retrospective data mining has tremendous potential in research but is time and labor intensive. Current data mining software contains many advanced search features but is limited in its ability to identify patients who meet multiple complex independent search criteria. Simple keyword and Boolean search techniques are ineffective when more complex searches are required, or when a search for multiple mutually inclusive variables becomes important. This is particularly true when trying to identify patients with a set of specific radiologic findings or proximity in time across multiple different imaging modalities. Another challenge that arises in retrospective data mining is that much variation still exists in how image findings are described in radiology reports. We present an algorithmic approach to solve this problem and describe a specific use case scenario in which we applied our technique to a real-world data set in order to identify patients who matched several independent variables in our institution's picture archiving and communication systems (PACS) database.
PURPOSE/AIM The purpose of this exhibit is: (1) To review common and uncommon cystic masses that ... more PURPOSE/AIM The purpose of this exhibit is: (1) To review common and uncommon cystic masses that develop in the fetal abdomen and pelvis (2) To describe the imaging findings of fetal cystic masses with antenatal and postnatal MRI, US, CT and CR (3) To understand how the imaging findings are used to determine maternal-fetal management CONTENT ORGANIZATION (1) Pathophysiology of fetal abdominal and pelvic cystic masses by anatomic system: hepatobiliary, gastrointestinal, genitourinary/retroperitoneum, mesentery/omentum, and miscellaneous (2) Review antenatal fetal imaging findings of cystic masses with US and Fetal MRI (3) Review postnatal and neonatal imaging findings of cystic masses with Ultrasound, CT, MRI, and CR (4) Correlate imaging findings and differential diagnoses with surgical findings and pathological diagnoses SUMMARY The major teaching points of this exhibit are: (1) To understand the etiology and pathophysiology of cystic masses of the fetal abdomen and pelvis (2) To d...
LEARNING OBJECTIVES 1) Understand the different methods of communication offered by Facebook and ... more LEARNING OBJECTIVES 1) Understand the different methods of communication offered by Facebook and Twitter. 2) Be able to establish active accounts/profiles on basic, mainstream social media platforms. ABSTRACT
Radiology's core assets include t... more Radiology's core assets include the production, interpretation, and distribution of quality imaging studies. Second-opinion services and concierge practices in radiology aim to augment traditional services by providing patient-centered and physician-centered care, respectively. Patient centeredness enhances patients' understanding and comfort with their radiology tests and procedures and allows them to make better decisions about their health care. As the fee-for-service paradigm shifts to value-based care models, radiology practices have begun to diversify imaging service delivery and communication to coincide with the American College of Radiology Imaging 3.0 campaign. Physician-centered consultation allows for communication of evidence-based guidelines to assist referring physicians and other providers in making the most appropriate imaging or treatment decision for a specific clinical condition. There are disparate practice models and payment schema for the various second-opinion and concierge practices. This review article explores the current state and payment models of second-opinion and concierge practices in radiology. This review also includes a discussion on the benefits, roadblocks, and ethical issues that surround these novel types of practices.
Journal of the American College of Radiology, 2015
To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR ... more To examine the effect of integrating point-of-care clinical decision support (CDS) using the ACR Appropriateness Criteria (AC) into an inpatient computerized provider order entry (CPOE) system for advanced imaging requests. Over 12 months, inpatient CPOE requests for nuclear medicine, CT, and MRI were processed by CDS to generate an AC score using provider-selected data from pull-down menus. During the second 6-month period, AC scores were displayed to ordering providers, and acknowledgement was required to finalize a request. Request AC scores and percentages of requests not scored by CDS were compared among primary care providers (PCPs) and specialists, and by years in practice of the responsible physician of record. CDS prospectively generated a score for 26.0% and 30.3% of baseline and intervention requests, respectively. The average AC score increased slightly for all requests (7.2 ± 1.6 versus 7.4 ± 1.5; P < .001), for PCPs (6.9 ± 1.9 versus 7.4 ± 1.6; P < .001), and minimally for specialists (7.3 ± 1.6 versus 7.4 ± 1.5; P < .001). The percentage of requests lacking sufficient structured clinical information to generate an AC score decreased for all requests (73.1% versus 68.9%; P < .001), for PCPs (78.0% versus 71.7%; P < .001), and for specialists (72.9% versus 69.1%; P < .001). Integrating CDS into inpatient CPOE slightly increased the overall AC score of advanced imaging requests as well as the provision of sufficient structured data to automatically generate AC scores. Both effects were more pronounced in PCPs compared with specialists.
Journal of the American College of Radiology, 2014
With the promotion and incentivization of electronic health records and computerized order entry ... more With the promotion and incentivization of electronic health records and computerized order entry by CMS, there is a unique opportunity to catalyze the use of evidence-based guidelines with the inclusion of clinical decision support (CDS) tools. Imaging CDS tools have evolved from static paper algorithms, checklists, and scores to interactive systems that provide feedback and recommendations with the intent of directing health care providers to deliver best practices. Some of the major limitations of first generation imaging CDS tools include a lack of comprehensive evidence-based guidelines, limited ability to input detailed patient conditions and symptoms, and time-intensive user interfaces. Next-generation imaging CDS tools will attempt to close the information and interface gaps to provide more meaningful guidance to health care providers and improve the delivery of best practices to patients.
Diagnostic imaging is often the first step in evaluating patients with back pain and likely funct... more Diagnostic imaging is often the first step in evaluating patients with back pain and likely functions as a "gateway" to a subsequent cascade of interventions. However, lumbar spine imaging frequently reveals incidental findings among normal, pain-free individuals suggesting that treatment of these "abnormalities" may not be warranted. Our prior work suggested that inserting the prevalence of imaging findings in patients without back pain into spine imaging reports may reduce subsequent interventions. We are now conducting a pragmatic cluster randomized clinical trial to test the hypothesis that inserting this prevalence data into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. We are using a stepped wedge design that sequentially randomizes 100 primary care clinics at four health systems to receive either standard lumbar spine imaging reports, or reports containing prevalence data for ...
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Papers by Safwan Halabi