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Biomedical subjects

W H Straub

Publications and source records attributed to W H Straub.

17 recordsLinked to original sources
PubMed1992

Clinicians' access to diagnostic imaging information at an academic center: perceived impact on patient management.

We studied the efficiency with which clinicians were able to obtain the results of radiologic studies during visits to the radiology department in an effort to determine how often delays occurred and, if so, how they were perceived to have influenced patient care. We monitored 322 physician's visits to four locations within the radiology department in search of imaging information or consultative services. The average duration of these visits was 6.2 min (range, 38 sec-55 min). Two hundred forty-three visits (75%) were completed successfully, and 10 additional visits were for consultation purposes only. In 43% of the 69 unsuccessful visits, physicians indicated that lack of access to imaging information would definitely (38%) or possibly (6%) result in delays in diagnosis and/or therapy. In 17% of the unsuccessful visits, physicians indicated that the inability to access imaging information would definitely (13%) or possibly (4%) extend the patient's length of stay in the hospital. Our study suggests that better access to imaging information may prevent delays in patient management decisions, thereby substantially reducing costs and potentially improving patient care.

Hospitals, University↗
PubMed1991

Primary CT diagnosis of abdominal masses in a PACS environment.

Whether the display medium--film versus cathode ray tube (CRT)--affects observer performance during interpretation of computed tomographic (CT) images is an important research issue in these times of implementation and growth of picture archiving and communications systems in radiology. The authors performed a multiobserver receiver operating characteristic (ROC) study to determine the performance of radiologists who read abdominal CT studies displayed on film, as well as on a high-resolution workstation (video monitor) that made use of three different display modes. A total of 166 examinations were evaluated by eight radiologists, who recorded their ordinal confidence ratings of the demonstration of presence or absence of abdominal masses. ROC analysis showed small differences in the confidence ratings assigned by individual readers for the detection and interpretation tasks. Results for the group as a whole showed no significant reduction or improvement in observer performance when ratings for any one of the workstation display modes were analyzed. The results of this study demonstrate that current CRT display technology is adequate for enabling the primary detection of abdominal masses with CT examinations.

Abdominal Neoplasms↗
PubMed1990

Effect of observer instruction on ROC study of chest images.

Receiver-operating characteristic (ROC) analysis has been used in many medical imaging applications during the past decade. In order to ensure that reader-confidence ratings are analyzable (well distributed to meet convergence requirements of curve-fitting algorithms) and meaningful (limit extrapolation of the data), many investigators train readers specifically for this purpose. No experimental data are available concerning the possible effects of such training on the results of ROC studies. We performed a multi-observer, multi-disease study in which 300 chest images were rated by four radiologists before and after they were trained to provide well-distributed confidence ratings. The results indicate that for our data set, reader and disease-specific accuracy was not significantly affected by the training process for interstitial disease and pneumothoraces. However, the accuracy of two readers was significantly affected for the detection of nodules (P less than 0.05), and the overall accuracy of one reader was significantly affected for the classification of normal versus abnormal images (P less than 0.01). Thus, in spite of the difficulties associated with the performance of ROC studies in a free-reading environment, one should carefully consider the possible effects of any intervention on the results prior to conducting ROC studies.

Humans↗
PubMed1990

Comparison of measured and perceived time values for radiologists' work: impact on relative value scales.

The authors compared the actual time required by radiologists to perform and/or interpret common diagnostic radiologic examinations with the times the same radiologists perceived were necessary (as determined with a survey) to perform and/or interpret those same examinations. Average measured times ranged from 1.7 minutes for radiologic examinations of extremities to 113.2 minutes for interventional procedures. Average survey times ranged from 3.2 minutes for examinations of extremities to 84.4 minutes for cerebral angiography. The mean difference between measured and survey times for all examinations was 48.6%. Relative value scales were developed based on measured and survey times, with the upper gastrointestinal examination assigned the base unit of 100. The difference between the measured-time and survey-time relative value scales was 98% on average for the 16 examinations compared. The study suggests that there is a need for actual measurement of at least the time component of physician work if resource-based relative value scales are to be used as the basis for physician compensation.

Academic Medical Centers↗
PubMed1987

Cholescintigraphic detection of intraperitoneal bile leakage from a perforated duodenal ulcer.

A 66-year-old woman with known gallstones and peptic ulcer disease presented with acute epigastric pain. Cholescintigraphy revealed nonvisualization of the gallbladder with subhepatic and perihepatic accumulation of tracer. An upper gastrointestinal examination with water-soluble contrast revealed a perforated duodenal ulcer, with leakage confirmed at laparotomy. The gallbladder was intact.

Aged↗
PubMed1986

Prostatic evaluation by transrectal sonography: criteria for diagnosis of early carcinoma.

Over a 7-month period, from a total of 417 transrectal ultrasound (US) studies, 45 transperineal biopsies of the prostate were performed in the radiology department. Transrectal US guidance and local anesthesia were used. Twenty-two of 32 hypoechoic lesions, located within the peripheral zone tissue of the gland, were proved by histologic study to be cancerous. Hyperechoic lesions were all histologically benign hyperplasias. The patients experienced no major complications necessitating hospitalization or increased length of hospital stay as a result of the procedure.

Adult↗
PubMed1985

Transrectal ultrasound in the diagnosis of prostate cancer: location, echogenicity, histopathology, and staging.

Adenocarcinoma of the prostate produces specific ultrasonic findings that can be used in diagnosis. We have examined 211 patients using transrectal ultrasound in both the sagittal and axial planes. Thirty-three carcinomas were detected, and 31 histologically confirmed; 24 by needle biopsy, six by transurethral resection, one by total prostatectomy, and two by the demonstration of distant metastases. On ultrasound, all of the carcinomas were less echogenic than normal prostate. All appeared to originate in the peripheral zone of the prostate and produced asymmetry of the gland. The majority of carcinomas in this series showed capsular involvement and ten penetrated and extended beyond the prostatic capsule. The results of this series indicate that transrectal ultrasound can be used to detect cancer of the prostate gland. Ultrasound demonstrated the extent of tumor involvement and enabled accurate staging of these cancers.

Adenocarcinoma↗
PubMed1982

Acute lymphocytic leukemia of the ovary: the value of sonography.

Leukemic involvement of ovary has been found in up to 30% of patients with acute lymphocytic leukemia (ALL) at autopsy, but is rarely found clinically. Since the ovary may be a sanctuary for ALL to reseed the marrow, early clinical detection of ovarian involvement is important. The use of sonography in evaluating the ovary is suggested as part of the management routine in ALL. It can be used prior to cessation of chemotherapy and on subsequent follow-up to assess the state of the ovary. A case is presented in which a young woman with ALL in remission developed a pelvic mass, documented by ultrasound, subsequently shown to represent leukemic infiltration of the ovary.

Adult↗