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Introduction Educational effects of transitioning from formative to summative progress testing are unclear. Our purpose was to investigate whether such transitioning in radiology residency is associated with a change in progress test results. Methods We investigated a national cohort of radiology residents (N > 300) who were semi-annually assessed through a mandatory progress test. Until 2014, this test was purely formative for all residents, but in 2014/2015, it was transitioned (as part of a national radiology residency program revision) to include a summative pass requirement for new residents. In 7 posttransitioning tests in 2015–2019, including summatively and formatively tested residents who followed the revised and pre-transitioning residency program, respectively, we assessed residents’ relative test scores and percentage of residents that reached pass standards. Results Due to our educational setting, most posttransitioning tests had no residents in the summative condition in postgraduate year 4–5, nor residents in the formative condition in year 0.5–2. Across the 7 tests, relative test scores in postgraduate year 1–3 of the summative resident group and year 3.5–4.5 of the formative group differed significantly (p < 0.01 and p < 0.05, respectively, Kruskal-Wallis test). However, scores fluctuated without consistent time trends and without consistent differences between both resident groups. Percentage of residents reaching the pass standard did not differ significantly across tests or between groups. Discussion Transitioning from formative to summative progress testing was associated with overall steady test results of the whole resident group in 4 post-transitioning years. We do not exclude that transitioning may have positive educational effects for resident subgroups.

Objectives More detailed evaluation of atherosclerosis and its key determinants in young individuals is warranted to improve knowledge on the pathophysiology of its development and progression. This study evaluated associations of magnetic resonance imaging (MRI)-derived aortic wall area, wall thickness, and pulse wave velocity (PWV) with cardiovascular risk factors in asymptomatic, young adults. Materials and methods In 124 adults (age: 25–35 years) from the general population-based Atherosclerosis Monitoring and Biomarker Measurements in the Young study, demography, anthropometry, and blood samples were collected. The studied MRI-parameters were measured using a 3.0T MRI system. Relations between cardiovascular risk factors and aortic characteristics were assessed using multivariable linear regression analyses. Results Mean age was 31.8 years, 47.6% was male. Aortic wall area was positively associated with age [β = 0.01, (95% confidence interval (CI) 2.00 × 10−3, 0.02), p = 0.01] and BMI [β = 0.01, (0.01, 0.02), p = 0.003] and negatively associated with sex (reference: men) [β = −0.06, (−0.11, −0.01), p = 0.02]. Natural logarithm transformed (ln) aortic wall thickness was positively associated with BMI [β = 0.01, (1.00 × 10−3, 0.02), p = 0.02]. Ln aortic PWV was positively associated with 10 mmHg increment of SBP [β = 0.06, (0.03, 0.09), p

Background Pre-clinical detection of atherosclerosis enables personalized preventive strategies in asymptomatic individuals. Cardiovascular magnetic resonance (CMR) has evolved as an attractive imaging modality for studying atherosclerosis in vivo. Yet, the majority of aortic CMR studies and proposed sequences to date have been performed at 1.5 tesla using 2D BB techniques and a slice thickness of 4–5 mm. Here, we evaluate for the first time the reproducibility of an isotropic, T1-weighted, three-dimensional, black-blood, CMR VISTA sequence (3D-T1-BB-VISTA) for quantification of aortic wall characteristics in healthy, young adults. Methods In 20 healthy, young adults (10 males, mean age 31.3 years) of the AMBITYON cohort study the descending thoracic aorta was imaged with a 3.0 T MR system using the 3D-T1-BB-VISTA sequence. The inter-scan, inter-rater and intra-rater reproducibility of aortic lumen, total vessel and wall area and mean and maximum wall thickness was evaluated using Bland-Altman analyses and Intraclass Correlation Coefficients (ICC). Based on these findings, sample sizes for detecting differences in aortic wall characteristics between groups were calculated. Results For each studied parameter, the inter-scan, inter-rater and intra-rater reproducibility was excellent as indicated by narrow limits of agreement and high ICCs (ranging from 0.76 to 0.99). Sample sizes required to detect a 5 % difference in aortic wall characteristics between two groups were 203, 126, 136, 68 and 153 per group for lumen area, total vessel area and vessel wall area and for mean and maximum vessel wall thickness, respectively. Conclusion The 3D-T1-BB-VISTA sequence provides excellent reproducibility for quantification of aortic wall characteristics and can detect small differences between groups with reasonable sample sizes. Hence, it may be a valuable tool for assessment of the subtle vascular wall changes of early atherosclerosis in asymptomatic populations. Electronic supplementary material The online version of this article (doi:10.1186/s12968-016-0237-2) contains supplementary material, which is available to authorized users.

To assess the accuracy of intraarterial measurement of transstenotic pressure gradients for the detection of hemodynamically suboptimal iliac angioplasty.In 14 patients, referred for diagnostic angiography, mean pressure gradients in the aorta and iliac artery were obtained twice, using a double-sensor pressure catheter. Additional iliac measurements were performed during pharmacologically induced flow augmentation. Repeatability was assessed by calculation of the mean difference plus standard deviation (MD +/- SD) and repeatability coefficient (2 x SD). These results were extrapolated to 137 iliac angioplasty procedures with secondary stenting where there was a residual pressure gradient10 mmHg.MD +/- SD for repeated measurements at rest and during flow augmentation were 0 +/- 2 mmHg and 1 +/- 3 mmHg, respectively. Repeatability coefficients were 3 and 6 mmHg. Mean pressure gradients after hemodynamically insufficient angioplasty were 8 +/- 7 mmHg at rest and 17 +/- 5 mmHg following vasodilatation. Inaccurate pressure recordings may have led to inappropriate stent placement in less than 2.5%, and inappropriate denial of stent placement in less than 5% of the lesions.Variability of intraarterial pressure measurements has little consequence in the detection of hemodynamically significant stenosis after angioplasty.

Purpose To determine initial technical results of percutaneous transluminal angioplasty (PTA) and stent procedures in the iliac artery, mean intraarterial pressure gradients were recorded before and after each procedure.

The costs of percutaneous transluminal angioplasty and stent placement for iliac artery occlusive disease in the United States were assessed and the cost-effectiveness was evaluated.Lifetime costs and quality-adjusted life expectancy were estimated using a Markov decision model for a hypothetic cohort of patients with life-style-limiting claudication caused by an iliac artery stenosis for whom a percutaneous intervention was indicated. Various percutaneous treatment strategies were evaluated, each consisting of an initial intervention followed by a secondary intervention. Procedures considered were angioplasty alone and angioplasty with selective stent placement.From the perspective of the interventional radiology department, angioplasty with selective stent placement costs more than angioplasty alone ($2926 versus $2106). Taking into account follow-up costs and procedures for long-term failures, the cost differential was reduced because of a lower failure rate of selective stent placement ($13,158 versus $12,458, respectively). Treatment strategies using angioplasty with selective stent placement (as an initial procedure or including reintervention) dominated treatment strategies using angioplasty alone (incremental cost-effectiveness ratio was $7,624-8,519 per quality-adjusted life-year gained).Angioplasty with selective stent placement is a cost-effective treatment strategy compared with angioplasty alone in the treatment of intermittent claudication in the United States.