1. Low-Volume and High-Volume Readers of Neurological and Musculoskeletal MRI: Achieving Subspecialization in Radiology
- Author
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Trinh, Brian, Calabrese, Evan, Vu, Thienkhai, Forman, Howard P, and Haas, Brian M
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Bioengineering ,Behavioral and Social Science ,Biomedical Imaging ,Aged ,Humans ,Magnetic Resonance Imaging ,Medicare ,Radiography ,Radiologists ,Radiology ,United States ,Methodology research ,quality ,specialization ,workforce organization ,Public Health and Health Services ,Nuclear Medicine & Medical Imaging ,Clinical sciences - Abstract
ObjectiveDifferentiate high- versus low-volume radiologists who interpret neurological (Neuro) MRI or musculoskeletal (MSK) MRI and measure the proportion of Neuro and MSK MRIs read by low-volume radiologists.MethodsWe queried the 2015 Medicare Physician and Other Supplier Public Use File for radiologists who submitted claims for Neuro or MSK MRIs. Radiologists were classified as high-volume versus low-volume based on their work relative value units (wRVUs) focus or volume of studies interpreted using three different methodologies: Method 1, percentage of wRVUs in Neuro or MSK MRI; Method 2, absolute number of Neuro or MSK MRIs interpreted; and Method 3, both percentage and absolute number. Multiple thresholds with each methodology were tested, and the percentage of Neuro or MSK MRIs interpreted by low-volume radiologists was calculated for each threshold.ResultsWith Method 1, 33% of Neuro MRI and 50% of MSK MRI studies were interpreted by a radiologist whose wRVUs in Neuro or MSK MRI were less than 20% (Method 1). With Method 2, 22% of Neuro MRIs and 37% of MSK MRIs were interpreted by radiologists who read fewer than the mean number of Neuro or MSK MRIs interpreted by an "average full-time radiologist" whose wRVUs in Neuro or MSK MRI were approximately 20%. With Method 3, 38% of Neuro MRIs and 57% of MSK MRIs were interpreted by "low-volume" radiologists. If instead a 50% wRVU threshold is used for Methods One, Two, and Three, then 70%, 58%, and 77% of Neuro MRIs and 86%, 80%, and 90% of MSK MRIs are read by low-volume radiologists.DiscussionA large number of radiologists read a low volume of Neuro or MSK MRIs; these low-volume Neuro or MSK MRI radiologists read a substantial portion of Neuro or MSK MRIs. It is unknown which of the methods for distinguishing low-volume radiologists, combined with which threshold, may best correlate with high-performing or low-performing radiologists.
- Published
- 2020