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Radiology 2nd Opinions

PodcastDX

Release Date: 05/23/2023

From Survival to Quality of Life: show art From Survival to Quality of Life:

PodcastDX

FROM SURVIVAL TO QUALITY OF LIFE: WHY OUTCOMES ARE BEING REDEFINED THE FUNDAMENTAL SHIFT IN MEDICINE For decades, medicine measured success through a singular lens: survival. Did the patient live? Did the procedure work? While these metrics remain important, healthcare is undergoing a profound transformation that redefines what "winning" actually means[1]. The new standard is no longer just extending life—it's enabling patients to live purposefully, functionally, and with dignity[2]. This shift reflects a critical insight: surviving is not the same as living well. WHY OUTCOMES ARE BEING...

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Ai in Medicine Tool Partner or Problem show art Ai in Medicine Tool Partner or Problem

PodcastDX

AI in medicine is best understood as a powerful tool and a conditional partner that can enhance care when tightly supervised by clinicians, but it becomes a problem when used as a replacement, deployed without oversight, or embedded in biased and opaque systems. Whether it functions more as a partner or a problem depends on how health systems design, regulate, and integrate it into real clinical workflows.​ Where AI Works Well Decision support and diagnosis: AI can read imaging, ECGs, and lab patterns with very high accuracy, helping detect cancers, heart...

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Medicine in Transition:   show art Medicine in Transition:

PodcastDX

Medicine has transitioned due to massive tech adoption (Electronic Health Records EHRs, Artificial Intelligence AI, Telehealth), shifting patient expectations (consumerism, convenience), the rise of value-based care, new treatments (precision medicine), and increased focus on population health and prevention, all while grappling with rising costs, data security, and persistent access/equity gaps, making healthcare more data-driven, personalized, and digitally integrated but also more complex and fragmented.  We try to break it down to try and understand the changes and how they might...

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A Primer on Stem Cells show art A Primer on Stem Cells

PodcastDX

​ This week we discuss stem cells.  Having great therapeutic and biotechnological potential, stem cells are extending the frontier in medicine. Not only replace dysfunctional or damaged cells, the so-called regenerative medicine, stem cells may also offer us new perspectives regarding the nature of aging and cancer. This review will cover some basics of stem cells, their current development, and possible applications in medicine. Meanwhile, important remaining challenges of stem cell research are discussed as well. ​Stem cells are unique, unspecialized cells that can divide to create...

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Functional Fitness show art Functional Fitness

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This week we will discuss the topic of "functional fitness"  With the new year upon us many people want to add fitness or getting healthy as goals and we are here to help! Functional fitness is a simple, effective way to keep your body moving and reduce restlessness. It focuses on exercises that help you perform everyday activities more easily and safely—like getting up off the floor, carrying groceries, or reaching for items on a shelf. By training your muscles to work the way you actually use them in daily life, functional fitness reduces injury risk and improves overall quality of...

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Why New Year Resolutions Often Fail show art Why New Year Resolutions Often Fail

PodcastDX

By the end of the first week of the new year, nearly 77% of New Year’s resolutions have already failed (Norcross, 1988). That’s discouraging—but it doesn’t mean you should stop trying. It means most of us are setting resolutions in ways that don’t work. You aren’t weak or lazy. More often, the problem is a misaligned system—one that relies too heavily on willpower and short-lived motivation. Motivation naturally fades over time, even when our intentions are good. Think about how often you enthusiastically agree to plans weeks in advance, only to feel tired or unmotivated when...

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The Lymphatic System show art The Lymphatic System

PodcastDX

The lymphatic system, or lymphoid system, is one of the components of the circulatory system, and it serves a critical role in both immune function and surplus extracellular fluid drainage.  Components of the lymphatic system include lymph, lymphatic vessels and plexuses, lymph nodes, lymphatic cells, and a variety of lymphoid organs. The pattern and form of lymphatic channels are more variable and complex but generally parallel those of the peripheral vascular system. The lymphatic system partly functions to convey lymphatic fluid, or lymph, through a network of lymphatic channels,...

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Pancreatic Cancer show art Pancreatic Cancer

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This week we are talking about Pancreatic cancer.  This is a type of cancer that begins as a growth of cells in the pancreas. The pancreas lies behind the lower part of the stomach. It makes enzymes that help digest food and hormones that help manage blood sugar. The most common type of pancreatic cancer is pancreatic ductal adenocarcinoma. This type begins in the cells that line the ducts that carry digestive enzymes out of the pancreas. Pancreatic cancer rarely is found at its early stages when the chance of curing it is greatest. This is because it often doesn't cause symptoms until...

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Diabetes Type 1 & 2 show art Diabetes Type 1 & 2

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This week we discuss diabetes mellitus, a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel. The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems. ​Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational...

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Mast Cell Activation Syndrome MCAS show art Mast Cell Activation Syndrome MCAS

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Mast cell activation syndrome (MCAS) is when you have unexplained episodes of severe symptoms like swelling, diarrhea, vomiting, flushing and itching. Unlike that happen with a specific exposure, MCAS episodes happen without a clear trigger. In some cases, mast cell activation can cause , a severe allergic condition that can be life-threatening. It can cause you to have trouble breathing and drop your to dangerously low levels. Call 911 (or your local emergency service number) or go to the nearest emergency room if you’re experiencing severe anaphylaxis. are a type of immune cell...

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More Episodes

This week we will discuss the topic of Diagnostic Radiology.  The error rate of radiology is 4% world wide which comes out to be 40 million interpretive errors a year.  Errors in diagnostic radiology occur for a variety of reasons related to human error, technical factors and system faults. It is important to recognize that various cognitive biases contribute to these errors.   

Cognitive biases have a complex and significant impact on the perception of examinations within diagnostic radiology, with the clear and present danger of diagnostic errors. The following are some of the more common cognitive biases that can affect day-to-day decision making

Alliterative bias

Alliterative bias (sometimes called satisfaction of report) is the tendency for your diagnostic impression to be unduly influenced by the prior interpretation made by another radiologist or clinician. It is a type of confirmation bias and it can result in the same incorrect impression being propagated from one radiologist to the next. Formulating your own interpretation before reviewing any prior imaging reports may help reduce alliterative bias.

Anchoring bias

Anchoring bias is the tendency for your initial impression to unduly influence your evaluation of subsequently collected information. Careful assessment of all imaging findings prior to formulating a diagnosis and consideration of alternate diagnoses may help minimize anchoring bias.

Automation bias

Automation bias is the tendency for reporters using computer-aided decision support to over rely on the software for the diagnosis, and to ignore their own opinions 2. Making your own assessment prior to reviewing the computer-aided findings, and knowing the limitations of the automated software, can help reduce this bias.

Availability bias

Availability bias refers to the tendency for your diagnostic judgements to be unduly influenced by information or experiences that are readily recalled in your mind. Use of information sources beyond your own personal experience, such as publications or an opinion from colleagues, may help to minimize availability bias.

Bandwagon effect

The bandwagon effect (sometimes termed diagnosis momentum) refers to the tendency for you to do or think as others do, simply because that's what others are doing. Applying your own judgment and not dismissing your own opinion can help avoid this bias.

Confirmation bias

Having a predetermined diagnosis in mind, then looking for evidence that supports this predetermined idea. Alliterative errors 3, sometimes referred to as satisfaction of report errors, are caused by the tendency to overvalue previous reports, and can be conceptualised as a type of confirmation bias.

Framing bias

Framing bias refers to the tendency to be unduly influenced by how a clinical question is asked or how the problem is presented. For example, a request form that presents a succinct history that perfectly matches a particular pathology, may influence your interpretation of the imaging. Reviewing the images prior to reading the clinical indication can help avoid any influence. Obtaining more detailed clinical information via the electronic medical record may help provide you with a more balanced assessment of the clinical situation.

Hindsight bias

Hindsight bias is the tendency to overestimate the prior predictability of an event (eg. a diagnosis) after the event is known. In other words, the difficulty of making the correct diagnostic decision initially is retrospectively de-emphasized, after the diagnosis has been proven. It is also informally termed as the “I knew it all along” or "retrospectoscope" bias 5. It is important to be conscious of this bias so that you are not overly critical of yourself or others when quite reasonable errors are made.

Outcome bias

A tendency to favor a less severe diagnosis based on empathy for a patient.

Representativeness bias

Making a judgment on an aspect of an image that is based on one's own perception of what that represents. Representativeness bias as the description suggest can also be heuristic in nature.

Search satisfaction

Search satisfaction is the tendency to prematurely stop searching after early findings satisfy the reader that the diagnosis or symptoms can be explained. Satisfaction of search (SOS) errors have been reported to account for 22% of diagnostic errors 4. A systematic approach to image interpretation and review of check areas and not-to-miss diagnoses can help to reduce this bias.

Zebra retreat bias 

A reader will not make a rare diagnosis, which is otherwise supported by the available evidence due to a lack of confidence.

 There are businesses that do "second opinion" reads, here are links for two such companies for your use: www.ndximaging.com www.xmri.com

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(Credits Radiopedia