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Radiology 2nd Opinions

PodcastDX

Release Date: 05/23/2023

Light & Health show art Light & Health

PodcastDX

This week we will discuss LED (light-emitting diode) therapy, a type of treatment that uses lights of different wavelengths to treat a variety of skin conditions, such as acne, scar tissue, and the effects of aging. Most commonly, red and blue lights are used for these treatments.   can be performed in a healthcare provider's office or at home. Multiple treatments are required to get results.  There will not be a guest for this week's episode

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Metabolic Systems show art Metabolic Systems

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This week we will discuss Metabolic Systems with our guest,  Francis Fessler.   A certified personal trainer and conditioning coach for the last 25 years, Francis Fessler has built a career by designing programs and coaching professional and amateur athletes, celebrities, business professionals, parents and children to achieve their wellness and fitness goals. Throughout his time in the health and wellness world he evaluated, tried and tested countless ‘diet and nutrition plans’ and could not find one that had consistent results for both women and men- so he built one. Francis...

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The Aftermath of 9/11 show art The Aftermath of 9/11

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On this week's episode we are running a rare re-run on the aftermath of 9/11. The tragic events of September 11, 2001, remain etched in the collective memory of not only Americans but also people worldwide. Beyond the immediate devastation, the aftermath of the World Trade Center (WTC) attacks brought forth an enduring health crisis among those who selflessly rushed to aid their fellow citizens. First responders, the courageous individuals who braved the smoke, debris, and toxic fumes of Ground Zero, now face a formidable foe: cancer. This essay delves into the harrowing issue of cancers among...

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BiPolar and a Caregiver show art BiPolar and a Caregiver

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This week we will discuss being Bi-Polar with Kitt O'Malley.   Kitt is an author, mental health advocate, and former psychotherapist who lives with bipolar disorder. Both her personal experience and clinical background inform her writing and enable her to help herself and guide others toward mental health recovery. She has a bachelor's in legal studies from UC Berkeley, a master's in psychology from New College of California, and has attended seminary. Visit  for more information.   "Balancing Act - Writing Through a Bipolar Life" offers hope to those living with mental...

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Young Onset Parkinson's show art Young Onset Parkinson's

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This week we will discuss Young Onset Parkinson's with Jennifer Crowder. ​ Jennifer has been living in the uncomfortable space of not using her career or family role to define herself for many years. Instead, she describes who she is as a person - she is tenacious, creative, stubborn, sarcastic, relentless, driven, compassionate, and courageous. Her proudest moments are making people laugh when they least expect it and finding a quick and simple solution to a complex problem. She spends most of her time in a boxing gym or carving eggshells. She has been living with Parkinson's disease for 27...

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Long COVID and Circulatory Problems show art Long COVID and Circulatory Problems

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This week we will discuss lasting symptoms months after catching COVID-19, also known as long COVID.  A recent study has found Long COVID  more than doubles a person’s likelihood of developing cardiovascular issues.  (credits: https://bit.ly/45gJq4e )  We will not have a guest on this episode.  If you or someone you know has Long COVID and had a healthy circulatory system until recently we would love to have you as a guest for a future episode. 

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Gastroparesis show art Gastroparesis

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This week we will discuss a serious motility disorder: Gastroparesis. Our guest is a strong advocate for this community and we are honored to have her join us today.  Melissa Adams VanHouten is a wife, mother, and former university political science instructor and corporate trainer who holds a B.S. in Political Science from St. Joseph's College and an M.A. in Political Science from Indiana State University. After being diagnosed with gastroparesis in February of 2014, she became a passionate advocate for those in her community who feel voiceless and ignored. She currently serves as the...

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Sepsis Rapid Test show art Sepsis Rapid Test

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This week we will discuss a new rapid response test for Sepsis with one of the developers, Richard Brandon. ​Sepsis describes a syndrome that occurs when severe infection results in critical illness and affects 750,000 Americans annually. Sepsis occurs when a bacterial, viral, or fungal infection causes a significant response from the body’s immune system, causing a high heart rate, fever, or fast breathing. Severe sepsis develops when the infection causes organ damage. Septic shock is the most severe form in which the infection causes low blood pressure, resulting in damage to multiple...

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Mast Cell Activation Syndrome show art Mast Cell Activation Syndrome

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On today’s show, we are talking about the complex world of multiple chronic illnesses once again with Anna Cooper. Anna is a 35-year-old female who has an independent spirit inside of a body that holds an alphabet of health conditions. Anna worked as a case manager for individuals with intellectual and developmental disabilities, where she loved to advocate for her clients. When her health forced her to take a step back from working, things have been rough as she looks for a new way to advocate for herself and for others. The Difficult illness we will discuss today is Mast Cell Activation...

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End Stage Achalasia show art End Stage Achalasia

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This week we will discuss Achalasia of the Esophagus Achalasia occurs when nerves in the esophagus become damaged. As a result, the esophagus becomes paralyzed and dilated over time and eventually loses the ability to squeeze food down into the stomach. Food then collects in the esophagus, sometimes fermenting and washing back up into the mouth, which can taste bitter. Some people mistake this for gastroesophageal reflux disease (GERD). However, in achalasia the food is coming from the esophagus, whereas in GERD the material comes from the stomach. ​There's no cure for achalasia. Once the...

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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