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Neuroradiology- A view from the other side - A Survey : November 2018
Neuroradiology- A view from the other side - A Survey : November 2018
Results
Results
A comparison of responses from Nurologists and Neurosurgeons is here
A comparison of responses from Nurologists and Neurosurgeons is here
The background to this survey is at this link
The background to this survey is at this link
My comments on the results of the survey are at on this page
My comments on the results of the survey are at on this page
This survey no longer accepts responses An inactive copy of the survey form is at this link
This survey no longer accepts responses An inactive copy of the survey form is at this link
If you have any comments to offer, please use this form
If you have any comments to offer, please use this form
The options :
The options :
Private hospital
Teaching hospital
A combination of the above
Private practice
Structured report (tick where applicable in a preformatted proforma) followed by a conclusion
No description - Just 'conclusion/impression
I really do care how a report is written
Essay type description of findings followed by 'conclusion/Impression'
A comparison of responses from Nurologists and Neurosurgeons is here
A comparison of responses from Nurologists and Neurosurgeons is here
If you have any comments to offer, please use this form
If you have any comments to offer, please use this form
Other Comments by Survey participants:
Other Comments by Survey participants:
Discussion with the treating consultant prior to talking to patient and if possible jointly is advisable. Differing opinions tend to confuse patients who already are under severe stress of having a brain problem.
Discussion with the treating consultant prior to talking to patient and if possible jointly is advisable. Differing opinions tend to confuse patients who already are under severe stress of having a brain problem.
It’s clearly clinical correlation of scan and patients personal options that decides the treatment
It’s clearly clinical correlation of scan and patients personal options that decides the treatment
They should have more clinical outlook.
They should have more clinical outlook.
The MRI/ CT report should be more clinician oriented rather than writing what is seen in pictures. The radiologist is a doctor not a technician. I find all mri reports particularly spine monotonous. Radiologist should know what the surgeon wants to see and know
The MRI/ CT report should be more clinician oriented rather than writing what is seen in pictures. The radiologist is a doctor not a technician. I find all mri reports particularly spine monotonous. Radiologist should know what the surgeon wants to see and know
Radiologists are no doubt well versed with imaging than the clinician and their opinion stands out at least in many doubtful cases with diagnostic dilemma if not all. However It would be better for a clinician to discuss the findings with a patient after correlating clinical findings and then the treatment options.. The rapport or the confidence that patient has with the clinician should not be superseded.
Radiologists are no doubt well versed with imaging than the clinician and their opinion stands out at least in many doubtful cases with diagnostic dilemma if not all. However It would be better for a clinician to discuss the findings with a patient after correlating clinical findings and then the treatment options.. The rapport or the confidence that patient has with the clinician should not be superseded.
Given 2D report only
Given 2D report only
Radiologist's report is an important adjunct to our findings but not necessary in every case. In many case I just rely on my findings.
Radiologist's report is an important adjunct to our findings but not necessary in every case. In many case I just rely on my findings.
I Opined that radiologist should not discuss findings with patient. The reason is it may provoke anxiety in patient. At all if they want the discuss then they should be thorough with clinical status of the patient and what clinician have discussed with patient. In other words there should not be any discordance in advise between radiologist and clinician. And of course advice should be scientific from both side, not to hide something from patient, but at the same time should not produce unnecessary anxiety in patient and relatives.
I Opined that radiologist should not discuss findings with patient. The reason is it may provoke anxiety in patient. At all if they want the discuss then they should be thorough with clinical status of the patient and what clinician have discussed with patient. In other words there should not be any discordance in advise between radiologist and clinician. And of course advice should be scientific from both side, not to hide something from patient, but at the same time should not produce unnecessary anxiety in patient and relatives.
I do not totally rely on radiologist report simply because they do not fully understand clinical situation. Otherwise our radiologist knowledge is extraordinary. They should structure the report in accordance to the clinical presentation. i don't like giving importance to the incidental lesions when the primary condition itself is challenging. Hope you understand what is my opinion about your aim of the study.
I do not totally rely on radiologist report simply because they do not fully understand clinical situation. Otherwise our radiologist knowledge is extraordinary. They should structure the report in accordance to the clinical presentation. i don't like giving importance to the incidental lesions when the primary condition itself is challenging. Hope you understand what is my opinion about your aim of the study.
Radiologists should discuss with referring clinicians before reporting or asking for additional sequences.
Radiologists should discuss with referring clinicians before reporting or asking for additional sequences.
When a radiologist wants to discuss findings with the patient, he should be completely aware of the patient's clinical problem and other issues (e.g. ethics, etc) and he should discuss this with the primary care physician. Only then, he should discuss only relevant radiology with the patient and family... Nothing else.
When a radiologist wants to discuss findings with the patient, he should be completely aware of the patient's clinical problem and other issues (e.g. ethics, etc) and he should discuss this with the primary care physician. Only then, he should discuss only relevant radiology with the patient and family... Nothing else.
CT scans for Neurosurgery patients are not usually reported in our hospital probably since we never ask for reports and radiologist give priority to other departments. The MRI is also seldom reported in time for similar reasons. I have had rare instances where operative decision has been changed for the better because I happened to read a report. So my policy is to glance at the reports but I seldom do it in practice.
CT scans for Neurosurgery patients are not usually reported in our hospital probably since we never ask for reports and radiologist give priority to other departments. The MRI is also seldom reported in time for similar reasons. I have had rare instances where operative decision has been changed for the better because I happened to read a report. So my policy is to glance at the reports but I seldom do it in practice.
Usually Neurosurgeon s will not depend as a routine for report But do discuss with wise Radiologist for clarifications
Usually Neurosurgeon s will not depend as a routine for report But do discuss with wise Radiologist for clarifications
Most diagnostic radiologists are not directly involved in the bedside evaluation of symptoms and in the surgical procedures. Hence, their discussions of scans with patients could sometimes be detached from clinical reality creating undue fears and victims of medical imaging technology. This doesn't apply to radiologists performing interventional procedures.
Most diagnostic radiologists are not directly involved in the bedside evaluation of symptoms and in the surgical procedures. Hence, their discussions of scans with patients could sometimes be detached from clinical reality creating undue fears and victims of medical imaging technology. This doesn't apply to radiologists performing interventional procedures.
Since radiologist are concerned with CT n MRI findings only, they tend to overlook the clinical symptoms n signs which definitely help better to correlate things rather than radiological findings alone so would suggest before concluding things it's better to have thorough clinical knowledge of the patient. Again about discussing findings with patients..I guess since the patient is admitted under the concerned department ,taking into consideration about the practice that is being followed in the particular institute and the resources that are available to fulfill it, particularly in public sector is very important and should be done before commenting anything.
Since radiologist are concerned with CT n MRI findings only, they tend to overlook the clinical symptoms n signs which definitely help better to correlate things rather than radiological findings alone so would suggest before concluding things it's better to have thorough clinical knowledge of the patient. Again about discussing findings with patients..I guess since the patient is admitted under the concerned department ,taking into consideration about the practice that is being followed in the particular institute and the resources that are available to fulfill it, particularly in public sector is very important and should be done before commenting anything.
We can not generalise the opinion. some radiologists report sincerely and sometimes call the doctor for advise. many times the radiologist himself is not seeing the mri being done and it is wrongly performed. many times an unexpected finding is found, radiologist does not bother to do additional studies (like contrast study) nor discusses with the doctor. they do not do additional studies by themselves to try to reach at diagnosis. there are many suburban centres where ct reports are absolutely wrong and foolish. may be the non medico owner reports them.
We can not generalise the opinion. some radiologists report sincerely and sometimes call the doctor for advise. many times the radiologist himself is not seeing the mri being done and it is wrongly performed. many times an unexpected finding is found, radiologist does not bother to do additional studies (like contrast study) nor discusses with the doctor. they do not do additional studies by themselves to try to reach at diagnosis. there are many suburban centres where ct reports are absolutely wrong and foolish. may be the non medico owner reports them.
The problem with radiologist discussing reports with patients is that they often speak out of context. It creates mulitple issues for the treating clinician.
The problem with radiologist discussing reports with patients is that they often speak out of context. It creates mulitple issues for the treating clinician.
The problem with radiologist discussing reports with patients is that they often speak out of context. It creates mulitple issues for the treating clinician.
The problem with radiologist discussing reports with patients is that they often speak out of context. It creates mulitple issues for the treating clinician.
I feel presently in private sectors some of them are multi tasking with many images of different patients in front of them either on console on laptop on smart phones or films and errors are creeping in, having said that if in doubt I personally talk to some senior radiologist to help the treatment
I feel presently in private sectors some of them are multi tasking with many images of different patients in front of them either on console on laptop on smart phones or films and errors are creeping in, having said that if in doubt I personally talk to some senior radiologist to help the treatment
Over interpretation irrelevant to patient, over reliance on technicians to print films and generate imagery and patient specific sequences would be helpful.
Over interpretation irrelevant to patient, over reliance on technicians to print films and generate imagery and patient specific sequences would be helpful.
Good communication between radiologist and surgeon solves and prevent lots of problem
Good communication between radiologist and surgeon solves and prevent lots of problem
radiology and neuroscience must go hand in hand ......way forward.
radiology and neuroscience must go hand in hand ......way forward.
Answer for que 11 is radiologist should discuss findings with patient only if he is sure about management plan....
Answer for que 11 is radiologist should discuss findings with patient only if he is sure about management plan....
Need more neuroclubs n neuroradiology sessions for better team work
Need more neuroclubs n neuroradiology sessions for better team work
In certain areas of our noble profession, the human mind and brain are very essential and AI could be just an adjuvant but not a replacement for the treating doctor or interpreting Radiologist, also AI won't be a substitute for the Empathy factor for our patients. Thanks so very much for this initiative and and the role of Radiologist is very integral to our routine clinical practice.
In certain areas of our noble profession, the human mind and brain are very essential and AI could be just an adjuvant but not a replacement for the treating doctor or interpreting Radiologist, also AI won't be a substitute for the Empathy factor for our patients. Thanks so very much for this initiative and and the role of Radiologist is very integral to our routine clinical practice.
Pertaining to question 11. Radiologist who can examine the patient and reporting the MRI/CT can surely talk to patient regarding the findings. But, with only reports, it is only a legal document with lots of incidental findings. In this case, it is better the referring physician discuss with the patient.
Pertaining to question 11. Radiologist who can examine the patient and reporting the MRI/CT can surely talk to patient regarding the findings. But, with only reports, it is only a legal document with lots of incidental findings. In this case, it is better the referring physician discuss with the patient.
Many have the habit of adding at the end that the findings have to be correlated clinically; I think it's superfluous to state that.
Many have the habit of adding at the end that the findings have to be correlated clinically; I think it's superfluous to state that.
often the radiologist does not have a clear clinical picture of the patient and hence is at loss to accurately report the scan and so is the referral physician
often the radiologist does not have a clear clinical picture of the patient and hence is at loss to accurately report the scan and so is the referral physician
Radiologist should alert referring doctor if there is a need for immediate therapeutic intervention and /or unexpected findings
Radiologist should alert referring doctor if there is a need for immediate therapeutic intervention and /or unexpected findings
There are a number of occasions where report by a radiologist regarding diagnosis were correct ( will come to know when I operate) and equally true the reverse scenario also. When it comes to pure neurological illness like de-myelination the former scenario is true and the latter becomes relevant when the disease is of neurosurgical in nature. Hence I believe that the training and experience received by the radiologist and of the involved physician matters. But one more thing is physicians spends time to take history and elicit signs which enables them to draw differentials even before imaging.
There are a number of occasions where report by a radiologist regarding diagnosis were correct ( will come to know when I operate) and equally true the reverse scenario also. When it comes to pure neurological illness like de-myelination the former scenario is true and the latter becomes relevant when the disease is of neurosurgical in nature. Hence I believe that the training and experience received by the radiologist and of the involved physician matters. But one more thing is physicians spends time to take history and elicit signs which enables them to draw differentials even before imaging.
Doctor should practice as they are trained I have not seen a single radiologist interested in talking to patient or their relative ,while they are trained either MD / DNB institute/ hospital It’s only in private practice due to dilution of work such practice has started nowadays as a part of “hold over practice “ and competitive practice .
Doctor should practice as they are trained I have not seen a single radiologist interested in talking to patient or their relative ,while they are trained either MD / DNB institute/ hospital It’s only in private practice due to dilution of work such practice has started nowadays as a part of “hold over practice “ and competitive practice .
spine mri report has too much stuff regarding spine degenerative changes and disc bulge that brings anxiety to pt. radiologist should inform directly to consultant if any emergency finding they finds
spine mri report has too much stuff regarding spine degenerative changes and disc bulge that brings anxiety to pt. radiologist should inform directly to consultant if any emergency finding they finds
Q no 11 is a BIG Elephant in the room . There are patients who have been told to do an emergency evacuation of a Subdural hygroma , emergency surgery of a Low Grade Glioma, urgent lumbar spinal decompression etc etc etc. A lot depends on who is the radiologist . Must realize that the treatment is for the patient and not the scan ! !!!!!!
Q no 11 is a BIG Elephant in the room . There are patients who have been told to do an emergency evacuation of a Subdural hygroma , emergency surgery of a Low Grade Glioma, urgent lumbar spinal decompression etc etc etc. A lot depends on who is the radiologist . Must realize that the treatment is for the patient and not the scan ! !!!!!!
Should always give DD.
Should always give DD.
With reference to question no 11, i feel radiologist may discuss the findings provided they have the clinical background of the case and we don't end up confusing the patient more than they already are which commonly happens
With reference to question no 11, i feel radiologist may discuss the findings provided they have the clinical background of the case and we don't end up confusing the patient more than they already are which commonly happens
The best Diagnosis & Patient management is when Radiological correlation is there with clinical findings where the clinician knows the best
The best Diagnosis & Patient management is when Radiological correlation is there with clinical findings where the clinician knows the best
Particularly in spine MRI the most likely patholoic level should be described first. Other changes which are normal for the age should be mentioned as to me likely to be age related
Particularly in spine MRI the most likely patholoic level should be described first. Other changes which are normal for the age should be mentioned as to me likely to be age related
Radiologist should have some involvement in patient care so that he knows the implications of what he is saying and what the neurosurgeon is looking for. Simply recounting every finding and measuring every orifice is useless for the surgeon and confusing for the patient.
Radiologist should have some involvement in patient care so that he knows the implications of what he is saying and what the neurosurgeon is looking for. Simply recounting every finding and measuring every orifice is useless for the surgeon and confusing for the patient.
Anatomically and pathophysiologically structured radiological report with attention to surgical/medical questions asked while requesting radiological evaluation. Followed by opinion. May be in some cases discussion with the clinician and then final impression / suggestion.
Anatomically and pathophysiologically structured radiological report with attention to surgical/medical questions asked while requesting radiological evaluation. Followed by opinion. May be in some cases discussion with the clinician and then final impression / suggestion.
Should report to the point with clinical significance, abnormalities in scan without clinical significance should be avoided, should discuss with clinician about required findings
Should report to the point with clinical significance, abnormalities in scan without clinical significance should be avoided, should discuss with clinician about required findings
"For your clinical correlation" means accepting the lack of clinical acumen. Being MD in Radiology does not disqualify Radiologist from properly examining the patient. They can personally do a clinical evaluation before reporting. Most of us Neurosurgeons take decisions on surgery on Films and not on reports. Radiologist can suggest further study in the same sitting and discussing with the Neurosurgeons, when required Eg: MRI brain (plain) done for headache reveals a suspicious lesion which would require a contrast. Let it be done, after explaining the patient & discussing with the referred doctor.
"For your clinical correlation" means accepting the lack of clinical acumen. Being MD in Radiology does not disqualify Radiologist from properly examining the patient. They can personally do a clinical evaluation before reporting. Most of us Neurosurgeons take decisions on surgery on Films and not on reports. Radiologist can suggest further study in the same sitting and discussing with the Neurosurgeons, when required Eg: MRI brain (plain) done for headache reveals a suspicious lesion which would require a contrast. Let it be done, after explaining the patient & discussing with the referred doctor.
Only what is clinically relevant needs to be reported.
Only what is clinically relevant needs to be reported.
A comparison of responses from Nurologists and Neurosurgeons is here
A comparison of responses from Nurologists and Neurosurgeons is here
The background to this survey is at this link
The background to this survey is at this link
My comments on the results of the survey are at on this page
My comments on the results of the survey are at on this page
This survey no longer accepts responses An inactive copy of the survey form is at this link
This survey no longer accepts responses An inactive copy of the survey form is at this link
If you have any comments to offer, please use this form
If you have any comments to offer, please use this form
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