A Call for AI Education

“Rather than succumb to fear and skepticism, future radiologists must be equipped with a working knowledge of ML to leverage the tools as they are deployed.”

Mass General Hospital radiologist, Monica J. Wood (and team), in an editorial on the growing gap between the role of AI/ML in radiology and the level of AI education/understanding.


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The Imaging Wire

A Call for AI Education
Despite the growing adoption of AI in radiology and the widespread expectation that radiologists will increasingly use AI/ML-based solutions in their daily work, there’s still a lack of formalized AI-related education available to radiologists, and therefore a general lack of AI understanding. That’s from a JACR editorial highlighting the need for (much) more AI training to ensure that radiologists understand how AI works and how to safely and effectively use the solutions available to them. The researchers urged radiology and medical imaging organizations to create curriculum covering all stages of AI (model development, translation, and clinical use), while suggesting that radiologists build their own understanding by getting involved in AI-related projects.


Mammography’s Big(ger) Three
IHS Market reported that the global mammography equipment market’s huge growth in 2017 allowed the segment’s leaders to capture an even greater share of the market. Hologic maintained its dominant position with an over 50% share, GE Healthcare (~20%) achieved the most growth to strengthen its second place position, and Siemens Healthineers (~10%) grew enough to keep its third spot (followed by Fujifilm and Philips). IHS Market attributed the big three mammography players’ growth to their innovative products (mainly 3D and comfort-related), which drove their sales in developed markets, while smaller players targeted emerging markets and struggled due to low demand compounded by low unit pricing. Strong performance in developed mammography markets was the name of the game in 2017, as these country’s well-established/funded screening programs drove replacement sales (W. Europe, N. America, S. Korea, and Japan). Although posting slower growth in 2017 than other developed regions, the US remained dominant, representing over half of all global mammography equipment revenue and 3D unit shipments.


Evidence for 3CB-Radiomics
A new study found that breast tissue composition data from three-compartment breast (3CB) imaging, analyzed using a radiomics CAD algorithm, could improve physicians’ ability to predict cancer and significantly reduce unnecessary biopsies. This latest study in support of 3CB imaging used 109 dual-energy mammograms that were identified as “suspicious or highly suggestive” of a malignancy (would typically be immediately biopsied), applying 3CB imaging and mammography radiomics to achieve an almost 50% positive predictive value (vs. 32% for visual interpretation), a 97% sensitivity rate (correctly ID’d 34/35 cancerous tumors), and a 36% reduction in unnecessary biopsies. The researchers were most excited about 3CB-radiomics’ ability to reduce biopsies, which combined with the fact that it can be implemented without major changes to existing mammography equipment, could earn the technique a role in breast cancer screening and diagnosis practices.


Healthcare’s Fax Dependency Goes Viral
The role of the fax machine in healthcare was a major topic in the news this week, following the UK NHS’ announcement that it will stop using the devices by 2020, aligning with the US CMS’ previously-announced (but possibly less-firm) 2020 goal. Dozens of publications (CNBC, the BBC, Vox, Forbes – plus all the healthcare and tech sites) covered the story, with angles ranging from how and why fax machines are still being used in healthcare, the experiences of young doctors learning to use fax machines for the first time (in addition to learning medicine), and how healthcare may be able to break its fax addiction. This was about as viral as a non-clinical healthcare tech story gets, but it’s really a story about interoperability and change management, and an important notice that more heavy-handed, NHS-style approaches to pull the plug on fax machines in healthcare may be on the way. This is probably a good trend to get in front of.


The Healthcare IT Bubble
A KPMG and Leavitt Partners survey of healthcare investors (n=175) found that, much like FANG stocks in 2018, healthcare IT will go into 2019 as a hot investment target that is also widely viewed by investors as overvalued. Healthcare IT led all segments in terms of investor interest (34% “most interested” in HIT), and despite the fact that 64% of all investors viewed healthcare IT companies as overvalued (12.5x acquisition multiplier vs. EBITDA), the vast majority of investors expect healthcare IT valuations to increase (40%) or stay the same (51%) in 2019. This doesn’t seem like a sustainable trend, but it’s an interesting one to watch, and could be a sign that it’s a good time to sell your HIT business while multipliers are in double digits. Notable from a radiology perspective, investors are also interested in Specialty Physician Groups (19% “most interested”, 8.9x acquisition multiplier) and Medical Devices (10% “most interested”).


The Wire

  • Primary care providers hold-back on MRI orders when they know they’ll be graded against their peers on guideline adherence. This is from a recent study (n=54 PCPs, 9,349 visits) that used clinical decision support programs (CDS) to send primary care providers (PCP) report cards following lumbar spine MRI orders for lower back pain and/or notify PCPs immediately upon ordering a nonadherent scan. The PCPs who received report cards on their rate of adherent and nonadherent LS MRI orders reduced their orders by 37% the following month, while PCPs who received both report cards and alerts reduced their orders by 27%. Interestingly, PCPs who only received alerts (no report cards) did not reduce their orders, suggesting that the context provided by the report cards is the most effective way to promote cost-conscious healthcare (and maybe that EHR alert fatigue is real).


The Resource Wire

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