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Editor's Notebook: March 2024

Rosenkrantz, Andrew B
PMID: 38536405
ISSN: 1546-3141
CID: 5644912

Editor's Notebook: January 2024

Rosenkrantz, Andrew B
PMID: 38294321
ISSN: 1546-3141
CID: 5627102

The Neiman Imaging Comorbidity Index: Development and Validation in a National Commercial Claims Database

Pelzl, Casey E; Rosenkrantz, Andrew B; Rula, Elizabeth Y; Christensen, Eric W
OBJECTIVE:To build the Neiman Imaging Comorbidity Index (NICI), based on variables available in claims datasets, which provides good discrimination of an individual's chance of receiving advanced imaging (CT, MR, PET), and thus, utility as a control variable in research. METHODS:This retrospective study used national commercial claims data from Optum's deidentified Clinformatics Data Mart database from the period January 1, 2018 to December 31, 2019. Individuals with continuous enrollment during this 2-year study period were included. Lasso (least absolute shrinkage and selection operator) regression was used to predict the chance of receiving advanced imaging in 2019 based on the presence of comorbidities in 2018. A numerical index was created in a development cohort (70% of the total dataset) using weights assigned to each comorbidity, based on regression β coefficients. Internal validation of assigned scores was performed in the remaining 30% of claims, with comparison to the commonly used Charlson Comorbidity Index. RESULTS:The final sample (development and validation cohorts) included 10,532,734 beneficiaries, of whom 2,116,348 (20.1%) received advanced imaging. After model development, the NICI included nine comorbidities. In the internal validation set, the NICI achieved good discrimination of receipt of advanced imaging with a C statistic of 0.709 (95% confidence interval [CI] 0.708-0.709), which predicted advanced imaging better than the CCI (C 0.692, 95% CI 0.691-0.692). Controlling for age and sex yielded better discrimination (C 0.748, 95% CI 0.748-0.749). DISCUSSION/CONCLUSIONS:The NICI is an easily calculated measure of comorbidity burden that can be used to adjust for patients' chances of receiving advanced imaging. Future work should explore external validation of the NICI.
PMID: 38276924
ISSN: 1558-349x
CID: 5625402

The Yellow Journal: A Look Back at 2023 [Editorial]

Rosenkrantz, Andrew B
PMID: 38090809
ISSN: 1546-3141
CID: 5589272

An Examination of Racial and Ethnic Disparities in the Use of Prostate Biopsy and Magnetic Resonance Imaging in Prostate Cancer Screening

Chartrand, Nicholas; Stecher, Chad; Rajendra, Shubhsri; Rosenkrantz, Andrew B.; Duszak, Richard; Hughes, Danny R.
Introduction:We assessed racial and ethnic disparities in the use of prostate biopsy or MRI following an elevated PSA result.Methods:We retrospectively evaluated insurance claims from Optum's de-identified Clinformatics Data Mart database from January 1, 2011 to December 31, 2017. This was a large commercially insured cohort from across the United States. We included all male enrollees over 40 years old receiving an elevated PSA result with no prior prostate biopsy or MRI and no confirmed urinary tract infection within 6 weeks of PSA test.Results:A total of 765,409 participants met inclusion criteria with 43,711 (5.71%) receiving a PSA result above 4 ng/mL. Of these, 7,399 received either a prostate biopsy or MRI within 180 days. Men between ages 40-54 (29.48%) were most likely to receive prostate biopsy or MRI after an elevated PSA, followed by those between 55-64 (24.91%), 65-74 (18.56%), 75-84 (6.33%), and above 85 (3.62%). Compared to White patients, Black patients were more likely to receive either a prostate biopsy or MRI (OR: 1.16, 95% CI: 1.01, 1.32) following an elevated PSA level, while Asian (OR: 0.72, 95% CI: 0.54, 0.96) and Hispanic (OR: 0.83, 95% CI: 0.70, 0/97) patients were less likely.Conclusions:Physicians appear to be following the reported statistical incidence of prostate cancer by race and ethnicity when using prostate biopsy or MRI for patients with elevated PSA levels. These results demonstrate the importance of publishing statistical data on disease incidence by race and ethnicity for informing physicians' decision-making.
ISSN: 2352-0779
CID: 5621232

Reply by Authors

Chartrand, Nicholas; Stecher, Chad; Rajendra, Shubhsri; Rosenkrantz, Andrew B.; Duszak, Richard; Hughes, Danny R.
ISSN: 2352-0779
CID: 5621212

Editor's Notebook: September 2023 [Editorial]

Rosenkrantz, Andrew B
PMID: 37607207
ISSN: 1546-3141
CID: 5598392

Editor's Notebook: August 2023 [Editorial]

Rosenkrantz, Andrew B
PMID: 37478381
ISSN: 1546-3141
CID: 5536202

American College of Radiology initiatives on prostate magnetic resonance imaging quality

Purysko, Andrei S; Tempany, Clare; Macura, Katarzyna J; Turkbey, Baris; Rosenkrantz, Andrew B; Gupta, Rajan T; Attridge, Lauren; Hernandez, Dina; Garcia-Tomkins, Kandice; Bhargavan-Chatfield, Mythreyi; Weinreb, Jeffrey; Larson, David B
Magnetic resonance imaging (MRI) has become integral to diagnosing and managing patients with suspected or confirmed prostate cancer. However, the benefits of utilizing MRI can be hindered by quality issues during imaging acquisition, interpretation, and reporting. As the utilization of prostate MRI continues to increase in clinical practice, the variability in MRI quality and how it can negatively impact patient care have become apparent. The American College of Radiology (ACR) has recognized this challenge and developed several initiatives to address the issue of inconsistent MRI quality and ensure that imaging centers deliver high-quality patient care. These initiatives include the Prostate Imaging Reporting and Data System (PI-RADS), developed in collaboration with an international panel of experts and members of the European Society of Urogenital Radiology (ESUR), the Prostate MR Image Quality Improvement Collaborative, which is part of the ACR Learning Network, the ACR Prostate Cancer MRI Center Designation, and the ACR Appropriateness Criteria. In this article, we will discuss the importance of these initiatives in establishing quality assurance and quality control programs for prostate MRI and how they can improve patient outcomes.
PMID: 37352683
ISSN: 1872-7727
CID: 5543002

Did They Really Just Say That?-The Academic Perspective

Nathan, Jennifer; Lexa, Frank J; Friedberg, Eric; Johnson, Pamela T; Rosenkrantz, Andrew B; Shah, Gaurang
PMID: 35985632
ISSN: 1558-349x
CID: 5300352