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Biomedical subjects

Stephen R Baker

Publications and source records attributed to Stephen R Baker.

17 recordsLinked to original sources
PubMed2005

Quality and operations of portable X-ray examination procedures in the emergency room: queuing theory at work.

The objective of this study was to evaluate the operation of the portable X-ray machine in relation to examinations ordered by the Emergency Department at the University of Medicine and Dentistry of New Jersey, as well as to identify any bottlenecks hindering the performance of the aforementioned system. To do so, the activity of the portable X-ray was monitored in the period from 8 June 2004 to 24 June 2004, as well as from 6 July 2004 to 12 July 2004, yielding 11 days of data and 116 individual X-ray examinations. During observation times was noted for various checkpoints in the procedure. Using the data gathered, the average input, output, processing times, and variance were calculated. In turn, these values were used to calculate the response times for the Ordering Phase (5.502 min), traveling (2.483 min), Examination Phase (4.453 min), returning (3.855 min), Order Processing Phase (2.962 min), and the Development Phase (3.437 min). These phases were combined for a total of 22.721 min from the time the examination was placed to the time the X-ray films were uploaded to the PACS computer network. Based on these calculations, the Ordering Phase was determined to be the single largest bottleneck in the portable X-ray system. The Examination Phase also represented the second largest bottleneck for a combined total of 44% of the total response time.

Computer Communication Networks↗
PubMed2005

The radiology assistant: a contrarian's view.

Recent and rapid increases in the utilization of diagnostic imaging have not been matched by concomitant additions to the supply of radiologists and radiology technologists. One proposal to alleviate an expected worsening of this emerging workforce crisis is to create a new job category, the radiology assistant (RA), encompassing a roster of enhanced capabilities that would allow the radiologists to divest themselves of some of their non-interpretative duties with respect to the performance of imaging tests. Through the collaborative efforts of the American College of Radiology and the American Society of Radiology Technologists a nationally recognized, baccalaureate-level curriculum has been designed for the training of RAs. A centerpiece of the curriculum is instruction in fluoroscopy. However, examinations of the GI tract by fluoroscopy are rapidly declining in frequency, raising doubt about the enhanced value an RA would bring to a radiology practice in the near future and worries about encroachment on the range of radiologists' responsibilities over the long term.

Diagnostic Imaging↗
PubMed2004

Histopathologic evaluation of tissue extracted on the radiofrequency probe after ablation of liver tumors: preliminary findings.

OBJECTIVE: Our aim was to evaluate the histologic characteristics of tissue extracted on the probe immediately after radiofrequency ablation of malignant tumors in the liver. MATERIALS AND METHODS: From April to December 2001, 20 radiofrequency ablations were performed in 19 patients with primary (n = 17) and metastatic (n = 2) liver masses. Track ablation according to device protocol was performed after each ablation. Tissue was adherent to the probe after all radiofrequency probe passes. All pieces of tissue found on the probe were collected and preserved in formalin. RESULTS: Tissue was examined by the study pathologist. In eight (40%) of 20 specimens, coagulation necrosis was present. In five (25%) of 20 specimens, possibly nonviable tissue was extracted, although some cell characteristics were identified. In seven (35%) of 20 specimens with hepatocellular carcinoma, possibly viable tissue was found. Five specimens were identified as hepatocellular carcinoma, and two, as cirrhotic nodules. CONCLUSION: Histopathologic evaluation of the tissue extracted on the radiofrequency probe after ablation is feasible. This study showed that coagulation necrosis was clearly present in at least 40% of the patients, which proves that nonviable tissue can be seen immediately after ablation. Whether this pathologic finding has prognostic value is not known.

Adult↗
PubMed2003

Call back or else.

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Communication↗
PubMed2003

Sickle crisis.

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Acute Disease↗
PubMed2002

Filmless in New Jersey: the New Jersey Medical School PACS Project.

Transitioning to a filmless department is no easy task, especially at a large academic medical center. At the University of Medicine and Dentistry of New Jersey-New Jersey Medical School, a phased modality integration schedule was implemented to allow the technical and clinical staff to gradually absorb all of the changes to workflow. One-on-one training sessions were designed to prepare radiologists and referring clinicians to access and navigate the in-house picture archiving and communication system (PACS) workstations as well as to view images over the Internet via the PACS Web server. An interdepartmental steering committee was formed to plan deployment of the in-house workstations. A planning committee met on a weekly basis to outline placement of workstations within the Radiology Department, and to redesign the reading room. A user group was created to discuss specific user problems. Of particular interest was the challenge of outfitting a dozen conference rooms with projection systems capable of displaying radiologic images. We distinguished between regular and working conferences. At regular conferences only a few cases are reviewed over the course of an hour and only after the diagnosis has been made at a PACS workstation. In contrast, the surgical and medical intensive care units conduct daily working conferences. At those sessions the images of 20 to 30 patients are reviewed, many of them for the first time, and for each case a definitive diagnosis is expected. During the implementation process, a range of issues came up that limited access of certain studies to radiologists and referring clinicians alike. Even after the initial PACS installation, many studies went unread because of a lack of worklists. Other problems included image ordering for head computed tomography and magnetic resonance imaging. A few of our modalities were not DICOM compliant and needed image capture devices in order to be integrated with the PACS. To our dismay, this was also true of one of our modalities that was supposed to be DICOM compliant. These problems, and the solutions we discovered, are discussed in this paper.

Academic Medical Centers↗