Neuroimaging clinics of North America
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Society is increasingly demanding proof that imaging has an impact on patient outcome and questioning its cost on the health care delivery system. Radiologists should provide the following three key components in their research publications: (1) the statistical power and confidence intervals of the results obtained; (2) the diagnostic performance of the tests, including sensitivity, specificity, and ROC curves; and (3) comprehensive decision analysis and cost-effectiveness analysis to determine the impact that imaging has on health outcome, cost, and quality of life. Strict adherence to these evidence-based medicine principles would help advance the field and provide the best health care for patients.
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Neuroimaging Clin. N. Am. · May 2003
ReviewOccult spinal dysraphism: evidence-based diagnosis and treatment.
This article reviews the scientific evidence behind the diagnostic tools available for the appropriate workup and management of patients with occult spinal dysraphism (OSD). The diagnostic tools include the use of detailed history and physical examination, plain films, ultrasound, MR imaging, and neurophysiologic tests. In addition, the article discusses the epidemiology of the most common causes of OSD in children, which will allow physicians caring for children to develop a pretest probability of disease and make a more educated decision as to when additional diagnostic testing is required.
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Neuroimaging Clin. N. Am. · May 2003
ReviewHow different MR imaging criteria relate to the diagnosis of multiple sclerosis and its outcome.
This article reviews the evolution of MR imaging criteria used to diagnose multiple sclerosis (MS) over the past decade and a half to help demonstrate how these changes have influenced the sensitivity and specificity of diagnosing and treating patients with MS. The article discusses the benefits and drawbacks of making very specific diagnoses versus sensitive but less specific diagnoses. In addition, the application of these various diagnostic criteria to patient outcomes and clinical trials is reviewed.
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This article summarizes the evidence behind the imaging evaluation of scoliosis, which is primarily performed with plain radiographs and MR imaging. Issues related to the radiographic evaluation of spinal curvature include interobserver variability of scoliosis measurements and the radiologist's detection of unexpected findings. The effects of radiation exposure during scoliosis evaluation and strategies to minimize radiation dose are summarized. The use of MR imaging in idiopathic scoliosis is discussed, with special attention to imaging groups at higher risk for underlying pathology of the neural axis.
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Neuroimaging Clin. N. Am. · May 2003
ReviewBrain neoplasms: epidemiology, diagnosis, and prospects for cost-effective imaging.
Currently, the literature lacks a solid body of research on decision and cost-effectiveness analysis of imaging strategies for adults and children suspected of having a brain neoplasm. This article describes the epidemiology and clinical presentation of brain neoplasms, reviews current diagnostic strategies, highlights gaps in the literature on decision and cost-effectiveness analysis, and suggests directions for future research.