Pelvic Radiographic Imaging in Obese WomenThursday, October 18, 2012
Readers of these pages are probably well aware that increasing body size poses important challenges for many areas of health care. Not least, when it comes to diagnostic imaging.
A paper by Phyllis Glanc and colleagues from the University of Toronto, published in RadioGraphics provides a succinct overview of some of these challenges when it comes to radiographic imaging of the pelvis in obese women.
As the authors point out,
“Obesity can contribute to missed diagnoses, nondiagnostic results of imaging studies, imaging examination cancellation because of weight or girth restrictions, scheduling of inappropriate examinations, and increased radiation dose exposure.”
“The utility of the clinical examination is often limited in the obese woman, which results in an even greater reliance on imaging.”
“Recognition of equipment limitations, imaging artifacts, optimization techniques, and appropriateness of modality choices is critical to providing good patient care.”
Although quite technical (as one would expect), this article is probably a worthwhile read for anyone who orders or performs pelvic exams in obese women.
photo credit: EUSKALANATO via photopin cc
Glanc P, O’Hayon BE, Singh DK, Bokhari SA, & Maxwell CV (2012). Challenges of pelvic imaging in obese women. Radiographics : a review publication of the Radiological Society of North America, Inc, 32 (6), 1839-62 PMID: 23065172
Thursday, October 18, 2012
EQ (Emotional Quotient) evidenced in radiological diagnostic publishing.
I do not know the mindset of the authors or their motives, but from the quotes you provide Dr. Sharma, I believe that their choice of words is not in keeping with your philosophy. At least I’m pretty sure it is not.
“Obesity contributes” – huh?
Writing “obesity can contribute to missed diagnosis….” is either evidence of mindlessness – by highly respected radiological caregivers – or yet another form of subtle bullying. To author a paper, to review it for errors, to then publish it with one aspect of the end result being that certain words can be interpreted to read that the patient, the consumer of healthcare, the citizen having equal rights, is the one whose obesity contributes to a machine’s failure to diagnose” -?- well, it misses. At minimum, this flags a paramount need for policy mandating EQ checklists in medical publishing, and likely in the practice of radiology, medicine, and biomedical engineering. And of course a machine can not miss a diagnosis. Obviously a doctor and patient can miss “their” diagnosis if they have limited resources.
I would like to ask the authors why they could not have written something like: “Evidence reveals a failure of current biomedical engineering tools to adequately provide for patients…. Policy on weight and girth restrictions is evidenced…. Currently, biomedically engineered machinery evidences limitations causing various patients to be excluded……” and so forth.
If we don’t catch the subtle ways in which language can bully patients, we condone the bullying. When we catch the misapplication of words and point them out, we can then allow the good of the article to flow. In this case, the article reveals the need for quality patient care in diagnostic imaging as well as consequent challenges within the biomedical engineering field.
Today’s blog not only reveals mechanical engineering issues in diagnostic imaging, but it also demonstrates how we, including diagnostic imagers, can gain an understanding of mindlessness in the process of medical publishing. In doing so, we can effectively curtail any impression of subtle bullying, particularly via today’s blog. We can also encourage continued awareness via future publications. The hope would be to eradicate any impression of subtle bullying/discrimination in all medical publications.
It’s a tough go, but worth it. So, thanks again for this forum Dr. Sharma.
Thursday, October 18, 2012
Well noted Anon, perhaps the authors (and others) will take note of your comment for future communications.