Since 2018 we have solicited abstract submissions to the CAR Annual Scientific Meeting related to projects that exemplify the value of radiology. Through this category, the Canadian Association of Radiologists (CAR) and Canadian Radiological Foundation (CRF) aim to encourage and recognize research that explores how radiology adds value to the health care system, such as improving patient care or enabling cost savings.
This stems from the research that was published on the Value of Radiology in Canada. In 2016 the CAR commissioned the Conference Board of Canada’s Canadian Alliance for Sustainable Health Care to publish a study on the Value of Radiology in Canada. The report was published on January 26, 2017. This was followed by a subsequent report published on June 26, 2019, the Value of Radiology Part II focusing on medical imaging inventory in Canada and the economic impact of investing in Canadians.
Value of Radiology submissions should focus on radiologists’ activities that add value outside of traditional radiology services, such as the radiology report. Projects should be suitable to publicize or publish to a wider audience to demonstrate the value of radiology.
Submissions in this category are informative exhibits designed to review known or emerging facts related specifically to the value of radiology. One of the goals of this category is to encourage the radiology community to think more deeply about the services they provide and the level of active positive engagement they have within the healthcare system.
The presentation should provide a synthesis of information on various topics, relate them in new ways, or extract common threads from diverse data. For example, projects may consider how to improve the economic impact of diagnostic imaging, how radiology can enhance diagnostic capacity and appropriateness of care, or how radiology can drive healthcare system improvements and deliver optimal patient outcomes.
The projects should enhance and promote the value of radiology in Canada. Awards for the top three presentations sponsored by CAR/CRF.
Note: this competition is separate and distinct from the Department Clinical Audit Project (DCAP). The DCAP tends to focus on quality improvement within the workplace environment at mostly a departmental level.
Oral presentations of 10 minutes – 7 minute presentations + 3 minute Q&A sessions
Who Can Present?
Attending radiologists and radiologists-in-training (residents, fellows and medical students). Separate awards will be presented to attending radiologists and radiologists-in-training.
a) Leadership, for example radiologists’ involvement in multidisciplinary consensus guidelines creation; these can be at the hospital, local, provincial or national levels.
b) Management, for example the role of radiologists in streamlining workflows for patients, technologists or interactions with support staff. Various collaborations with hospital management or health authorities that result in improved quality of care would be eligible for this category.
c) Cost-effectiveness of radiologyas a specialty in healthcare; for example: cost savings related to the use of CT for assessing trauma versus exploratory laparotomy. New interventional radiology procedures that result in better outcomes and cost savings. Please see additional expanded examples provided below.
d) Radiology-specific and multi-disciplinary collaborations, for example the role of radiologists in multidisciplinary patient rounds and measurable effect on final patient management/disposition. Any initiative, which protects patients’ interests in terms of excess imaging/radiation and cost could be presented. This includes educational endeavors directed towards patients.
Note: Multi-disciplinary authorship is strongly encouraged for this Value-added category of submissions.
Please see examples of published abstracts that align with this category below. All abstracts must have a maximum of 250 words. One table, chart or graph in JPEG or PDF format is encouraged.
- Authors (Note: Multi-disciplinary authorship is strongly encouraged for this Value-added category of submissions.)
- Presenting Author’s level of training (Attending, fellow, resident, medical student)
Sample Published Abstract
Cost-effectiveness of Elective Endovascular Aneurysm Repair Versus Open Surgical Repair of Abdominal Aortic Aneurysms
Burgers LT1, Vahl AC2, Severens JL3, Wiersema AM4, Cuypers PW5, Verhagen HJ6, Redekop WK3.
The aim of this study was to estimate the lifetime cost-effectiveness of endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) in the Netherlands, based on recently published literature.
A model was developed to simulate a cohort of individuals (age 72 years, 87% men) with an abdominal aortic aneurysm (AAA) diameter of at least 5.5 cm and considered fit for both repairs. The model consisted of two sub-models that estimated the lifetime cost-effectiveness of EVAR versus OSR: (1) a decision tree for the first 30 post-operative days; and (2) a Markov model for the period thereafter (31 days-30 years).
In the base case analysis, EVAR was slightly more effective (4.704 vs. 4.669 quality adjusted life years) and less expensive (€24,483 vs. €25,595) than OSR. Improved effectiveness occurs because EVAR can reduce 30 day mortality risk, as well as the risk of events following the procedure, while lower costs are primarily due to a reduction in length of hospital stay. The cost-effectiveness of EVAR is highly dependent on the price of the EVAR device and the reduction in hospital stay, complications, and 30 day mortality.
EVAR and OSR can be considered equally effective, while EVAR can be cost saving compared with OSR. EVAR can therefore be considered as a cost-effective solution for patients with AAAs.
Cost-effectiveness of Stereotactic Body Radiation Therapy versus Radiofrequency Ablation for Hepatocellular Carcinoma: A Markov Modeling Study
Pollom EL1, Lee K1, Durkee BY1, Grade M1, Mokhtari DA1, Wahl DR1, Feng M1, Kothary N1, Koong AC1, Owens DK1, Goldhaber-Fiebert J1, Chang DT1.
To assess the cost-effectiveness of stereotactic body radiation therapy (SBRT) versus radiofrequency ablation (RFA) for patients with inoperable localized hepatocellular carcinoma (HCC) who are eligible for both SBRT and RFA.
Materials and Methods
A decision-analytic Markov model was developed for patients with inoperable, localized HCC who were eligible for both RFA and SBRT to evaluate the cost-effectiveness of the following treatment strategies: (a) SBRT as initial treatment followed by SBRT for local progression (SBRT-SBRT), (b) RFA followed by RFA for local progression (RFA-RFA), (c) SBRT followed by RFA for local progression (SBRT-RFA), and (d) RFA followed by SBRT for local progression (RFA-SBRT). Probabilities of disease progression, treatment characteristics, and mortality were derived from published studies. Outcomes included health benefits expressed as discounted quality-adjusted life years (QALYs), costs in U.S. dollars, and cost-effectiveness expressed as an incremental cost-effectiveness ratio. Deterministic and probabilistic sensitivity analysis was performed to assess the robustness of the findings.
In the base case, SBRT-SBRT yielded the most QALYs (1.565) and cost $197 557. RFA-SBRT yielded 1.558 QALYs and cost $193 288. SBRT-SBRT was not cost-effective, at $558 679 per QALY gained relative to RFA-SBRT. RFA-SBRT was the preferred strategy, because RFA-RFA and SBRT-RFA were less effective and more costly. In all evaluated scenarios, SBRT was preferred as salvage therapy for local progression after RFA. Probabilistic sensitivity analysis showed that at a willingness-to-pay threshold of $100 000 per QALY gained, RFA-SBRT was preferred in 65.8% of simulations.
SBRT for initial treatment of localized, inoperable HCC is not cost-effective. However, SBRT is the preferred salvage therapy for local progression after RFA.