Jeff Ware

Not every intracerebral hemorrhage needs a CTA Am I just screaming into the void? karger.com/ced/article/do…

@francisdeng While much attention is paid to false positives/overdiagnosis etc, this is why these screening mri companies will fail. These scans accumulate so many medicolegal landmines that bad outcomes can now be traced back to (rightly or wrongly)

The merits of this case are going to come down to causation. The radiologist missed a R MCA moderate stenosis. But for that miss, though, would the patient have developed a stroke months later? Is primary prevention even indicated and how much risk reduction can it achieve?

@francisdeng @prenuvo “This stenotic vessel could have been treated with targeted stenting”. 🥴

New lawsuit alleges that this allegedly 60% MCA stenosis was missed on a @prenuvo whole body MR and led to an allegedly preventable stroke. Would you have called it? radiologybusiness.com/topics/healthc…

Among 241 persons with disorders of consciousness who had no observable response to commands, 25% had a verifiable response to commands on EEG or functional MRI, a condition known as cognitive motor dissociation. Read the full study results: nej.md/3X2abYs

This research was a team effort—many thanks to all who contributed. It truly takes a village. #radiomics, @TheASNR @adamcresnick @PennRadiology @NastranKhalili @jeffbware ajnr.org/content/early/…

@VPrasadMDMPH Everyone will say Nadal Fed 2008 Wimbledon but the match I most lived and died with was Roddick Federer 2009 Wimbledon

Greatest match of all time or no? (If no, then...)

@francisdeng Pretty disheartening to see a case like this largely pinned on 2 residents who seemed to be trying their best

What do you think? Do we need more assurances of radiology resident competency for critical diagnoses before call? Do we need around the clock radiology attending or neurology or neurointerventional attending image review of all stroke codes?

DAMAGES: Past+future pain and suffering: $9+42 million Past+future medical care: $0.55+34.6 million Past+future damage sustained by his wife for loss of services and society: $9.4+41.6 million Total ~$137 million

@emigal @ezrainc You may be in a world of hurt once all the bad things being missed by these scans start manifesting

I believe we have a cure for cancer. Early detection. Here’s how @ezrainc plans to detect cancer early for everyone in the world (the secret Ezra master plan): Step 1 (done): Launch a 60-minute full-body MRI that screens for cancer and 500 other conditions in up to 14 organs. Priced at the high end of the market (that’s our Full Body Plus, priced at $2350). Step 2 (done): Use the success of our high end scan to roll out a more affordable 30-minute scan (Ezra Flash). We integrated our proprietary FDA-cleared Ezra Flash AI to create a scanning protocol with twice the speed and the same image quality. We're proud to offer a faster scan that's 35% cheaper than our standard Full Body. It’s the fastest, most accurate, most affordable Full Body MRI in the world. Step 3 (In progress): Use the success of the 30-minute scan to create a 15-minute scan. It’s still early, but we’re confident we can achieve this in 2-3 years. It will be priced at just $500, and we’re aiming to get payor reimbursement for it. Now, here’s 3 things I’m excited about for the future: 1) The most advanced AI company in the cancer screening space Ezra is the only company in the world that leverages AI across the entire screening process: • The scan itself (Ezra Flash AI) • The radiology read (Ezra Assist AI, currently FDA-cleared for Prostate) • The report generation (Ezra Reporter AI) 2) The (data) moat We've been rolling out an AI each year for the past three years. This is incredibly hard to achieve (most medical startups take 3+ years per AI). One key to our success has been our proprietary dataset of full body MRI data: Over the past 5 years, we’ve built the most comprehensive dataset of full body MRI scans ever done in an asymptomatic, screening population. For the geeks reading this: We have multiple terabytes of data across millions of MRI images, from over 5,000 individuals. Roughly half of our members have come back for a second annual scan, and some of them are on their third or fourth. This longitudinal dataset enables Ezra to find changes in the body much earlier than we would by looking at a single data point. We gather data regarding findings from our scans, and follow up diagnostic scan/biopsy data. To best leverage our dataset, we’ve built a number of internal tools to: • Curate • Anonymize • Create AI training pipelines We experiment with multiple AI model variations/week. 3) What's next Our team is working hard on several incredible innovations that are pushing the boundaries of what’s possible with MRI. I get an email every week from someone who discovered cancer through an Ezra scan. Many of the individuals who reach out have gotten treatment and are now cancer-free. We’ve literally saved their lives. I’m hopeful our 30-minute scan will enable more people to be able to afford Ezra, and I’m excited to see what our amazing team will accomplish in the next 5 years. Get screened - it can save your life. – Follow me @emigal or emigal.com for more.

@northwoods1980 What a terrible metric to use. Nearly every scan could be said to have an actionable finding (athero, djd etc)

82% of CTA head and neck scans in 1 emergency department had no actionable findings radiologybusiness.com/topics/healthc…

@RogueRad @francisdeng I sort of admire them for trying to take this on. But everyone knows this is going to be flat out ignored

CT not recommended for dizziness. What’ll this edict do to frequency of stat MRIs? onlinelibrary.wiley.com/doi/ftr/10.111… @francisdeng

@jbcarmody The claim that “the value of the work each resident performs annually is $232,726” is in desperate need of a fact check

Today is the first day of Resident Appreciation Week! Now, I know you’re all excited for “Thank A Resident Day” on February 24, but let’s start the week with a question: How much are resident physicians worth? thesheriffofsodium.com/2022/02/04/how…

Our work in Automated Segmentation in pediatric #brain tumor is available @medrxivpreprint This model allows segmentation of all #RAPNO labels Thank you @anahita_fathi for leading this @CBTNetwork @NeuroradAI @jeffbware @MariamAboian @FamiliarAriana @Sina_Bagherii @NastranKhalili

@DrGRuralMD 😂

@becker_rad 🙏

95% of radiology departments would do well to direct 100% of their AI efforts and budget towards upgrade and maintenance of PACS, RIS and dictation software for the next 5 years Our field is plagued by legacy software

@PulmCrit An alternative explanation is that a positive CT is a self fulfilling prophecy. I’m also not sure I would call interpretation of MRI subjective or at least not more subjective e than CT

what do folks think about CT-vs-MRI? the evidence base for CT isn't gigantic, but I think it's better than the data for MRI. MRI requires subjective interpretation which introduces a source of bias 😤 more on quantitative CT for prognostication IBNCC: #CT_scan,_quantitative" target="_blank" rel="nofollow noopener">emcrit.org/ibcc/np/#CT_sc…

I think this paper by the Nielsen group on the use of CT scans to neuroprognosticate after cardiac arrest may be a game-changer. But it will take a few tweets to explain why... 🧵 pubmed.ncbi.nlm.nih.gov/35931271/

@XavierHelgesen Have you ever wondered why this kind of thing is only ever advocated by people who aren’t doctors

@becker_rad I agree that phrase is annoying but this thread simply boils down to different ways of saying the same thing

Radiology reporting tip for #Radres Do not use the term "cannot be excluded". You can never exclude anything. That is not the radiologists' job. Our job is to describe the findings and assign a likelihood for something to be present or absent, based on history and imaging.

@Kedz That doesn’t look like philly

Not a bad start to the day.

@fatnutritionist Can you explain the calculus that says going camping in bear country is safe but going camping in bear country with caramels is not?

Even if you don't experience a bad outcome, whenever public health measures are removed, it means dice have been thrown that effectively gamble your life and safety. And they are thrown by people with the power to weight those dice in their own favour, regardless of yours.

This point in the pandemic reminds me of when I went camping with friends in an area where I'd previously run into bears. One friend kept a bag of caramels in her tent overnight though I begged her not to. No bears came overnight. She took it as proof that there was never a risk.

Why is "mental health" so popular/ "mental illness" neglected? Clinicians: Easiest people to treat dont need it. Public: Identify with MH issues/stigmatize MI Media: MH sells/MI repels Politicians: MH voters>MI voters Result: Resources are wasted on MH & denied to MI.