Robert E Koehler

University of Alabama at Birmingham, Birmingham, AL, United States

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Publications (4)6.73 Total impact

  • Journal of the American College of Radiology: JACR 04/2006; 3(3):220-2.
  • Cheri L Canon, Susan Mulligan, Robert E Koehler
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    ABSTRACT: To organize and implement a mock oral examination for radiology residents in an attempt to prepare them for the American Board of Radiology Oral Examination. A mock oral examination was administered to junior and senior radiology residents by radiology faculty. All participants completed postexamination surveys. The mock oral examination process not only provided practice for preboard residents, but also determined areas of deficiency in their fund of knowledge and presenting skills. Additionally, it provided faculty members with areas of curricular weakness. Administration of a mock oral examination reaps multiple benefits, which far exceed the task of its implementation.
    Academic Radiology 04/2005; 12(3):368-72. · 1.91 Impact Factor
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    ABSTRACT: The purpose of our study was to determine the effectiveness, clinical impact, and feasibility of double reading barium enemas. Independent double readings of 1,003 consecutive barium enemas (822 double- and 181 single-contrast examinations) were prospectively performed. From this pool of 1,003 examinations, 994 were included in our study. Examinations showing at least one polyp or carcinoma 5 mm or larger were considered to have positive results. For combined readings, results were considered positive if either of the two interpreters reported finding a polyp or carcinoma. A McNemar test was used to compare the first reader's results with the combined results of the first and second readers. Results were retrospectively correlated with endoscopic or surgical results in 360 patients, and agreement between first and combined readings and endoscopic results was determined. Adding a second reader increased the number of positive results on examinations from 249 to 315 (p < 0.0001) and resulted in potential alteration of clinical treatment in 98 patients (9.9%). Sensitivity of the first and combined readings for detection of all lesions was identical, 76.3% (95% CI, 65.4-87.1%). Specificity decreased from 91.0% (95% CI, 87.9-94.3%) for the first reading to 86.4% (95% CI, 82.2-90.0%) for the combined reading. The overall measurement of agreement decreased from a kappa value of 61.8 (95% CI, 51.2-72.4%) for the first reading to 52.9 (95% CI, 42.2-63.6%) for the combined reading. The second reading required an average of 3.3 min. Sensitivity for the detection of adenocarcinomas was 100%. Although feasible, double reading of barium enemas does not improve sensitivity for detection of polyps and produces a higher false-positive rate.
    American Journal of Roentgenology 01/2004; 181(6):1607-10. · 2.90 Impact Factor
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    ABSTRACT: The authors attempted to determine whether videotaping the fluoroscopic portion of hysterosalpingography would result in changed diagnoses or an increase in diagnostic confidence. Ninety-nine consecutive outpatients underwent routine hysterosalpingography. The fluoroscopic portion of the examination was captured on videotape. Two consecutive interpretations of each hysterosalpingogram were made by attending radiologists. First, spot radiographs were interpreted alone. Second, these images were viewed along with videofluoroscopy. Concordance of and confidence in findings for the two interpretations were assessed with the two-tailed Fisher exact test. Interpretations of spot radiographs alone and with videofluoroscopy were in agreement in 92 of 99 uterine examinations and 164 of 198 tubal examinations. For uterine examinations classified as normal, interpretations of spot radiographs and videofluoroscopy were in agreement in 56 of 57 cases; there was no change in confidence with review of videofluoroscopic images. For uterine examinations interpreted as abnormal, agreement was noted in 36 of 42 cases (P = .04), and confidence increased with videofluoroscopy in 10 of 42 cases (P = .00001). With normal tubal findings, interpretations agreed in 94 of 118 cases, and confidence increased in 56 of 118 cases (P = .002). With abnormal tubal findings, interpretations agreed in 70 of 80 cases, and confidence increased in 20 of 80 cases (P = .002). When findings with and without videofluoroscopy were discordant, confidence was always higher after review of video-fluoroscopic images. Review of videofluoroscopic images obtained during hysterosalpingography increases the accuracy and confidence of diagnoses compared with review of spot radiographs alone.
    Academic Radiology 08/1998; 5(7):480-4. · 1.91 Impact Factor