Edward Weinberger

Seattle Children's Hospital, Seattle, Washington, United States

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Publications (21)30.09 Total impact

  • Ramesh S Iyer, Andrew Munsell, Edward Weinberger
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    ABSTRACT: Peer review is a requisite for a comprehensive quality assurance program. Although RADPEER implementations have been well documented, the feedback process has been underemphasized. Our radiology department developed feedback scorecards to address this gap. In this article, we describe our scorecard components, the software applications we independently created and utilize, and how they align missions of quality improvement and radiologist education. The result is a web-based, comment-enhanced, monthly feedback scorecard that to our knowledge is the first of its kind described in the literature.
    Current problems in diagnostic radiology. 07/2014; 43(4):169-74.
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    ABSTRACT: LEARNING OBJECTIVES As healthcare costs become a primary area of emphasis, the "premium" that was allowed for academic medical centers is no longer in place. However, optimal care at acceptable cost is readily attainable in an academic center when the missions of the academic department and the hospital are aligned. In this presentation, the learner will recognize approaches to educating the next generation of radiologists while improving access, decreasing overutilization, enhancing safety and decreasing cost.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
  • Journal of the American College of Radiology 08/2013; 10(8):627-632. · 2.10 Impact Factor
  • Ramesh S Iyer, Jeffrey P Otjen, Edward Weinberger
    Journal of the American College of Radiology: JACR 03/2013;
  • Shawn E Parnell, Corey Wall, Edward Weinberger
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    ABSTRACT: BACKGROUND: Skeletal dysplasias are conditions of abnormal bone and cartilage growth resulting in short stature. Developing expertise in the radiographic evaluation of dysplasias can be difficult because more than 250 skeletal dysplasias have been described. Exhaustive description of individual dysplasias can be found in hard copy textbooks, without the ability to compare dysplasias side by side. OBJECTIVE: To provide radiographic images of several common skeletal dysplasias with comparative normal skeletal surveys, thus facilitating understanding of the terminology and differences in imaging appearances commonly encountered in interpreting dysplasias. MATERIALS AND METHODS: Images from skeletal surveys obtained at our institution from 2006 to 2010 were compiled and reviewed for best quality images. Selected surveys were divided into body parts. The software program used for viewing the atlas permits linked scrolling, resizing of images, and simultaneous comparison of cases. RESULTS: Radiographic images for 13 common skeletal dysplasias and 3 comparative normal skeletons (neonate, infant and child) are provided as an interactive digital atlas. CONCLUSION: The placement of images of several common skeletal dysplasias with descriptive text in an interactive and comparative format facilitates understanding of basic radiographic terminology and appearances. We describe the atlas and discuss skeletal survey interpretation.
    Pediatric Radiology 03/2013; · 1.57 Impact Factor
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    ABSTRACT: The objective of our study was to categorize radiologist peer review comments and evaluate their functions within the context of a comprehensive quality assurance (QA) program. All randomly entered radiology peer review comments at our institution were compiled over a 1-year period (January 1, 2011, through December 31, 2011). A Web-based commercially available software package was used to query the comments, which were then exported into a spreadsheet. Each comment was then placed into a single most appropriate category based on consensus decision of two board-certified pediatric radiologists. QA scores associated with each comment were recorded. A total of 427 peer review comments were evaluated. The majority of comments (85.9%) were entered voluntarily with QA scores of 1. A classification system was devised that augments traditional error classification. Seven broad comment categories were identified: errors of observation (25.5%), errors of interpretation (5.6%), inadequate patient data gathering (3.7%), errors of communication (9.6%), interobserver variability (21.3%), informational and educational feedback (23.0%), and complimentary (11.2%). Comment-enhanced peer review expands traditional diagnostic error classification, may identify errors that were underscored, provides continuous educational feedback for participants, and promotes a collegial environment.
    American Journal of Roentgenology 01/2013; 200(1):132-7. · 2.90 Impact Factor
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    ABSTRACT: PURPOSE/AIM 1. Radiology online resources are ubiquitous and include teaching files, case collections, lectures, training modules, journals with online content, and more recently podcasts. 2. It is time consuming for trainees and practitioners to know which online resources have trustworthy information, and to organize them for learning and quick reference. 3. We present an application to access these resources on smartphones and portable devices. CONTENT ORGANIZATION 1. 348 free radiology online resources have been organized into the following categories: radiologic anatomy, radiology physics, radiology teaching file collections, open access lectures, MSK radiology, nuclear medicine, neuroradiology, breast imaging, chest imaging, cardiac imaging, gastrointestinal and genitourinary radiology, pediatric radiology, ultrasound, emergency imaging, miscellaneous, radiology journals, radiology societies, medical education, radiology freeware, and productivity tools. 2. To the best of our knowledge a mobile application to organize radiology education online content allowing trainees to supplement their learning has not been developed. SUMMARY 1. Our application is accessible from any smartphone or portable device such as iphone, ipad, android platform among others, providing a valuable tool for organized access to the high-quality online radiology resources.
    Radiological Society of North America 2012 Scientific Assembly and Annual Meeting; 12/2012
  • Jason N Nixon, Luana A Stanescu, Edward Weinberger
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    ABSTRACT: Spinal cord signal abnormality resulting from alterations in cerebrospinal fluid flow at the craniocervical junction has been termed a presyrinx state. This condition has been described in the adult literature in association with a variety of conditions that cause obstruction to normal cerebrospinal fluid flow. We present a case of presyrinx in a child in the setting of acquired Chiari I malformation caused by lumboperitoneal overshunting. Awareness of the potentially reversible nature of this condition might allow for intervention before irreversible neurological damage has occurred.
    Pediatric Radiology 08/2012; · 1.57 Impact Factor
  • Journal of the American Academy of Dermatology 07/2012; 67(1):e62-4. · 4.91 Impact Factor
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    ABSTRACT: A 5-month-old previously healthy girl presented to the emergency department with a large palpable nontender mass in the hypothenar soft tissues of her left hand. US revealed a well-demarcated nonvascular soft tissue mass. Subsequent MR imaging showed a rim-enhancing mass with heterogeneous intrinsic signal characteristics. Abscess and necrotic tumor were the primary considerations. Surgery demonstrated a thrombosed aneurysm continuous with the ulnar artery system. The aneurysm was resected and the ulnar artery was ligated at the wrist.
    Pediatric Radiology 06/2012; 42(11):1401-4. · 1.57 Impact Factor
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    ABSTRACT: Peer review has become an essential component of a comprehensive radiology department quality assurance program. Multiple commercial programs, such as RADPEER, are available to fill this need but may be limited by low radiologist compliance and delayed or limited feedback. Consequently, these peer review programs may not achieve the greater goal of improving diagnostic quality. This article presents data from a peer review system implemented in an academic radiology group at a large urban multidisciplinary children's hospital. The peer review system offered instantaneous feedback with an enhanced comment feature for peer radiologists. Peer review data were collected on 5278 radiologic studies over a 12-month period including 15 radiologists. The data were analyzed for compliance rate, discrepancy rate, and comment usage. The compliance rate for peer review averaged 52% for the 12-month period. The compliance rate trended upward over the course of the year, with a final month's compliance rate of 76%. The discrepancy rate between original interpretation and peer review was 3.6%. Comments were voluntarily included in 7.3% of nondiscrepant peer review scores. Our peer review process was enhanced by real-time comment-enriched feedback on both discrepant and nondiscrepant peer reviews. We show improved radiologist compliance over the course of a year in a peer review program with no incentives or penalties for performing reviews. To our knowledge, no compliance rates exist in current literature for comparison.
    American Journal of Roentgenology 05/2012; 198(5):1121-5. · 2.90 Impact Factor
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    ABSTRACT: The authors created a computer-based, interactive atlas of pediatric chest radiographs to facilitate (1) understanding of normal variants and (2) interpretation of pediatric chest radiographs in the acute setting. Seventy-three normal pediatric chest radiographs were selected for inclusion in the atlas by consensus after review by 3 pediatric radiologists. Sixteen abnormal pediatric chest radiographs showing a variety of abnormalities (infection, malignancy, congenital abnormalities, foreign body, and acquired disease), as well as 4 normal adult chest radiographs, were also included in the atlas. Images for the atlas were derived from Digital Imaging and Communications in Medicine-compliant data. The atlas software was written in C# and offers features of a picture archiving and communication system viewer. In addition, the atlas offers annotated series that describe particular radiographic features of normal variants and disease. The digital, interactive pediatric chest atlas displays normal chest radiographs of children aged 7 days to 17.8 years, as well as 4 normal adult chest radiographs and 16 abnormal pediatric chest radiographs. The digital interactive format of the atlas allows for (1) easy manipulation of atlas cases and (2) direct comparison between normal atlas cases and provided abnormal cases, as well as (3) the potential for direct comparison with images displayed on an institution's picture archiving and communication system. The atlas is available for free download at http://www.seattlechildrens.org/radiologyeducation/pediatric-chest. Improved interpretation of pediatric chest radiographs in the acute setting may be facilitated by a comprehensive, computer-based, pediatric chest atlas.
    Pediatric emergency care 02/2012; 28(2):145-7. · 0.92 Impact Factor
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    ABSTRACT: OBJECTIVE: Our objective was to develop a way to enhance scientific and educational PowerPoint presentations containing stack-based, multiple-image techniques such as CT and MRI. CONCLUSION: We developed a PowerPoint add-in that facilitates the creation of stackable image sets in a simple and intuitive manner, permitting real-time scrolling, editing, and manipulation of imbedded image stacks. Contrast and brightness adjustments, cropping, and linking are supported. Once created, the PowerPoint presentation can be viewed without hardware or venue limitations on any computer, without reinstallation of the add-in.
    American Journal of Roentgenology 03/2009; 192(2):W71-4. · 2.90 Impact Factor
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    ABSTRACT: PURPOSE In pediatrics, we wanted to evaluate the diagnostic accuracy of using a ≥ 6 mm diameter measurement of the appendix to identify appendiits. METHOD AND MATERIALS In this pilot study, right lower quadrant ultrasounds for suspected appendicitis performed on 78 consecutive patients referred to the radiology department during on-call hours from September 2003 to April 2004 were retrospectively evaluated. There were a total of 29 boys and 49 girls, with ages ranging between 1.5 and 16 years. RESULTS Of the 78 patients in our study, the presumed appendix was found and measured in 57 cases. In 2 additional cases where the appendix was not visualized, a diagnosis of abscess secondary to perforated appendicitis was made. None of the 20 patients with maximum appendix diameter (MAD) of 6 mm or less had appendicitis with one exception where an appendix measuring 5.1 mm was correctly identified as perforated with abscess formation. With the exception of 2 cases, all 28 patients with MAD measurement greater than 7.5 mm had appendicitis. Of the 8 patients with MAD measurement between 0.60 and 0.75 cm, 4 had appendicitis, 1 had a Meckel’s diverticulum, and 3 had no appendicitis. None of the 3 cases with a normal appendix at surgery had strong secondary signs of inflammation. CONCLUSION Based on our initial pilot results, we suggest the following for diagnosing appendix in the pediatric population: If appendix ≤ 0.60 cm, negative for appendicitis with the caveat that incomplete visualization of the appendix and/or presence of secondary signs of appendicitis may reflect perforated appendicitis. A normal appendix may not be visualized by ultrasound If appendix ≥ 0.75 cm, appendicitis is likely present, although rare exceptions will occur. If 0.61 cm ≤ Appendix ≤ 0.74 cm, indeterminate zone. The ultrasound report can be further colored by the presence or absence of secondary inflammatory signs. (i.e. Indeterminate but likely negative in the absence of secondary signs) Now, we will evaluate > 2000 patients to verify our conclusions. CLINICAL RELEVANCE/APPLICATION Close attention to secondary signs and size of the appendix, will significantly improve diagnostic accuracy of appendicitis.
    Radiological Society of North America 2007 Scientific Assembly and Annual Meeting; 11/2007
  • Dave DeRegt, Edward Weinberger
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    ABSTRACT: PURPOSE/AIM DICOM based external studies can pose difficulty in interpretation for the radiologist as he or she may not be familiar with the built in viewer. We believed this problem could be solved with a lightweight application capable of both viewing and uploading external studies into any PACS system. CONTENT ORGANIZATION To solve these problems we created DICOMManager, a Windows application written in C#, which imports DICOM CDs and other DICOM filesets with very little user interaction required. The user selects the CD to load or drags files to be transferred onto the application, selects a send destination, and the images are transferred using DICOM. The user also has the ability to automatically anonymize or uncompress the images before sending, as well as viewing the study in a built-in viewer. SUMMARY The application fills the need for a simple application for viewing outside exams and general DICOM image transfer needs demanded by a computer-based workflow. The application can import a vast collection of DICOM image types from different modalities, and will correct any deviations in the DICOM format of the image from the official specifications. The images can then be quickly viewed, merged into a PACS system, or anonymized images can be viewed on an external research system.
    Radiological Society of North America 2007 Scientific Assembly and Annual Meeting; 11/2007
  • Srdjan Jelacic, David de Regt, Edward Weinberger
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    ABSTRACT: The interpretation of magnetic resonance (MR) images of the pediatric brain may require consultation of an atlas to determine if a perceived finding represents an abnormality. However, most hard-copy atlases show only a few levels of the brain at selected points of time in myelination, and therefore a simultaneous comparison of different age groups is difficult with a hard-copy approach. The authors believe that a digital atlas of the normal pediatric brain may be a more efficient way to present this information and that correct interpretation of potential abnormalities may be facilitated by the online atlas they have created (available for free download from http://radiology.seattlechildrens.org/teaching/pediatricbrainatlas). Images for the atlas were derived from Digital Imaging and Communications in Medicine-compliant data sets from brain MR imaging in patients younger than 4 years. The images were interpreted as normal with respect to the appearance of the brain parenchyma. The software program used for viewing the atlas, written in C#, incorporates many features of a picture archiving and communication system viewer, such as linked scrolling and resizing. Simultaneous comparison of cases also is possible. The digital atlas facilitates learning about normal changes in the MR appearance of the pediatric brain, and it may be used during online interpretation of cases on a picture archiving and communication system.
    Radiographics 01/2006; 26(2):497-501. · 2.79 Impact Factor
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    Emerging infectious diseases 11/2003; 9(10):1226-31. · 5.99 Impact Factor
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    ABSTRACT: PURPOSE/AIM 1.To review normal CT/MR anatomy of the nasal cavity and paranasal sinuses using an online large-data-set, interactive format that allows scroll feature in axial, coronal, and sagittal planes. 2.To review CT/MR examples of normal variants and pathology of the nasal cavity and paranasal sinuses in children using format described in Aim 1. CONTENT ORGANIZATION 1. Normal CT/MR anatomy of the nasal cavity and paranasal sinuses with emphasis on changes seen throughout childhood. 2. Normal variants 3. Pathological conditions: a)Congenital b)Infectious/Inflammatory c)Neoplastic d)Traumatic e)Iatrogenic/Surgical SUMMARY The major goals of this exhibit are: 1. To provide an online, easy-to-use, interactive method to learn imaging anatomy and variants of the pediatric nasal cavity and paranasal sinuses. 2. To provide an online, interactive, digital CT/MR teaching file of pathological conditions of the pediatric nasal cavity and paranasal sinuses that a) contains scroll feature in three planes for each case b)allows for side-by-side comparison with normal subject c)includes option to "take cases" as unknowns.
    Radiological Society of North America 2007 Scientific Assembly and Annual Meeting;
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    ABSTRACT: PURPOSE/AIM 1. Test your diagnostic skills with a spectrum of challenging pediatric cases. 2. Construct a differential diagnosis based on clinical history and a multimodality imaging approach. 3. Case discussions will emphasize important points that lead to the diagnosis in each case.
    Radiological Society of North America 2010 Scientific Assembly and Annual Meeting;
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    ABSTRACT: PURPOSE/AIM 1. Test your diagnostic skills with a spectrum of challenging pediatric cases. 2. Construct a differential diagnosis based on clinical history and a multimodality imaging approach. 3. Case discussions will emphasize important points that lead to the diagnosis in each case.
    Radiological Society of North America 2009 Scientific Assembly and Annual Meeting;