Clinical Focus

  • Diagnostic Radiology

Academic Appointments

  • Clinical Instructor, Radiology

Professional Education

  • Board Certification: American Board of Radiology, Diagnostic Radiology (2023)
  • Fellowship: Brigham and Women's Hospital Neuroradiology Fellowship (2023) MA
  • Residency: Geisinger Medical Center Diagnostic Radiology Residency (2022) PA
  • Internship: Newark Beth Israel Internal Medicine Residency (2018) NJ
  • Medical Education: St George's University School of Medicine Grenada West Indies (2017) NY West Indies

All Publications

  • Recommendations for Additional Imaging on Head and Neck Imaging Examinations: Interradiologist Variation and Associated Factors. AJR. American journal of roentgenology Guenette, J. P., Lynch, E., Abbasi, N., Schulz, K., Kumar, S., Haneuse, S., Kapoor, N., Lacson, R., Khorasani, R. 2024


    Background: A paucity of relevant guidelines may lead to pronounced variation among radiologists in issuing recommendations for additional imaging (RAI) for head and neck imaging. Objective: To explore associations of RAI for head and neck imaging examinations with examination, patient, and radiologist factors, and to assess the role of individual radiologist-specific behavior in issuing such RAI. Methods: This retrospective study included 39,200 patients (median age, 58 years; 21,855 female, 17,315 male, 30 with missing sex information) who underwent 39,200 head and neck CT or MRI examinations, interpreted by 61 radiologists, from June 1, 2021 through May 31, 2022. A natural language processing (NLP) tool with manual review of NLP results was used to identify RAI in report impressions. Interradiologist variation in RAI rates was assessed. A generalized mixed-effects model was used to assess associations between RAI and examination, patient, and radiologist factors. Results: A total of 2946 (7.5%) reports contained an RAI. Individual radiologist RAI rates ranged from 0.8% to 22.0% (median 7.1%, IQR 5.2%-10.2%), representing 27.5-fold difference between minimum and maximum values and 1.8-fold difference between 25th and 75th percentiles. In multivariable analysis, RAI likelihood was higher for CTA than for CT examinations (OR: 1.32), for examinations that included a trainee in report generation (OR: 1.23), and for patients with self-identified race of Black or African American than of White (OR: 1.25); lower for male than female patients (OR: 0.90); and associated with increasing patient age (OR: 1.09 per decade) and inversely associated with radiologist years since training (OR: 0.90 per 5 years). The model accounted for 10.9% of the likelihood of RAI. Of explainable likelihood of RAI, 25.7% was attributable to examination, patient, and radiologist factors; 74.3% was attributable to radiologist-specific behavior. Conclusion: Interradiologist variation in RAI rates for head and neck imaging was substantial. RAI appeared to be more substantially associated with individual radiologist-specific behavior than with measurable systemic factors. Clinical Impact: Quality improvement initiatives, incorporating best practices for incidental findings management, may help reduce radiologist preference-sensitive decision-making in issuing RAI for head and neck imaging and associated care variation.

    View details for DOI 10.2214/AJR.23.30511

    View details for PubMedID 38294159