Impact of trainee involvement on patient radiation exposure and contrast volumes during invasive cardiac procedures
Bibliographic record
Abstract
PURPOSE: The impact of cardiology fellows (CFs) and interventional cardiology fellows (ICFs) on patient radiation and contrast exposure during diagnostic coronary angiography and percutaneous coronary intervention is unknown. METHODS: Between 2011 and 2014, 16,175 cases were retrospectively assessed involving 27 CFs, 22 ICFs and 24 staff as primary operators. RESULTS: During diagnostic coronary angiography, ICFs administered the lowest radiation dose (5,648±5,523 cGy*cm2; 1.30 ± 1.27 mSv)-achieving 22% less radiation than the staff (6,889±4,294 cGy*cm2; 1.58 ± 0.99 mSv) and 36% less than CFs (7,700±6,751 cGy*cm2; 1.77 ± 1.55 mSv) (p<0.01). When adjusted for access site, CFs administered more radiation than either the ICFs or staff. However, differences between ICFs and staff were exclusively observed during transradial procedures (p<0.01). With regards to contrast administration, ICFs administered less contrast (126.3 ± 57.6 mL) than either CFs (130±52.4 mL) or staff (132.7±47.6 mL) (p<0.01)-again, a finding isolated to the transradial cohort. Of the 6,751 percutaneous coronary intervention cases, no significant differences existed between the ICFs or staff cardiologists in patient radiation exposure-but a CF as the primary operator resulted in an 18% increase in radiation exposure. Notably, contrast use was not different amongst the types of operators (p<0.05). CONCLUSION: In conclusion, having a cardiology fellow as primary operator during invasive cardiac procedures increases patient radiation exposure and minimally increases contrast administration. Strategies to minimize patient radiation exposure while maintaining trainee involvement should be evaluated.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".