title: The effects of changes in utilization and technological advancements of cross-sectional imaging on radiologist workload.
abstract: OBJECTIVE
  To examine the effect of changes in utilization and advances in cross-sectional imaging on radiologists' workload.
  
  
  METHODS
  All computed tomography (CT) and magnetic resonance imaging (MRI) examinations performed at a single institution between 1999 and 2010 were identified and associated with the total number of images for each examination. Annual trends in institutional numbers of interpreted examinations and images were translated to changes in daily workload for the individual radiologist by normalizing to the number of dedicated daily CT and MRI work assignments, assuming a 255-day/8-hour work day schedule. Temporal changes in institutional and individual workload were assessed by Sen's slope analysis (Q = median slope) and Mann-Kendall test (Z = Z statistic).
  
  
  RESULTS
  From 1999 to 2010, a total of 1,517,149 cross-sectional imaging studies (CT = 994,471; MRI = 522,678) comprising 539,210,581 images (CT = 339,830,947; MRI = 199,379,634) were evaluated at our institution. Total annual cross-sectional studies steadily increased from 84,409 in 1999 to 147,336 in 2010, representing a twofold increase in workload (Q = 6465/year, Z = 4.2, P < .0001). Concomitantly, the number of annual departmental cross-sectional images interpreted increased from 9,294,140 in 1990 to 94,271,551 in 2010, representing a 10-fold increase (Q = 8707876/year, Z = 4.5, P < .0001). Adjusting for staffing changes, the number of images requiring interpretation per minute of every workday per staff radiologist increased from 2.9 in 1999 to 16.1 in 2010 (Q = 1.7/year, Z = 4.3, P < .0001).
  
  
  CONCLUSIONS
  Imaging volumes have grown at a disproportionate rate to imaging utilization increases at our institution. The average radiologist interpreting CT or MRI examinations must now interpret one image every 3-4 seconds in an 8-hour workday to meet workload demands.
authors.affiliation: Clinician Investigator Training Program, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905; Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905. Electronic address: mcdonald.robert@mayo.edu.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: McDonald
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Kara M
authors.initials: KM
authors.lastname: Schwartz
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Eckel
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Felix E
authors.initials: FE
authors.lastname: Diehn
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Hunt
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Bartholmai
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Erickson
authors.affiliation: Department of Radiology, College of Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN 55905; Department of Neurosurgery, College of Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: David F
authors.initials: DF
authors.lastname: Kallmes
mesh_terms: D019412:Anatomy, Cross-Sectional / Q000706:statistics & numerical data / Q000639:trends; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data* / Q000639:trends; D008910:Minnesota; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data / Q000639:trends; D000072177:Radiologists; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data / Q000639:trends; D011873:Radiology Information Systems / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data* / Q000639:trends; D016526:Workload
keywords: Cross-sectional imaging; fatigue; imaging volumes; utilization; workload