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<meta name="DC.Title" content="How Are We Handling Fluoroscopy-Guided Lumbar Puncture Requests? A Nationwide Survey of Practice Trends" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7684" />
<meta name="DC.Date" content="2022-11-03" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Referrals to perform fluoroscopy-guided lumbar punctures by neuroradiologists have increased. The purpose of our study was to determine the management of fluoroscopy-guided lumbar puncture referrals in different practice settings.

MATERIALS AND METHODS: We sent an online questionnaire to neuroradiologists and radiology trainees between May and June 2020 to survey their handling of fluoroscopy-guided lumbar puncture requests, preprocedural work-up, and the use of physician extenders/trainees to perform fluoroscopy-guided lumbar punctures, among other questions. Categories were compared using ORs.

RESULTS: Of the 123 US respondents, 81.3% were in combined academic and 18.7% in combined private practice groups. Regarding fluoroscopy-guided lumbar puncture referrals, 27.6% of respondents did not require a bedside lumbar puncture attempt before a fluoroscopy-guided lumbar puncture. Of private practice, 95.7%, and of academic respondents, 85.0%, were often asked to perform fluoroscopy-guided lumbar punctures by clinicians because of the clinician’s lack of procedural competence. Of those, 74.8% stated that they always or sometimes agreed to the request. 41.5% of respondents stated that they would always comply with patients’ requests for a fluoroscopy-guided lumbar puncture without a bedside lumbar puncture attempt, a 5.26 times higher likelihood (95% CI, 2.04–14.29) for private practice respondents. To perform fluoroscopy-guided lumbar punctures, 32.0% of academic respondents and 47.8% of private practice respondents use physician extenders. 75.0% of academic respondents reported that trainees perform &gt;50% of their fluoroscopy-guided lumbar punctures.

CONCLUSIONS: This survey demonstrates that many academic and private practice neuroradiologists engage in practices that may promote an increase in fluoroscopy-guided lumbar puncture referrals including not requiring a non-image-guided lumbar puncture attempt, complying with clinicians’ requests for a fluoroscopy-guided lumbar puncture due to lack of competence in performing lumbar punctures, and fulfilling patient requests for fluoroscopy-guided lumbar punctures.

FGLP
:   fluoroscopy-guided lumbar puncture
LP
:   lumbar puncture" />
<meta name="DC.Contributor" content="T.J. Richards" />
<meta name="DC.Contributor" content="J.C. Durieux" />
<meta name="DC.Contributor" content="A.P. Nayate" />
<meta name="article:published_time" content="2022-11-03" />
<meta name="article:section" content="SPINE" />
<meta name="citation_title" content="How Are We Handling Fluoroscopy-Guided Lumbar Puncture Requests? A Nationwide Survey of Practice Trends" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Referrals to perform fluoroscopy-guided lumbar punctures by neuroradiologists have increased. The purpose of our study was to determine the management of fluoroscopy-guided lumbar puncture referrals in different practice settings.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;We sent an online questionnaire to neuroradiologists and radiology trainees between May and June 2020 to survey their handling of fluoroscopy-guided lumbar puncture requests, preprocedural work-up, and the use of physician extenders/trainees to perform fluoroscopy-guided lumbar punctures, among other questions. Categories were compared using ORs.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Of the 123 US respondents, 81.3% were in combined academic and 18.7% in combined private practice groups. Regarding fluoroscopy-guided lumbar puncture referrals, 27.6% of respondents did not require a bedside lumbar puncture attempt before a fluoroscopy-guided lumbar puncture. Of private practice, 95.7%, and of academic respondents, 85.0%, were often asked to perform fluoroscopy-guided lumbar punctures by clinicians because of the clinician’s lack of procedural competence. Of those, 74.8% stated that they always or sometimes agreed to the request. 41.5% of respondents stated that they would always comply with patients’ requests for a fluoroscopy-guided lumbar puncture without a bedside lumbar puncture attempt, a 5.26 times higher likelihood (95% CI, 2.04–14.29) for private practice respondents. To perform fluoroscopy-guided lumbar punctures, 32.0% of academic respondents and 47.8% of private practice respondents use physician extenders. 75.0% of academic respondents reported that trainees perform &amp;gt;50% of their fluoroscopy-guided lumbar punctures.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;This survey demonstrates that many academic and private practice neuroradiologists engage in practices that may promote an increase in fluoroscopy-guided lumbar puncture referrals including not requiring a non-image-guided lumbar puncture attempt, complying with clinicians’ requests for a fluoroscopy-guided lumbar puncture due to lack of competence in performing lumbar punctures, and fulfilling patient requests for fluoroscopy-guided lumbar punctures.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_reference" content="citation_journal_title=Journal of health economics;citation_journal_abbrev=J Health Econ;citation_author=M. Allard;citation_author=I. Jelovac;citation_author=PT. Léger;citation_title=Treatment and referral decisions under different physician payment mechanisms.;citation_pages=880-893;citation_volume=30;citation_year=2011;citation_issue=5;citation_pmid=21782263;citation_doi=10.1016/j.jhealeco.2011.05.016" />
<meta name="citation_reference" content="citation_journal_title=Acad Med J Med;citation_author=A. Vaisman;citation_author=P. Cram;citation_title=Procedural competence among faculty in academic health centers: challenges and future directions;citation_pages=31-34;citation_volume=92;citation_year=2017;citation_pmid=27465227;citation_doi=10.1097/ACM.0000000000001327" />
<meta name="citation_reference" content="citation_journal_title=JAMA;citation_author=R. Smith-Bindman;citation_author=ML. Kwan;citation_author=EC. Marlow;citation_title=Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016;citation_pages=843-56;citation_volume=322;citation_year=2019;citation_pmid=http://www.n;citation_doi=10.1001/jama.2019.11456" />
<meta name="citation_reference" content="citation_journal_title=Journal of Vascular and Interventional Radiology;citation_journal_abbrev=J. Vasc. Interv. Radiol.;citation_author=Standards of Practice Committee, with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement;citation_title=Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions.;citation_pages=727-736;citation_volume=23;citation_year=2012;citation_issue=6;citation_pmid=22513394;citation_doi=10.1016/j.jvir.2012.02.012" />
<meta name="citation_reference" content="citation_journal_title=Journal of Vascular and Interventional Radiology;citation_journal_abbrev=J. Vasc. Interv. Radiol.;citation_author=Standards of Practice Committee with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement;citation_title=Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions.;citation_pages=S240-S249;citation_volume=20;citation_year=2009;citation_issue=7 Suppl;citation_pmid=19394868;citation_doi=10.1016/j.jvir.2008.11.027" />
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<meta name="citation_reference" content="citation_journal_title=J Clin Imaging Sci;citation_author=TJ. Richards;citation_author=JE. Schmitt;citation_author=LJ. Wolansky;citation_title=Radiology performed fluoroscopy-guided lumbar punctures decrease volume of diagnostic study interpretation: impact on resident training and potential solutions;citation_pages=39;citation_volume=11;citation_year=2021;citation_pmid=34345529;citation_doi=10.25259/JCIS_2_2021" />
<meta name="citation_reference" content="citation_journal_title=Journal of general internal medicine :  official journal of the Society for Research and Education in Primary Care Internal Medicine;citation_journal_abbrev=J Gen Intern Med;citation_author=MERN Group;citation_title=Supervising the supervisors--procedural training and supervision in internal medicine residency.;citation_pages=351-356;citation_volume=25;citation_year=2010;citation_issue=4;citation_pmid=20077049;citation_doi=10.1007/s11606-009-1226-z" />
<meta name="citation_reference" content="citation_journal_title=Annals of Internal Medicine;citation_journal_abbrev=ANN INTERN MED;citation_author=American College of Physicians;citation_title=The Declining Number and Variety of Procedures Done by General Internists: A Resurvey of Members of the American College of Physicians;citation_pages=355-360;citation_volume=146;citation_year=2007;citation_issue=5;citation_pmid=17339620;citation_doi=10.7326/0003-4819-146-5-200703060-00007" />
<meta name="citation_reference" content="citation_journal_title=Annals of Internal Medicine;citation_journal_abbrev=ANN INTERN MED;citation_author=FD. Duffy;citation_author=ES. Holmboe;citation_title=What Procedures Should Internists Do?;citation_pages=392-393;citation_volume=146;citation_year=2007;citation_issue=5;citation_pmid=17339625;citation_doi=10.7326/0003-4819-146-5-200703060-00012" />
<meta name="citation_reference" content="citation_journal_title=Pract Neurol;citation_author=KC. Dodd;citation_author=HCA. Emsley;citation_author=MJR. Desborough;citation_title=Periprocedural antithrombotic management for lumbar puncture: Association of British Neurologists clinical guideline;citation_volume=18;citation_year=2018;citation_pmid=30154234;citation_doi=10.1136/practneurol-2017-001820" />
<meta name="citation_reference" content="The American College of Radiology. ACR-ASNR-SPR practice parameter for the performance of myelography and cisternography. 2019. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Myelog-Cisternog.pdf. Accessed March 1, 2022" />
<meta name="citation_reference" content="citation_journal_title=Clin Infect Dis;citation_author=M. Glimåker;citation_author=B. Johansson;citation_author=Ö. Grindborg;citation_title=Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture;citation_volume=60;citation_year=2015;citation_pmid=25663160;citation_doi=10.1093/cid/civ011" />
<meta name="citation_reference" content="citation_journal_title=Headache;citation_journal_abbrev=Headache;citation_author=RW. Evans;citation_author=DI. Friedman;citation_title=Expert opinion: the management of pseudotumor cerebri during pregnancy.;citation_pages=495-497;citation_volume=40;citation_year=2000;citation_issue=6;citation_pmid=10849049;citation_doi=10.1046/j.1526-4610.2000.00076.x" />
<meta name="twitter:title" content="How Are We Handling Fluoroscopy-Guided Lumbar Puncture Requests? A Nationwide Survey of Practice Trends" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Referrals to perform fluoroscopy-guided lumbar punctures by neuroradiologists have increased. The purpose of our study was to determine the management of fluoroscopy-guided lumbar puncture referrals in different practice settings.

MATERIALS AND METHODS: We sent an online questionnaire to neuroradiologists and radiology trainees between May and June 2020 to survey their handling of fluoroscopy-guided lumbar puncture requests, preprocedural work-up, and the use of physician extenders/trainees to perform fluoroscopy-guided lumbar punctures, among other questions. Categories were compared using ORs.

RESULTS: Of the 123 US respondents, 81.3% were in combined academic and 18.7% in combined private practice groups. Regarding fluoroscopy-guided lumbar puncture referrals, 27.6% of respondents did not require a bedside lumbar puncture attempt before a fluoroscopy-guided lumbar puncture. Of private practice, 95.7%, and of academic respondents, 85.0%, were often asked to perform fluoroscopy-guided lumbar punctures by clinicians because of the clinician’s lack of procedural competence. Of those, 74.8% stated that they always or sometimes agreed to the request. 41.5% of respondents stated that they would always comply with patients’ requests for a fluoroscopy-guided lumbar puncture without a bedside lumbar puncture attempt, a 5.26 times higher likelihood (95% CI, 2.04–14.29) for private practice respondents. To perform fluoroscopy-guided lumbar punctures, 32.0% of academic respondents and 47.8% of private practice respondents use physician extenders. 75.0% of academic respondents reported that trainees perform &gt;50% of their fluoroscopy-guided lumbar punctures.

CONCLUSIONS: This survey demonstrates that many academic and private practice neuroradiologists engage in practices that may promote an increase in fluoroscopy-guided lumbar puncture referrals including not requiring a non-image-guided lumbar puncture attempt, complying with clinicians’ requests for a fluoroscopy-guided lumbar puncture due to lack of competence in performing lumbar punctures, and fulfilling patient requests for fluoroscopy-guided lumbar punctures.

FGLP
:   fluoroscopy-guided lumbar puncture
LP
:   lumbar puncture" />
<meta name="og-title" property="og:title" content="How Are We Handling Fluoroscopy-Guided Lumbar Puncture Requests? A Nationwide Survey of Practice Trends" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2022/11/03/ajnr.A7684" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Referrals to perform fluoroscopy-guided lumbar punctures by neuroradiologists have increased. The purpose of our study was to determine the management of fluoroscopy-guided lumbar puncture referrals in different practice settings.

MATERIALS AND METHODS: We sent an online questionnaire to neuroradiologists and radiology trainees between May and June 2020 to survey their handling of fluoroscopy-guided lumbar puncture requests, preprocedural work-up, and the use of physician extenders/trainees to perform fluoroscopy-guided lumbar punctures, among other questions. Categories were compared using ORs.

RESULTS: Of the 123 US respondents, 81.3% were in combined academic and 18.7% in combined private practice groups. Regarding fluoroscopy-guided lumbar puncture referrals, 27.6% of respondents did not require a bedside lumbar puncture attempt before a fluoroscopy-guided lumbar puncture. Of private practice, 95.7%, and of academic respondents, 85.0%, were often asked to perform fluoroscopy-guided lumbar punctures by clinicians because of the clinician’s lack of procedural competence. Of those, 74.8% stated that they always or sometimes agreed to the request. 41.5% of respondents stated that they would always comply with patients’ requests for a fluoroscopy-guided lumbar puncture without a bedside lumbar puncture attempt, a 5.26 times higher likelihood (95% CI, 2.04–14.29) for private practice respondents. To perform fluoroscopy-guided lumbar punctures, 32.0% of academic respondents and 47.8% of private practice respondents use physician extenders. 75.0% of academic respondents reported that trainees perform &gt;50% of their fluoroscopy-guided lumbar punctures.

CONCLUSIONS: This survey demonstrates that many academic and private practice neuroradiologists engage in practices that may promote an increase in fluoroscopy-guided lumbar puncture referrals including not requiring a non-image-guided lumbar puncture attempt, complying with clinicians’ requests for a fluoroscopy-guided lumbar puncture due to lack of competence in performing lumbar punctures, and fulfilling patient requests for fluoroscopy-guided lumbar punctures.

FGLP
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LP
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      <h1 class="highwire-cite-title" id="page-title">How Are We Handling Fluoroscopy-Guided Lumbar Puncture Requests? A Nationwide Survey of Practice Trends</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.J. Richards</span>, <span class="highwire-citation-author" data-delta="1">J.C. Durieux</span> and <span class="highwire-citation-author" data-delta="2">A.P. Nayate</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2022,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7684 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-99775--61890211825" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T.J. Richards </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology and Imaging Sciences (T.J.R.), University of Utah School of Medicine, Salt Lake City, Utah</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.J.%2BRichards%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Richards%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AT.J.%2BRichards%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7078-7353" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for T.J. Richards</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.C. Durieux </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (J.C.D., A.P.N.), University Hospitals Cleveland Medical Center, University Hospitals, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.C.%2BDurieux%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Durieux%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.C.%2BDurieux%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1238-5580" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.C. Durieux</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.P. Nayate </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Radiology (J.C.D., A.P.N.), University Hospitals Cleveland Medical Center, University Hospitals, Cleveland, Ohio</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.P.%2BNayate%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nayate%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.P.%2BNayate%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-6846-2074" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A.P. Nayate</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2 class="">REFERENCES</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.1" data-doi="10.3174/ajnr.A7049"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Johnson</span>  <span class="cit-name-given-names">DR</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Waid</span>  <span class="cit-name-given-names">MD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Rula</span>  <span class="cit-name-given-names">EY</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Comparison of radiologists and other specialists in the performance of lumbar puncture procedures over time</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2021</span>;<span class="cit-vol">42</span>:<span class="cit-fpage">1174</span>–<span class="cit-lpage">81</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A7049</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>33664117</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiI0Mi82LzExNzQiO3M6NDoiYXRvbSI7czozODoiL2FqbnIvZWFybHkvMjAyMi8xMS8wMy9ham5yLkE3Njg0LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.2" data-doi="10.1016/j.jhealeco.2011.05.016"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Allard</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Jelovac</span>  <span class="cit-name-given-names">I</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Léger</span>  <span class="cit-name-given-names">PT</span></span></li></ol><cite>. <span class="cit-article-title">Treatment and referral decisions under different physician payment mechanisms</span>. <abbr class="cit-jnl-abbrev">J Health Econ</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">30</span>:<span class="cit-fpage">880</span>–<span class="cit-lpage">93</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jhealeco.2011.05.016</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>21782263</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jhealeco.2011.05.016&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=21782263&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">3.</span><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3. in text" id="ref-3">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.3" data-doi="10.1097/ACM.0000000000001327"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Vaisman</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Cram</span>  <span class="cit-name-given-names">P</span></span></li></ol><cite>. <span class="cit-article-title">Procedural competence among faculty in academic health centers: challenges and future directions</span>. <abbr class="cit-jnl-abbrev">Acad Med J Med</abbr> <span class="cit-pub-date">2017</span>;<span class="cit-vol">92</span>:<span class="cit-fpage">31</span>–<span class="cit-lpage">34</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1097/ACM.0000000000001327</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>27465227</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/ACM.0000000000001327&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=27465227&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">4.</span><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4. in text" id="ref-4">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.4" data-doi="10.1001/jama.2019.11456"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Smith-Bindman</span>  <span class="cit-name-given-names">R</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kwan</span>  <span class="cit-name-given-names">ML</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Marlow</span>  <span class="cit-name-given-names">EC</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Trends in use of medical imaging in US health care systems and in Ontario, Canada, 2000-2016</span>. <abbr class="cit-jnl-abbrev">JAMA</abbr> <span class="cit-pub-date">2019</span>;<span class="cit-vol">322</span>:<span class="cit-fpage">843</span>–<span class="cit-lpage">56</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1001/jama.2019.11456</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>31479136</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1001/jama.2019.11456&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=http://www.n&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">5.</span><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5. in text" id="ref-5">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.5" data-doi="10.1016/j.jvir.2012.02.012"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Patel</span>  <span class="cit-name-given-names">IJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Davidson</span>  <span class="cit-name-given-names">JC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Nikolic</span>  <span class="cit-name-given-names">B</span></span>, <span class="cit-etal">et al</span></li></ol><cite>; <span class="cit-auth cit-collab">Standards of Practice Committee, with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement</span>. <span class="cit-article-title">Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions</span>. <abbr class="cit-jnl-abbrev">J Vasc Interv Radiol</abbr> <span class="cit-pub-date">2012</span>;<span class="cit-vol">23</span>:<span class="cit-fpage">727</span>–<span class="cit-lpage">36</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jvir.2012.02.012</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>22513394</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jvir.2012.02.012&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=22513394&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000304691400001&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">6.</span><a class="rev-xref-ref" href="#xref-ref-6-1" title="View reference 6. in text" id="ref-6">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.6" data-doi="10.1016/j.jvir.2008.11.027"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Malloy</span>  <span class="cit-name-given-names">PC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Grassi</span>  <span class="cit-name-given-names">CJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kundu</span>  <span class="cit-name-given-names">S</span></span>, <span class="cit-etal">et al</span></li></ol><cite>; <span class="cit-auth cit-collab">Standards of Practice Committee with Cardiovascular and Interventional Radiological Society of Europe (CIRSE) Endorsement</span>. <span class="cit-article-title">Consensus guidelines for periprocedural management of coagulation status and hemostasis risk in percutaneous image-guided interventions</span>. <abbr class="cit-jnl-abbrev">J Vasc Interv Radiol</abbr> <span class="cit-pub-date">2009</span>;<span class="cit-vol">20</span>:<span class="cit-fpage">S240</span>–<span class="cit-lpage">49</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jvir.2008.11.027</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>19394868</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jvir.2008.11.027&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=19394868&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000267613200007&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><span class="ref-label">7.</span><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7. in text" id="ref-7">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.7" data-doi="10.1016/j.jacr.2016.04.009"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Schemmel</span>  <span class="cit-name-given-names">A</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lee</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hanley</span>  <span class="cit-name-given-names">T</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Radiology workflow disruptors: a detailed analysis</span>. <abbr class="cit-jnl-abbrev">J Am Coll Radiol</abbr> <span class="cit-pub-date">2016</span>;<span class="cit-vol">13</span>:<span class="cit-fpage">1210</span>–<span class="cit-lpage">14</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1016/j.jacr.2016.04.009</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>27313127</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.jacr.2016.04.009&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=27313127&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">8.</span><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8. in text" id="ref-8">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.8" data-doi="10.25259/JCIS_2_2021"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Richards</span>  <span class="cit-name-given-names">TJ</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Schmitt</span>  <span class="cit-name-given-names">JE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Wolansky</span>  <span class="cit-name-given-names">LJ</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Radiology performed fluoroscopy-guided lumbar punctures decrease volume of diagnostic study interpretation: impact on resident training and potential solutions</span>. <abbr class="cit-jnl-abbrev">J Clin Imaging Sci</abbr> <span class="cit-pub-date">2021</span>;<span class="cit-vol">11</span>:<span class="cit-fpage">39</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.25259/JCIS_2_2021</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>34345529</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.25259/JCIS_2_2021&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=34345529&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">9.</span><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9. in text" id="ref-9">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.9" data-doi="10.1007/s11606-009-1226-z"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Mourad</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Kohlwes</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Maselli</span>  <span class="cit-name-given-names">J</span></span>, <span class="cit-etal">et al</span></li></ol><cite>; <span class="cit-auth cit-collab">MERN Group</span>. <span class="cit-article-title">Supervising the supervisor: procedural training and supervision in internal medicine residency</span>. <abbr class="cit-jnl-abbrev">J Gen Intern Med</abbr> <span class="cit-pub-date">2010</span>;<span class="cit-vol">25</span>:<span class="cit-fpage">351</span>–<span class="cit-lpage">56</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1007/s11606-009-1226-z</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>20077049</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/s11606-009-1226-z&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=20077049&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">10.</span><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10. in text" id="ref-10">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.10" data-doi="10.7326/0003-4819-146-5-200703060-00007"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Wigton</span>  <span class="cit-name-given-names">RS</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Alguire</span>  <span class="cit-name-given-names">P</span></span></li></ol><cite>; <span class="cit-auth cit-collab">American College of Physicians</span>. <span class="cit-article-title">The declining number and variety of procedures done by general internists: a resurvey of members of the American College of Physicians</span>. <abbr class="cit-jnl-abbrev">Ann Intern Med</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">146</span>:<span class="cit-fpage">355</span>–<span class="cit-lpage">60</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.7326/0003-4819-146-5-200703060-00007</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>17339620</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.7326/0003-4819-146-5-200703060-00007&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17339620&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">11.</span><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11. in text" id="ref-11">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.11" data-doi="10.7326/0003-4819-146-5-200703060-00012"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Duffy</span>  <span class="cit-name-given-names">FD</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Holmboe</span>  <span class="cit-name-given-names">ES</span></span></li></ol><cite>. <span class="cit-article-title">What procedures should internists do?</span> <abbr class="cit-jnl-abbrev">Ann Intern Med</abbr> <span class="cit-pub-date">2007</span>;<span class="cit-vol">146</span>:<span class="cit-fpage">392</span>–<span class="cit-lpage">93</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.7326/0003-4819-146-5-200703060-00012</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>17339625</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.7326/0003-4819-146-5-200703060-00012&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17339625&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">12.</span><a class="rev-xref-ref" href="#xref-ref-12-1" title="View reference 12. in text" id="ref-12">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.12" data-doi="10.1136/practneurol-2017-001820"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Dodd</span>  <span class="cit-name-given-names">KC</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Emsley</span>  <span class="cit-name-given-names">HCA</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Desborough</span>  <span class="cit-name-given-names">MJR</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Periprocedural antithrombotic management for lumbar puncture: Association of British Neurologists clinical guideline</span>. <abbr class="cit-jnl-abbrev">Pract Neurol</abbr> <span class="cit-pub-date">2018</span>;<span class="cit-vol">18</span>:<span class="cit-fpage">436</span>–<span class="cit-lpage">46</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1136/practneurol-2017-001820</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>30154234</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6MTE6InByYWN0bmV1cm9sIjtzOjU6InJlc2lkIjtzOjg6IjE4LzYvNDM2IjtzOjQ6ImF0b20iO3M6Mzg6Ii9ham5yL2Vhcmx5LzIwMjIvMTEvMDMvYWpuci5BNzY4NC5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">13.</span><a class="rev-xref-ref" href="#xref-ref-13-1" title="View reference 13. in text" id="ref-13">↵</a><div class="cit ref-cit ref-web" id="cit-ajnr.A7684v1.13"><div class="cit-metadata"><cite><span class="cit-auth cit-collab">The American College of Radiology</span>. <span class="cit-article-title">ACR-ASNR-SPR practice parameter for the performance of myelography and cisternography</span>. <span class="cit-pub-date">2019</span>. <a href="https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Myelog-Cisternog.pdf">https://www.acr.org/-/media/ACR/Files/Practice-Parameters/Myelog-Cisternog.pdf</a>. <span class="cit-date-in-citation">Accessed March 1, 2022</span></cite></div><div class="cit-extra"></div></div></li><li><span class="ref-label">14.</span><a class="rev-xref-ref" href="#xref-ref-14-1" title="View reference 14. in text" id="ref-14">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.14" data-doi="10.1093/cid/civ011"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Glimåker</span>  <span class="cit-name-given-names">M</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Johansson</span>  <span class="cit-name-given-names">B</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Grindborg</span>  <span class="cit-name-given-names">Ö</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture</span>. <abbr class="cit-jnl-abbrev">Clin Infect Dis</abbr> <span class="cit-pub-date">2015</span>;<span class="cit-vol">60</span>:<span class="cit-fpage">1162</span>–<span class="cit-lpage">69</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1093/cid/civ011</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>25663160</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1093/cid/civ011&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=25663160&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><span class="ref-label">15.</span><a class="rev-xref-ref" href="#xref-ref-15-1" title="View reference 15. in text" id="ref-15">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A7684v1.15" data-doi="10.1046/j.1526-4610.2000.00076.x"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Evans</span>  <span class="cit-name-given-names">RW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Friedman</span>  <span class="cit-name-given-names">DI</span></span></li></ol><cite>. <span class="cit-article-title">Expert opinion: the management of pseudotumor cerebri during pregnancy</span>. <abbr class="cit-jnl-abbrev">Headache</abbr> <span class="cit-pub-date">2000</span>;<span class="cit-vol">40</span>:<span class="cit-fpage">495</span>–<span class="cit-lpage">97</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.1046/j.1526-4610.2000.00076.x</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>10849049</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1046/j.1526-4610.2000.00076.x&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=10849049&amp;link_type=MED&amp;atom=%2Fajnr%2Fearly%2F2022%2F11%2F03%2Fajnr.A7684.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div></div>  </div>

  
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