key: cord-1012108-wcybc4kj
authors: Demirjian, Natalie L.; Fields, Brandon K.K.; Cen, Steven Y.; Lei, Xiaomeng; Gholamrezanezhad, Ali
title: Reply to “Impact of COVID-19 on the mental health of radiologists”()
date: 2021-04-06
journal: Clin Imaging
DOI: 10.1016/j.clinimag.2021.03.025
sha: 5e3d95b9eb8091108a4eee56daef8cf3c51fd330
doc_id: 1012108
cord_uid: wcybc4kj

nan

We thank the authors for their thoughtful appraisal of our work investigating the impacts of Coronavirus Disease 2019 (COVID-19) on radiologists in the United States [2] . We certainly acknowledge that there are more psychological impacts COVID-19 beyond what was captured by our survey. Our study was not necessarily intended to report a clinical score of anxiety, but rather to invite discussion on COVID-19's impact on the mental health of radiologists and highlight a key area warranting further investigation.

We must be cautious when conducting extensive subgroup analyses in order to avoid common pitfalls of overinterpretation [3] . As previously reported, we did not observe large differences in the β coefficients when we stratified for residents and fellows or private practice radiologists [2] . However, we do acknowledge the benefit of understanding how COVID-19 is impacting radiologists in different workforce sectors on a more granular level. Thus, per Dr.

Triana's and Dr. Forero's recommendation, we have elected to run an additional analysis to formally assess the interaction effects of practice environments on factors influencing anxiety.

In contrast to the findings reported by Florin et al.

[4], we did not observe any statistically significant (p < 0.05) interaction effects when we stratified for private versus non-private institutions. However, when we stratified for academic versus non-academic institutions, the interaction terms for the following items were found to be statistically significant: gender (p = 0.03), increased use of personal protective equipment (PPE) as an anticipated effect on clinical practice in one year (p = 0.04), adequate supply of PPE for patients (p = 0.03), and teleradiology as a respondent's main setting of practice (p = 0.04). Identifying with female gender was found to be a greater risk factor for anxiety at academic institutions (RR: 1.16; 95% CI: 1.06-1.27, p < 0.01) as compared to non-academic facilities (RR: 0.94; 95% CI: 0.79-1.11, p = 0.44).

Similarly, an anticipated increase in PPE usage in one year was also found to be a greater risk J o u r n a l P r e -p r o o f Journal Pre-proof

Conversely, having an adequate PPE supply for patients was found to be more of a protective factor at academic institutions (RR: 0.83; 95% CI: 0.72-0.96, p < 0.01) than non-academic institutions (RR: 1.12; 95% CI: 0.9-1.38, p = 0.31). Finally, reporting a primary practice setting of teleradiology was found to be more protective at non-academic centers

These results are similar to recently published data which suggest that female gender/sex and lack of adequate PPE supply were also associated with poorer mental health outcomes in related healthcare professions

Funding: None Conflicts of Interest: None Disclosures: None IRB: Exempt Review References

Impact of COVID-19 on the mental health of radiologists

Impacts of the Coronavirus Disease 2019 (COVID-19) pandemic on healthcare workers: A nationwide survey of United States radiologists

The challenge of subgroup analyses--reporting without distorting

Experiences and management of physician psychological symptoms during infectious disease outbreaks: a rapid review

Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease