We use cookies to understand how you use our site and to improve your experience. This includes personalizing content and advertising. To learn more, click here. By continuing to use our site, you accept our use of cookies. Cookie Policy.

Features Partner Sites Information LinkXpress hp
Sign In
Advertise with Us
GLOBETECH PUBLISHING LLC

Download Mobile App




Imaging Self-Referral Drives Unnecessary MRI Scanning for Patients

By MedImaging International staff writers
Posted on 30 Sep 2013
Patients undergoing knee magnetic resonance imaging (MRI) scanning are substantially more apt to receive a negative finding if referred by physicians who have a financial interest in the imaging equipment being used, according to new research.

The study’s findings were published online September 17, 2013, in the journal Radiology. Imaging self-referral, whereby a nonradiologist physician refers their own patients for imaging to facilities in which they or their partners have a financial interest, is a growing trend in medicine and a significant driver of healthcare costs. Medical imaging self-referral leads to higher utilization and unnecessary imaging examinations.

“Our study was the first to examine one of the most common advanced outpatient imaging studies ordered in the United States today: orthopedic knee MRI,” said Matthew P. Lungren, MD, codirector of the interventional radiology translational research lab at Duke University Medical Center (Durham, NC, USA). “In our work, we were able not only to evaluate the outcome of the knee MRI examinations ordered by physicians with financial interest in the imaging equipment, but to compare this to another matched referral physician group that had no financial stake in the imaging equipment.”

From 2004 through 2010, the number of self-referred MRI services increased by more than 80%, compared with an increase of 12% for non-self-referred MRI services. Similarly, the growth rate of costs for self-referred MRI services was also higher than for non-self-referred MRI services, according to the US Government Accountability Office. It is estimated that in 2010, providers who self-referred made as many as 400,000 more referrals for advanced imaging services than they would have if they were not self-referring, costing Medicare about USD 109 million.

For the study, researchers reviewed 700 consecutive diagnostic knee scans from 667 patients to determine if ownership of MRI equipment by ordering physicians affected the probability of positive findings, and they assessed the pathology rates as a metric for comparison of utilization. The scans had been interpreted by one radiology practice between January and April 2009 and referred by two separate physician groups serving the same geographic community. The first group had financial interest in the MRI equipment used (FI group), and the second had no financial interest in the equipment used (NFI group).

For each group, the research team studied the percentage of negative exams and the frequency of each type of abnormalities found on positive exams. The results showed that among the 700 MRI scans (350 per group) there was no substantial discrepancy in the number of abnormalities per positive scan between the two groups. However, the researchers found that knee MRI exams ordered by the FI group were 33% more likely to be negative, indicating a significantly higher number of potentially unnecessary exams. Of the 205 negative exams, 117 belonged to the FI group, compared to 88 for the NFI group. In the FI group, 33% of patients referred for exams had negative scan results, compared to 25% of the NFI group.

“This occurred despite otherwise highly similar pathology, demographics, and referring physician characteristics between the two groups,” Dr. Lungren said. “These findings suggest that there is a different threshold for ordering MRI examinations which may be due to financial incentive.”

Dr. Lungren noted that self-referral has been shown to be an important driver of rising medical costs, and that this study has revealed powerful evidence of greater use of high-tech imaging when physicians can financially benefit. “This increase in unnecessary costs is of paramount importance in the current national conversation regarding health care cost and implementation,” he said.

Related Links:

Duke University Medical Center


Gold Member
Electrode Solution and Skin Prep
Signaspray
Gold Member
Ultrasound System
FUTUS LE
PACS Workstation
PaxeraView PRO
Mobile Imaging Table
medifa 8000 hybrid

Radcal

Channels

Nuclear Medicine

view channel
Image: In vivo imaging of U-87 MG xenograft model with varying mass doses of 89Zr-labeled KLG-3 or isotype control (Photo courtesy of L Gajecki et al.; doi.org/10.2967/jnumed.124.268762)

Novel Radiolabeled Antibody Improves Diagnosis and Treatment of Solid Tumors

Interleukin-13 receptor α-2 (IL13Rα2) is a cell surface receptor commonly found in solid tumors such as glioblastoma, melanoma, and breast cancer. It is minimally expressed in normal tissues, making it... Read more

Imaging IT

view channel
Image: The new Medical Imaging Suite makes healthcare imaging data more accessible, interoperable and useful (Photo courtesy of Google Cloud)

New Google Cloud Medical Imaging Suite Makes Imaging Healthcare Data More Accessible

Medical imaging is a critical tool used to diagnose patients, and there are billions of medical images scanned globally each year. Imaging data accounts for about 90% of all healthcare data1 and, until... Read more
Copyright © 2000-2025 Globetech Media. All rights reserved.

Notice: The user specified as a definer ('admin'@'%') does not exist in /home/www/medsites/shared/includes/database.php on line 307

/home/www/medsites/shared/includes/post_processing.php:42
/home/www/medsites/shared/includes/post_processing.php:5
/home/www/medsites/medicalimaging/index.php:409164 queries executed
1
(83.208084106445): SET sql_mode = 'MYSQL40'
2 (63.180923461914): SELECT folder, element, published, params FROM jos_mambots WHERE published >= 1 AND access <= 0 AND folder = 'system' ORDER BY ordering
3 (350.9521484375): SELECT template FROM jos_templates_menu WHERE client_id = 0 AND ( menuid = 0 OR menuid = 294748444 ) ORDER BY menuid DESC LIMIT 1
4 (370.97930908203): DELETE FROM jos_session WHERE time < 1750808026 AND guest = 1 AND userid = 0
5 (65.088272094727): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1
6 (46.968460083008): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1
7 (35.04753112793): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1
8 (223.87504577637): SELECT * FROM jos_menu WHERE id = 294748444
9 (653.02848815918): SELECT dp.*, ch.title as channel, ch.name as channel_name, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 #AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
10 (476.12190246582): SELECT dp.*, ch.title as channel, ch.name as channel_name, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 #AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
11 (55.074691772461): SELECT dp.*, ch.title as channel, ch.name as channel_name, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 #AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
12 (806.80847167969): SELECT * FROM jos_deeppockets WHERE 1=1 AND cat=10 AND type='deeppockets_item' AND published='1' AND (id<>294748444) AND (fid=212) ORDER BY id DESC, `created` DESC LIMIT 0,16
13 (112.05673217773): SELECT * FROM jos_deeppockets WHERE 1=1 AND cat=10 AND type='deeppockets_item' AND published='1' AND (id<>294748444) AND (fid=212) ORDER BY id DESC, `created` DESC LIMIT 0,16
14 (!!!!! 3875.9708404541): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='P' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_item.fid=212 and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) AND (jos_number.channelID=294748444 OR jos_number.channelID=0) ORDER BY RAND() DESC LIMIT 3
15 (!!!!! 6672.8591918945): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='P' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_item.fid=212 and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) AND (jos_number.channelID=294748444 OR jos_number.channelID=0) ORDER BY RAND() DESC LIMIT 3
16 (!!!!! 1564.0258789062): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='P' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) AND (jos_number.channelID=294748444 OR jos_number.channelID=0) ORDER BY RAND() DESC LIMIT 3
17 (!!!!! 3348.1121063232): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='P' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) AND (jos_number.channelID=294748444 OR jos_number.channelID=0) ORDER BY RAND() DESC LIMIT 3
18 (!!!!! 2261.1618041992): SELECT name,id,title FROM jos_deeppockets WHERE id=212 LIMIT 1
19 (102.04315185547): SELECT name,id,title FROM jos_deeppockets WHERE id=212 LIMIT 1
20 (!!!!! 3296.8521118164): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
21 (617.98095703125): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
22 (98.943710327148): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
23 (141.14379882812): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
24 (515.93780517578): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
25 (596.04644775391): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
26 (69.856643676758): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
27 (64.849853515625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
28 (66.995620727539): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
29 (63.896179199219): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
30 (77.962875366211): SELECT conference_items.channel_id, conference_items.tracking_code FROM conference_items LEFT JOIN conference_groups ON conference_groups.id = conference_items.group_id LEFT JOIN jos_deeppockets ON jos_deeppockets.id = conference_items.channel_id LEFT JOIN jos_journal ON jos_journal.cat = jos_deeppockets.cat AND jos_journal.real = 1 AND jos_journal.directory IS NOT NULL WHERE 1 = 1 ORDER BY conference_items.id
31 (295.16220092773): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294748444 LIMIT 1
32 (43.153762817383): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294748444 LIMIT 1
33 (300.16899108887): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294748444 LIMIT 1
34 (72.002410888672): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294748444 LIMIT 1
35 (37.193298339844): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294748444 LIMIT 1
36 (31.232833862305): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294748444 LIMIT 1
37 (30.994415283203): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294748444 LIMIT 1
38 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294748444 LIMIT 1
39 (810.14633178711): SELECT id, title, module, position, content, showtitle, params FROM jos_modules AS m INNER JOIN jos_modules_menu AS mm ON mm.moduleid = m.id WHERE m.published = 1 AND m.access <= 0 AND m.client_id != 1 AND ( mm.menuid = 0 OR mm.menuid = 294748444 ) ORDER BY ordering
40 (!!!!! 1548.0518341064): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
41 (69.141387939453): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
42 (!!!!! 3970.1461791992): SELECT * FROM jos_bannersmanager_banner WHERE `groupid` = 98 AND `site_id` = 10 AND `published` = 1
43 (!!!!! 4306.0779571533): SELECT * FROM jos_bannersmanager_banner WHERE `groupid` = 99 AND `site_id` = 10 AND `published` = 1
44 (145.91217041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
45 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
46 (185.96649169922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
47 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
48 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
49 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
50 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
51 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
52 (334.9781036377): SELECT name FROM jos_deeppockets WHERE id=294748444 LIMIT 1
53 (279.90341186523): SELECT name FROM jos_deeppockets_archive WHERE id=294748444 LIMIT 1
54 (62.942504882812): SELECT a.* FROM jos_components AS a WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' ) AND a.option = 'com_syndicate'
55 (54.121017456055): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
56 (422.00088500977): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
57 (!!!!! 1115.083694458): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
58 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
59 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
60 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
61 (88.930130004883): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1
62 (533.10394287109): SELECT fid FROM jos_deeppockets WHERE id=294748444 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748444 AND published='1' LIMIT 1
63 (305.8910369873): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`
64 (61.03515625): select jos_twitters.link from jos_twitters where cat=10
65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10
66 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10
67 (27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10
68 (46.968460083008): SELECT fid FROM jos_deeppockets WHERE id=294748444 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294748444 AND published='1' LIMIT 1
69 (33.140182495117): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`
70 (379.08554077148): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
71 (265.83671569824): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
72 (50.067901611328): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`
73 (!!!!! 1416.9216156006): SELECT show_live FROM jos_com_show_setting LIMIT 1
74 (50.783157348633): SELECT show_live FROM jos_com_show_setting LIMIT 1
75 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1
76 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1
77 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1
78 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1
79 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1
80 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1
81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1
82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
83 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
84 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1
85 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1
86 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1
87 (81.062316894531): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
88 (75.101852416992): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
89 (55.074691772461): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`
90 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1
91 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1
92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1
93 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1
94 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1
95 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1
96 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1
97 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1
98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1
99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1
100 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1
101 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1
102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1
103 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1
104 (!!!!! 1672.9831695557): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
105 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
106 (55.789947509766): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
107 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
108 (76.770782470703): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
109 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
110 (116.10984802246): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
111 (385.04600524902): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
112 (517.12989807129): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1
113 (378.84712219238): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1
114 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
115 (47.206878662109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
116 (91.075897216797): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
117 (78.916549682617): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
118 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
119 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
120 (56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
121 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
122 (250.10108947754): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`
123 (!!!!! 63153.028488159): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7
124 (715.97099304199): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748444 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748444 AND type='deeppockets_item' AND published='1' LIMIT 1
125 (!!!!! 35449.981689453): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3
126 (66.041946411133): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3
127 (325.91819763184): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1
128 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1
129 (223.15979003906): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1
130 (36.001205444336): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1
131 (192.88063049316): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1
132 (34.093856811523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1
133 (184.05914306641): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1
134 (33.140182495117): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1
135 (!!!!! 8039.9513244629): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
136 (!!!!! 2676.9638061523): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
137 (!!!!! 1645.8034515381): SELECT name FROM jos_deeppockets WHERE id=212
138 (!!!!! 3997.802734375): SELECT name FROM jos_deeppockets WHERE id=212
139 (731.9450378418): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3
140 (!!!!! 2183.198928833): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3
141 (!!!!! 4696.8460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
142 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
143 (!!!!! 6549.1199493408): TRUNCATE TABLE jos_trademed_module
144 (165.93933105469): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
145 (128.03077697754): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294748444 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1
146 (566.95938110352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
147 (54.121017456055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
148 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
149 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
150 (!!!!! 1161.0984802246): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6
151 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
152 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
153 (60.081481933594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294748444 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294748444 AND type='deeppockets_item' AND published='1' LIMIT 1
154 (572.20458984375): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)
155 (51.021575927734): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)
156 (91.075897216797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1
157 (!!!!! 3548.1452941895): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
158 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294748444 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294748444 AND published='1' LIMIT 1
159 (145.91217041016): select jos_twitters.link from jos_twitters where cat=10
160 (36.954879760742): select jos_facebook.link from jos_facebook where cat=10
161 (35.04753112793): select jos_google_plus.link from jos_google_plus where cat=10
162 (33.140182495117): select jos_linkedin.link from jos_linkedin where cat=10
163 (250.10108947754): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)
164 (!!!!! 7011.1751556396): insert into jos_banners_delta values (14615,'2025-06-24 23:48:47','216.73.216.120','view'),(14202,'2025-06-24 23:48:47','216.73.216.120','view'),(14203,'2025-06-24 23:48:47','216.73.216.120','view')