1
|
Clerkin N, Ski C, Suleiman M, Gandomkar Z, Brennan P, Strudwick R. An initial exploration of factors that may impact radiographer performance in reporting mammograms. Radiography (Lond) 2024; 30:1495-1500. [PMID: 39276754 DOI: 10.1016/j.radi.2024.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/29/2024] [Accepted: 09/02/2024] [Indexed: 09/17/2024]
Abstract
OBJECTIVES In the United Kingdom, radiographers with a qualification in image interpretation have interpreted mammograms since 1995. These radiographers work under the title of radiography advanced practitioners (RAP) or Consultant Radiographer. This study extends upon what has been very recently published by exploring further clinical, non-clinical and experiential factors that may impact the reporting performance of RAPs. METHODS Fifteen RAPs interpreted an image test set of 60 2D mammograms of known truth using the Detected-X software platform. Unknown to the reader, twenty cases contained a malignancy. Sensitivity, specificity, lesion sensitivity, receiver operating characteristic (ROC) and jack-knife free response operating characteristic (AFROC) values were established for each RAP. Specific features that had significant impact on accuracy were identified using Student's-T and Mann Whitney tests. RESULTS RAPs with more than 10 years' experience in image interpretation, compared to those with less than 10 years' experience, demonstrated lower specificity (51.3% vs 84.8%, p = 0.0264), ROC (0.83 vs 0.91, p = 0.0264) and AFROC (0.75 vs 0.87, p = 0.0037) values. Further, higher sensitivity values of 90.7% were seen in those RAPs who had an eye test in the last year compared to those who had not, 82% (p = 0.021). Other changes are presented in the paper. CONCLUSION These data reveal previously unidentified factors that impact the diagnostic efficacy of RAPs when interpreting mammographic images. Highlighting such findings will empower screening authorities to better examine ways of standardising performance and offer a baseline for performance benchmarks. IMPLICATIONS FOR PRACTICE This study for the first time performs an initial exploration of the factors that may be associated with RAP performance when interpreting screening mammograms.
Collapse
Affiliation(s)
- N Clerkin
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich IP4 1QJ, UK.
| | - C Ski
- University of Sydney, Camperdown NSW 2006, Australia
| | - M Suleiman
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Z Gandomkar
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - P Brennan
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - R Strudwick
- University of Suffolk, Waterfront Building, 19 Neptune Quay, Ipswich IP4 1QJ, UK
| |
Collapse
|
2
|
Trivett E, MacKay S. An NHS Trust comparison of reporting radiographers and consultant radiologists ability to identify cancer on chest radiographs with confirmation through a Fast track CT thorax referral system. Radiography (Lond) 2024; 30:821-826. [PMID: 38520958 DOI: 10.1016/j.radi.2024.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/25/2024]
Abstract
INTRODUCTION The National Institute for Health and Care Excellence (NICE) recommends that GPs initially refer patients with suspected lung cancer for a chest X-ray (CXR). The Radiology department has a 'fast track system' to identify those patients who may have lung cancer on CXR and are referred for a CT thorax with contrast to help determine a cancer diagnosis. This fast track system was put in place to ensure the NICE guidelines and NHS England's standards on a faster cancer diagnosis are being met. This audit studied the ability of radiologists and reporting radiographers to identify lung cancer on CXRs and the accuracy of the fast-track system. METHODS 846 cases with lung alerts were analysed and 545 CXRs were audited. The CXRs were split into images reported by radiologists (168) and those reported by reporting radiographers (377). CT thorax results were collected through PACS and Cerner computer systems to identify if the 'fast track' system had yielded a "positive", "negative", or "other findings" result for lung cancer. RESULTS 32.8% (179) of CXRs flagged for lung cancer were positive, 40.6% (221) were negative, and 26.6% (145) had other findings. Chi square statistical test showed no significant difference (p = 0.14) between the two reporting groups in their ability to identify lung cancer on CXRs. 27% (38) of CXRs flagged by radiologists and 35% (125) by reporting radiographers were positive for lung cancer. CONCLUSION This clinical audit indicates, reporting radiographers and radiologists are not statistically significantly different regarding their ability to identify lung cancer on CXRs, when supported by the fast track system. The fast-track system had a 59.4 % accuracy rate, detected by the number of imaging of reports that identified a serious pathology. This concludes that the system is performing well, yet could still be improved. IMPLICATIONS FOR PRACTICE This audit provides further evidence for the value of developing and deploying reporting radiographers for projection radiography reporting.
Collapse
Affiliation(s)
- E Trivett
- School of Healthcare Professions and Nursing, University of Liverpool, UK.
| | - S MacKay
- School of Healthcare Professions and Nursing, University of Liverpool, UK
| |
Collapse
|
3
|
Jensen J, Blackburn PA, Gale N, Senior C, Woznitza N, Heales CJ, Pedersen MRV. Reporting radiographers within the European Federation of Radiographer Society (EFRS) member countries - motivation for becoming a reporting radiographer. Radiography (Lond) 2024; 30:731-736. [PMID: 38428197 DOI: 10.1016/j.radi.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/06/2024] [Accepted: 02/20/2024] [Indexed: 03/03/2024]
Abstract
INTRODUCTION Radiographer-led reporting originated in the United Kingdom as a strategy to reduce reporting backlog and time taken to report images. The effectiveness of reporting radiographers has been demonstrated, but their motivational factors have not been thoroughly explored. This survey aims to understand the incentives for radiographers to pursue postgraduate education in reporting radiography across Europe. METHODS An online survey was conducted, collecting data across a range of topics such as demographic information, professional role, and job satisfaction. Questions assessing the influence of motivational factors on the decision to become a reporting radiographer are presented in this study. Descriptive statistics characterized the respondents' demographics. The motivational aspects were analysed quantitatively by regression analyses. Thematic analyses were performed for the free text responses on motivational aspects. RESULTS 239 respondents from the UK, Denmark, Norway, Sweden, The Netherlands, Ireland, and Malta completed the survey's motivation section. Increased knowledge and new challenges were the most motivating factors for becoming a reporting radiographer, while less exposure to radiation and less patient contact were the least motivating factors. Job satisfaction was a significant motivator. Gender significantly correlated with the importance of social connections for female reporting radiographers. A cross-country comparison showed that title and position and job security were more important for reporting radiographers from the UK. CONCLUSION Taking in consideration that a sample of 239 is not generalisable for the role, this survey does provides insights into the motivation behind being a reporting radiographer in Europe. Factors such as increased knowledge, new challenges, and job satisfaction play significant roles. Hindrances experienced by reporting radiographers included lack of time, support, and standards, while aspirations for further professional development were expressed. IMPLICATIONS FOR PRACTICE A thorough understanding of the motivation behind pursuing postgraduate studies in reporting radiography is a valuable tool for managers, aiding in fostering a positive work environment and attracting/keeping qualified personnel. The findings of this study can be employed in the development of strategies to support and enhance the practice of reporting radiographers.
Collapse
Affiliation(s)
- J Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense, Denmark; Department of Radiology, Odense University Hospital, Odense, Denmark.
| | - P A Blackburn
- Department of Radiology, Kolding Hospital- Part of Lillebaelt Hospital, Kolding, Denmark; Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark
| | - N Gale
- Medical Imaging, Faculty of Health and Life Sciences, University of Exeter, UK
| | - C Senior
- Dorset County Hospital NHS Foundation Trust, UK
| | - N Woznitza
- University College London Hospitals, UK; Canterbury Christ Church University, UK
| | - C J Heales
- Medical Imaging, Faculty of Health and Life Sciences, University of Exeter, UK
| | - M R V Pedersen
- Department of Radiology, Kolding Hospital- Part of Lillebaelt Hospital, Kolding, Denmark; Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
4
|
Pedersen MRV, Jensen J, Senior C, Gale N, Heales CJ, Woznitza N. Reporting radiographers in Europe survey: An overview of the role within the European Federation of Radiographer Society (EFRS) member countries. Radiography (Lond) 2023; 29:1100-1107. [PMID: 37757677 DOI: 10.1016/j.radi.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Reporting radiographers undertake an important role in healthcare and for the radiographer profession in general. First introduced in the United Kingdom, reporting radiographers are now practicing in several other European countries. Our objective was to investigate the workforce of reporting radiographers across the European Federation of Radiographer Societies (EFRS) community. METHOD AND MATERIAL A voluntary anonymous 34 item electronic survey was distributed online using social media accounts such as Twitter, Facebook and LinkedIn covering a wide range of topics relating to professional role, advanced practice, education, and seniority. The questionnaire was distributed during a 12-week period in 2022. RESULT A total of 345 individual responses were received from 15 countries with majorities of respondent from United Kingdom (n = 245, 71%) and Denmark (n = 66, 19%). Mean age was 41.9 (S.D 9.8), similar for females, 42.5 (S.D 9.0) and men 40.9 years (S.D 9.7). Most reporting radiographers worked in public hospitals (90%). The vast majority of the respondents (n = 270, n = 94%) authored and signed their own clinical reports while a minority (n = 18, 6%) stated that their reports were checked by radiologists. CONCLUSION The survey highlights the scope of practice of reporting radiographers working in Europe. Reporting is becoming a career path for an increasing number of radiographers across Europe and there is assess to academic education and clinical support. IMPLICATION FOR PRACTICE Reporting radiographers fulfil an important role within the current demands of healthcare. This demand is likely to increase in the future, and therefore it is vital that there is some form of standardisation in the level of education that this group of healthcare professionals receive.
Collapse
Affiliation(s)
- M R V Pedersen
- Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark; Department of Radiology, Kolding Hospital - Part of Lillebaelt Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - J Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense Denmark; Department of Radiology, Odense University Hospital, Odense, Denmark
| | - C Senior
- Dorset County Hospital NHS Foundation Trust, UK
| | - N Gale
- Medical Imaging, University of Exeter, UK
| | - C J Heales
- Medical Imaging, College of Medicine and Health, University of Exeter, UK
| | - N Woznitza
- University College London Hospitals, UK; Canterbury Christ Church University, UK
| |
Collapse
|
5
|
Shir A, Micha A, Novik FE, Elizabeth HS, Shani P, Maija L, Inbal R, Aviv G, Yotam D, Inbal GT. Comparison of chest X-ray interpretation by pediatric pulmonologists, pediatric radiologists, and pediatric residents in children with suspected foreign body aspiration-a retrospective cohort study. Eur J Pediatr 2023:10.1007/s00431-023-04943-z. [PMID: 37081195 DOI: 10.1007/s00431-023-04943-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/22/2023]
Abstract
Chest X-ray (CXR) is an important tool in the assessment of children with suspected foreign body aspiration (FBA), although it can falsely be interpreted as normal in one-third of the cases. The aim of this study is to evaluate the positive predictive value of CXR in children hospitalized with suspected FBA, when interpreted by three disciplines: pediatric pulmonology, pediatric radiology, and pediatric residents. This is a retrospective study that included children aged 0-18 years, admitted with suspected FBA, between 2009 and 2020 in one tertiary center. All patients underwent CXR and a flexible/rigid bronchoscopy for the definitive diagnosis of FBA, up to 1 week apart. Two physicians from each discipline interpreted the CXR, independently. Intra-raters' and inter-raters' agreements were assessed. Sensitivity, specificity, and area under the curve (AUC) were calculated for each discipline. Four hundred seventy-three children were included in the study, 175 (37%) with FBA and 298 (63%) without FBA on flexible/rigid bronchoscopy. The most common radiological findings, as interpreted by a pediatric pulmonologist, were unilateral hyperinflation (47%), radiopaque FB (37.6%), lobar atelectasis (10.3%), unilateral hyperinflation with atelectasis (3.4%), and lobar consolidation (1.7%). Intra-raters' agreement ranged from 0.744 (p < 0.001) among pediatric pulmonologists to 0.326 (p < 0.001) among pediatric radiologists. AUC for predicting FBA based on a CXR was 0.81, 0.77, and 0.7 when interpreted by pediatric pulmonologists, pediatric residents, and radiologists, respectively (p < 0.001). CONCLUSIONS CXR has a high positive predictive value and independently predicts FBA in children; however, normal CXR should not rule out FBA. Predictability is variable among different disciplines. WHAT IS KNOWN • Chest X-ray is an important tool in the assessment of children with suspected foreign body aspiration (FBA). • Chest X-ray can be interpreted as normal in one-third of the cases. WHAT IS NEW • Chest X-ray independently predicts FBA in children, with a high positive predictive value. • The ability of chest x-ray to predict FBA in children differs between pediatric residents, pediatric radiologists, and pediatric pulmonologists.
Collapse
Affiliation(s)
- Avraham Shir
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Aviram Micha
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | - Hoch Sarah Elizabeth
- Department of Radiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
| | - Pozailov Shani
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Levin Maija
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
| | - Raviv Inbal
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Goldbart Aviv
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Dizitzer Yotam
- Departmant of Pediatrics, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Golan-Tripto Inbal
- Department of Pediatrics, Soroka University Medical Center, Beer-Sheva, Israel.
- Pediatric Pulmonary Unit, Soroka University Medical Center, Yitzhak Rager Ave, PO Box 151, Beer-Sheva, 8410101, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| |
Collapse
|
6
|
Hall H, Ruparel M, Quaife SL, Dickson JL, Horst C, Tisi S, Batty J, Woznitza N, Ahmed A, Burke S, Shaw P, Soo MJ, Taylor M, Navani N, Bhowmik A, Baldwin DR, Duffy SW, Devaraj A, Nair A, Janes SM. The role of computer-assisted radiographer reporting in lung cancer screening programmes. Eur Radiol 2022; 32:6891-6899. [PMID: 35567604 PMCID: PMC9474336 DOI: 10.1007/s00330-022-08824-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/11/2022] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Successful lung cancer screening delivery requires sensitive, timely reporting of low-dose computed tomography (LDCT) scans, placing a demand on radiology resources. Trained non-radiologist readers and computer-assisted detection (CADe) software may offer strategies to optimise the use of radiology resources without loss of sensitivity. This report examines the accuracy of trained reporting radiographers using CADe support to report LDCT scans performed as part of the Lung Screen Uptake Trial (LSUT). METHODS In this observational cohort study, two radiographers independently read all LDCT performed within LSUT and reported on the presence of clinically significant nodules and common incidental findings (IFs), including recommendations for management. Reports were compared against a 'reference standard' (RS) derived from nodules identified by study radiologists without CADe, plus consensus radiologist review of any additional nodules identified by the radiographers. RESULTS A total of 716 scans were included, 158 of which had one or more clinically significant pulmonary nodules as per our RS. Radiographer sensitivity against the RS was 68-73.7%, with specificity of 92.1-92.7%. Sensitivity for detection of proven cancers diagnosed from the baseline scan was 83.3-100%. The spectrum of IFs exceeded what could reasonably be covered in radiographer training. CONCLUSION Our findings highlight the complexity of LDCT reporting requirements, including the limitations of CADe and the breadth of IFs. We are unable to recommend CADe-supported radiographers as a sole reader of LDCT scans, but propose potential avenues for further research including initial triage of abnormal LDCT or reporting of follow-up surveillance scans. KEY POINTS • Successful roll-out of mass screening programmes for lung cancer depends on timely, accurate CT scan reporting, placing a demand on existing radiology resources. • This observational cohort study examines the accuracy of trained radiographers using computer-assisted detection (CADe) software to report lung cancer screening CT scans, as a potential means of supporting reporting workflows in LCS programmes. • CADe-supported radiographers were less sensitive than radiologists at identifying clinically significant pulmonary nodules, but had a low false-positive rate and good sensitivity for detection of confirmed cancers.
Collapse
Affiliation(s)
- Helen Hall
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Mamta Ruparel
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Samantha L Quaife
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jennifer L Dickson
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Carolyn Horst
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - Sophie Tisi
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
| | - James Batty
- Department of Radiology, University College London Hospital, London, UK
| | | | - Asia Ahmed
- Department of Radiology, University College London Hospital, London, UK
| | - Stephen Burke
- Department of Radiology, Homerton University Hospital, London, UK
| | - Penny Shaw
- Department of Radiology, University College London Hospital, London, UK
| | - May Jan Soo
- Department of Radiology, Homerton University Hospital, London, UK
| | - Magali Taylor
- Department of Radiology, University College London Hospital, London, UK
| | - Neal Navani
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK
- Department of Thoracic Medicine, University College London Hospital, London, UK
| | - Angshu Bhowmik
- Department of Thoracic Medicine, Homerton University Hospital, London, UK
| | - David R Baldwin
- Respiratory Medicine Unit, David Evans Research Centre, Nottingham University Hospitals, Nottingham, UK
| | - Stephen W Duffy
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anand Devaraj
- Department of Radiology, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Arjun Nair
- Department of Radiology, University College London Hospital, London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, UCL Respiratory, Rayne Institute, University College London, 5 University Street, London, WC1E 6JF, UK.
- Department of Thoracic Medicine, University College London Hospital, London, UK.
| |
Collapse
|
7
|
Elshami W, Abuzaid MM, McConnell J, Baird M. Changing the model of radiography practice: Challenges of role advancement and future needs for radiographers working in the UAE. Radiography (Lond) 2022; 28:949-954. [PMID: 35841689 DOI: 10.1016/j.radi.2022.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/04/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The radiographers' role in the United Arab Emirates (UAE) is focused on image acquisition with a willingness to accept advanced practice roles after appropriate education and training. Radiographers working in the UAE are highly motivated and ambitious to achieve those internationally identified levels of professional recognition and opportunities for role advancement. This study investigates the radiographers' perspectives, perceptions and hopes for role advancement in the UAE. METHODS A qualitative research study design using Focus Group Discussions (FGD) was used to elicit the perceptions of radiographers. Participants were radiographers working in the hospitals and clinics supervised by the Ministry of Health and Prevention. Participants were asked about the recognized tasks defined as advancement roles, needs for roles clinically, challenges and requirements to prepare radiographers to participate in extended/developed roles. The discussions were audio recorded and later transcribed by an independent research assistant. Thematic analysis was used for data analysis RESULTS: 29 radiographers participated in the FGDs, and 83% (n = 24) were interested in role advancement. FGD revealed that their current practice showed some informal extended role that may promote career progression. The most significant challenges identified by participants was their knowledge level as provided by the current curriculum and the need for education and licensing body support to accommodate change. CONCLUSION The study identified a need for education and licensing body support to enable change in roles by radiographers, through improving radiographer knowledge and experience for role advancement. IMPLICATIONS FOR PRACTICE To sustain role advancement, formal intense training and education are necessary, normally above bachelor's degree level. Furthermore, establishing standards, licensing organizations/professional bodies should be part of the transformation of the profession to enable internationally recognized models to be followed.
Collapse
Affiliation(s)
- W Elshami
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - M M Abuzaid
- Medical Diagnostic Imaging Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
| | - J McConnell
- Yorkshire Imaging Collaborative, United Kingdom.
| | - M Baird
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
| |
Collapse
|
8
|
Cain G, Pittock LJ, Piper K, Venumbaka MR, Bodoceanu M. Agreement in the reporting of General Practitioner requested musculoskeletal radiographs: Reporting radiographers and consultant radiologists compared with an index radiologist. Radiography (Lond) 2022; 28:288-295. [PMID: 35000869 DOI: 10.1016/j.radi.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study assessed the inter-observer agreement of reporting radiographers and consultant radiologists compared with an index radiologist when reporting General Practitioner (GP) requested musculoskeletal radiographs. The potential effect of discordant reports on patient management and outcome was also examined. METHODS Three reporting radiographers, three consultant radiologists and an index radiologist reported on a retrospective randomised sample of 219 GP requested musculoskeletal radiographs, in conditions simulating clinical practice. A speciality doctor in radiology compared the observers' reports with the index radiologist report for agreement and assessed whether any discordance between reports was clinically important. RESULTS Overall agreement with the index radiologist was 47.0% (95% CI, 40.5-53.6) and 51.6% (95% CI, 45.0-58.1) for the consultant radiologists and reporting radiographers, respectively. The results for the appendicular and axial skeleton were 48.6% (95% CI, 41.3-55.9) and 40.9% (95% CI, 27.7-55.6) for the radiologists, and 52.6% (95% CI, 45.2-59.8) and 47.7% (95% CI, 33.8-62.1) for the radiographers, respectively. The difference in overall observer agreement between the two professional groups with the index radiologist was not statistically significant (p = 0.34). Discordance with the index radiologist's reports was judged to be clinically important in less than 10% of the observer's reports. CONCLUSION Reporting radiographers and consultant radiologists demonstrate similar levels of concordance with an index radiologist when reporting GP requested musculoskeletal radiographs. IMPLICATIONS FOR PRACTICE These findings contribute to the wider evidence base that selected radiographers with appropriate postgraduate education and training are proficient to report on musculoskeletal radiographs, irrespective of referral source.
Collapse
Affiliation(s)
- G Cain
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK.
| | - L J Pittock
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
| | - K Piper
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
| | - M R Venumbaka
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK
| | - M Bodoceanu
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK
| |
Collapse
|
9
|
White SA, Shellikeri S, Muñoz ML, Edgar JC, Nguyen JC, Sze RW. Can Radiology Technologists be Trained to Measure Leg Length Discrepancies as Accurately as Pediatric Radiologists? Acad Radiol 2022; 29:51-55. [PMID: 33257257 DOI: 10.1016/j.acra.2020.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE AND OBJECTIVES Leg length discrepancy studies are labor intensive. They are procedurally simple and represent inefficient use of the radiologists' time and expertise. We hypothesized that radiology technologists could be trained to measure leg length discrepancies, and that their performance would be statistically equivalent to that of board-certified, fellowship-trained pediatric radiologists. MATERIAL AND METHODS Four radiology technologists were selected to participate in a supervised practice session. They independently measured and calculated leg length discrepancies on 10 randomly selected cases. Their performance was compared to measurements obtained by an experienced pediatric radiologist (reference standard). After 1 week, the technologists repeated their measurements on the same cases, which were resorted to simulate new cases. Intraclass correlation coefficients (ICC) determined interobserver agreement between the technologists and radiologist and intra-observer reliability among the technologists. RESULTS Among the four technologists, similarity in measurements between session 1 and the reference standard was very high, with ICC values ranging from 0.93 to 0.98 (p < 0.001). The ICC between session 2 and the reference standard was also high, ranging from 0.93 to 0.98 (p < 0.001). Finally, among the four technologists, ICC values between session 1 and session 2 were ≥ 0.96 (p < 0.001). CONCLUSION Radiology technologists can be rapidly trained to calculate leg length discrepancies as accurately as a board-certified pediatric radiologist. Delegation of this time-consuming task to technologists or radiology assistants will permit radiologists to spend time on more demanding studies, such as studies that require subspecialty training.
Collapse
Affiliation(s)
- Stacy A White
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Sphoorti Shellikeri
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Marlon L Muñoz
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - J Christopher Edgar
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jie C Nguyen
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Raymond W Sze
- Division of Radiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
| |
Collapse
|
10
|
Accuracy of radiographers in Fiji in interpreting adult chest X-ray images. J Med Imaging Radiat Sci 2021; 53:93-101. [DOI: 10.1016/j.jmir.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022]
|
11
|
Leide R, Bohman A, Wenger D, Overgaard S, Tiderius CJ, Rogmark C. Hip dysplasia is not uncommon but frequently overlooked: a cross-sectional study based on radiographic examination of 1,870 adults. Acta Orthop 2021; 92:575-580. [PMID: 34238106 PMCID: PMC8519544 DOI: 10.1080/17453674.2021.1936918] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - Hip dysplasia in adults is a deformity in which the acetabulum inadequately covers the femoral head. The prevalence is sparingly described in the literature. We investigated the prevalence in Malmö (Sweden) and assessed whether the condition was recognized in the radiology reports.Subjects and methods - All pelvic radiographs performed in Malmö during 2007-2008 on subjects aged 20-70 years with a Swedish personal identity number were assessed. 1,870 digital radiographs were eligible for analysis. The lateral center-edge angle (LCEA) and acetabular index angle (AIA) were measured. Hip dysplasia was defined as an LCEA ≤ 20°. Intraclass correlation coefficients (ICC) for intra-observer measurements ranged from 0.87 (AIA, 95% CI 0.78-0.93) to 0.98 (LCEA, CI 0.97-0.99).Results - The prevalence of hip dysplasia (LCEA ≤ 20°) was 5.2% (CI 4.3-6.3), (98/1,870). There was no statistically significant difference between the sexes for either prevalence of hip dysplasia or mean LCEA. The mean AIA was 0.9° (CI 0.3-1.3) higher in men (4.1 SD 5.5) compared with women (3.2 SD 5.4). The radiologists had reported hip dysplasia in 7 of the 98 cases.Interpretation - The prevalence of hip dysplasia in Malmö (Sweden) is similar to previously reported data from Copenhagen (Denmark) and Bergen (Norway). Our results indicate that hip dysplasia is often overlooked by radiologists, which may influence patient treatment.
Collapse
Affiliation(s)
- Rebecka Leide
- Department of Clinical Sciences, Lund University, Lund, Sweden,Department of Orthopedics, Halland Hospital, Halmstad, Sweden,Correspondence: Rebecka LEIDE Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Anna Bohman
- Department of Emergency Medicine, Central Hospital, Kristianstad, Sweden
| | - Daniel Wenger
- Department of Clinical Sciences, Lund University, Lund, Sweden,Department of Orthopedics, Skåne University Hospital, Lund and Malmö, Sweden
| | - Søren Overgaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark,Department of Orthopaedic Surgery and Traumatology, Copenhagen University Hospital, Bispebjerg, Denmark
| | - Carl Johan Tiderius
- Department of Clinical Sciences, Lund University, Lund, Sweden,Department of Orthopedics, Skåne University Hospital, Lund and Malmö, Sweden
| | - Cecilia Rogmark
- Department of Clinical Sciences, Lund University, Lund, Sweden,Department of Orthopedics, Skåne University Hospital, Lund and Malmö, Sweden
| |
Collapse
|
12
|
DeStigter K, Pool KL, Leslie A, Hussain S, Tan BS, Donoso-Bach L, Andronikou S. Optimizing integrated imaging service delivery by tier in low-resource health systems. Insights Imaging 2021; 12:129. [PMID: 34529166 PMCID: PMC8444174 DOI: 10.1186/s13244-021-01073-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 08/11/2021] [Indexed: 12/16/2022] Open
Abstract
Access to imaging diagnostics has been shown to result in accurate treatment, management, and optimal outcomes. Particularly in low-income and low-middle-income countries (LICs, LMICs), access is limited due to a lack of adequate resources. To achieve Sustainable Development Goal (SDG) 3, access to imaging services is critical at every tier of the health system. Optimizing imaging services in low-resource settings is best accomplished by prescriptive, integrated, and coordinated tiered service delivery that takes contextual factors into consideration. To our knowledge, this is the first recommendation for optimized, specific imaging care delivery by tier. A model for tier-based essential imaging services informs and guides policymakers as they set priorities and make budgetary decisions. In this paper, we recommend a framework for tiered imaging services essential to reduce the global burden of disease and attain universal health coverage (UHC). A lack of access to basic imaging services, even at the lowest tier of the health system, can no longer be justified by cost. Worldwide, affordable modalities of modern ultrasound and X-ray are becoming an accessible mainstay for the investigation of common conditions such as pregnancy, pneumonia, and fractures, and are safely performed and interpreted by qualified professionals. Finally, given the vast gap in access to imaging resources between LMICs and high-income countries (HICs), a scale-up of tiered imaging services in low-resource settings has the potential to reduce health disparities between, and within countries. As the access to appropriately integrated imaging services improves, UHC may be achieved.
Collapse
Affiliation(s)
- Kristen DeStigter
- Department of Radiology, Larner College of Medicine, University of Vermont, 111 Colchester Avenue Main Campus, McClure, Level 1, Burlington, VT, 05401, USA
| | - Kara-Lee Pool
- RAD-AID International, 8004 Ellingson Drive, Chevy Chase, MD, 20815, USA.
| | - Abimbola Leslie
- Department of Radiology, Larner College of Medicine, University of Vermont, 111 Colchester Avenue Main Campus, McClure, Level 1, Burlington, VT, 05401, USA
| | - Sarwat Hussain
- Department of Radiology, University of Massachusetts, 55 North Lake Ave, Worcester, MA, 01655, USA
| | - Bien Soo Tan
- Department of Vascular and Interventional Radiology, Singapore General Hospital, Outram Rd, Singapore, 169608, Singapore
| | - Lluis Donoso-Bach
- Department of Medical Imaging, Hospital Clínic of Barcelona, University of Barcelona, C. de Villarroel, 170, 08036, Barcelona, Spain
| | - Savvas Andronikou
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia and the Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
| |
Collapse
|
13
|
Wood K. How is the reporting radiographer role portrayed in published studies? A scoping review. Radiography (Lond) 2021; 28:215-221. [PMID: 34404577 DOI: 10.1016/j.radi.2021.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/23/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Radiographers have been undertaking reporting tasks since the 1980's with a wealth of evidence published to support this practice. Radiographers have since developed skills in reporting all body systems, from all referral sources across a range of modalities. Radiographer reporting is now considered established and demand for radiographers in this role is rising to meet service demand. Reporting radiographers work as part of multi-professional image reporting teams, it is unclear how the radiographer role is perceived as part of this model. The aim was to review peer-reviewed literature to evaluate how the role of the reporting radiographer is portrayed and how the relationship between the two imaging professions has developed. KEY FINDINGS Language used to discuss the role of the reporting radiographer has changed over time. There is progress demonstrated from the practice of radiographer reporting being considered contentious or opposed to accepted and established. Recent publications focus on the importance utilising the skills of all multi-disciplinary team members in workforce structure. This features prominently when discussing future workforce design, such as with the Cancer workforce strategy and the development of the national standards for musculoskeletal reporting. CONCLUSION Published literature has highlighted a move towards acceptance of the reporting radiographer role. Multi-disciplinary team working, utilising the skills of all imaging team members, is essential to the success and sustainability of the imaging workforce moving forwards. IMPLICATIONS FOR PRACTICE Reporting by radiographers is established and will be prominent in the reporting workforce as part of long-term workforce planning, considering skills mix to form effective and sustainable multidisciplinary reporting teams.
Collapse
Affiliation(s)
- K Wood
- College of Health, Psychology and Social Care, University of Derby, UK.
| |
Collapse
|
14
|
Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, Blake H, Yogeswaran G, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open 2021; 11:e048171. [PMID: 34353799 PMCID: PMC8344309 DOI: 10.1136/bmjopen-2020-048171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK. DESIGN A scoping review was undertaken following JBI methodological guidance. METHODS 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative. RESULTS 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway. CONCLUSION This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.
Collapse
Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jeanette Eldridge
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gowsika Yogeswaran
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Leicester, UK
| | - Joy Conway
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Richard Collier
- Centre for Advancing Practice, Health Education England, Leeds, UK
| |
Collapse
|
15
|
Teng PH, Liang CH, Lin Y, Alberich-Bayarri A, González RL, Li PW, Weng YH, Chen YT, Lin CH, Chou KJ, Chen YS, Wu FZ. Performance and educational training of radiographers in lung nodule or mass detection: Retrospective comparison with different deep learning algorithms. Medicine (Baltimore) 2021; 100:e26270. [PMID: 34115023 PMCID: PMC8202613 DOI: 10.1097/md.0000000000026270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/21/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of this investigation was to compare the diagnostic performance of radiographers and deep learning algorithms in pulmonary nodule/mass detection on chest radiograph.A test set of 100 chest radiographs containing 53 cases with no pathology (normal) and 47 abnormal cases (pulmonary nodules/masses) independently interpreted by 6 trained radiographers and deep learning algorithems in a random order. The diagnostic performances of both deep learning algorithms and trained radiographers for pulmonary nodules/masses detection were compared.QUIBIM Chest X-ray Classifier, a deep learning through mass algorithm that performs superiorly to practicing radiographers in the detection of pulmonary nodules/masses (AUCMass: 0.916 vs AUCTrained radiographer: 0.778, P < .001). In addition, heat-map algorithm could automatically detect and localize pulmonary nodules/masses in chest radiographs with high specificity.In conclusion, the deep-learning based computer-aided diagnosis system through 4 algorithms could potentially assist trained radiographers by increasing the confidence and access to chest radiograph interpretation in the age of digital age with the growing demand of medical imaging usage and radiologist burnout.
Collapse
Affiliation(s)
- Pai-Hsueh Teng
- Department of Radiology, Kaohsiung Veterans General Hospital
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung
| | - Chia-Hao Liang
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University
- Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yun Lin
- Department of Radiology, Kaohsiung Veterans General Hospital
| | - Angel Alberich-Bayarri
- Radiology Department, Hospital Universitarioy Polite’cnico La Fe and Biomedical Imaging Research Group (GIBI230)
- QUIBIM SL, Valencia, Spain
| | - Rafael López González
- Radiology Department, Hospital Universitarioy Polite’cnico La Fe and Biomedical Imaging Research Group (GIBI230)
- QUIBIM SL, Valencia, Spain
| | - Pin-Wei Li
- Department of Radiology, Kaohsiung Veterans General Hospital
| | - Yu-Hsin Weng
- Department of Radiology, Kaohsiung Veterans General Hospital
| | - Yi-Ting Chen
- Department of Radiology, Kaohsiung Veterans General Hospital
| | - Chih-Hsien Lin
- Department of Radiology, Kaohsiung Veterans General Hospital
| | - Kang-Ju Chou
- Institute of Clinical Medicine, National Yang Ming University, Taipei
| | - Yao-Shen Chen
- Institute of Clinical Medicine, National Yang Ming University, Taipei
| | - Fu-Zong Wu
- Department of Radiology, Kaohsiung Veterans General Hospital
- Faculty of Medicine, School of Medicine, i Institute of Clinical Medicine, National Yang Ming Chiao Tung University
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| |
Collapse
|
16
|
Stevens BJ, Skermer L, Davies J. Radiographers reporting chest X-ray images: Identifying the service enablers and challenges in England, UK. Radiography (Lond) 2021; 27:1006-1013. [PMID: 33875356 DOI: 10.1016/j.radi.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/18/2021] [Accepted: 03/21/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The chest x-ray (CXR) is the most commonly performed x-ray examination in England, UK. Reporting radiographers provide a cost-effective and safe solution for managing CXR backlogs, but not all Trusts support this service development. This study aimed to establish the service enablers and challenges associated with training and employing radiographers to report CXR images in acute hospital sites in England, UK. METHODS Approval for this electronic survey was granted in 84 of 146 (58%) Trusts approached. The survey was open for 10 weeks during August to October 2020, comprising of qualitative and quantitative questions. Data was exported in to an Excel spreadsheet where manual thematic analysis was performed. Descriptive statistics were also generated. RESULTS Sample size was 75 (89% response rate). Thirty-three departments (44%) had at least one trainee. Most departments (n = 53, 71%) employ at least one CXR reporting radiographer. A total of 121/160 (76%) radiographers report CXRs. Number of reporting sessions shows progression. Factors enabling training and employment arise from service improvements, financial pressures, and developing the workforce. The main challenges relate to staffing issues with a number of associated sub-themes. A small faction indicated lack of radiographer interest to report CXRs due to litigation worries; possibly uncovering a new and emerging issue. CONCLUSION Enablers and challenges associated with radiographers reporting CXRs are similar to previous studies. The growth of CXR reporting radiographers and reporting sessions indicates a continuing reliance on radiographers to contributing to managing CXR backlogs. IMPLICATIONS FOR PRACTICE It is recommended that potential trainees are explicitly informed of the legal protection that will be provided, to prevent accountability concerns impacting on the continuing progression in this area of advanced practice.
Collapse
Affiliation(s)
- B J Stevens
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK.
| | - L Skermer
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK
| | - J Davies
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall West Midlands, WS2 9PS, UK
| |
Collapse
|
17
|
Mander GTW, Munn Z. Understanding diagnostic test accuracy studies and systematic reviews: A primer for medical radiation technologists. J Med Imaging Radiat Sci 2021; 52:286-294. [PMID: 33741279 DOI: 10.1016/j.jmir.2021.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 01/18/2023]
Abstract
Diagnostic test accuracy studies are performed in order to determine the value of a diagnostic test. Primary studies of diagnostic accuracy describe the accuracy of a test calculated using the number of true and false positive and negative cases of a given diagnosis of interest. Systematic reviews of diagnostic test accuracy are performed to identify accuracy of a test but also to investigate where the test might sit in a diagnostic pathway or determine how different tests compare against each other. This introductory discussion paper aims to give the reader an overview of the various features in primary and secondary diagnostic test accuracy study designs for medical imaging professionals.
Collapse
Affiliation(s)
- Gordon T W Mander
- Darling Downs Health, Pechey St, Toowoomba, QLD 4350, Australia; JBI, The University of Adelaide, North Adelaide, SA, Australia; School of Clinical Sciences, Queensland University of Technology, QLD, Australia.
| | - Zachary Munn
- JBI, The University of Adelaide, North Adelaide, SA, Australia
| |
Collapse
|
18
|
Al Shammari M, Hassan A, AlShamlan N, Alotaibi S, Bamashmoos M, Hakami A, Althunyan A, Basager S, Motabgani S, Aljubran S, Alsaif HS. Family medicine residents' skill levels in emergency chest X-ray interpretation. BMC FAMILY PRACTICE 2021; 22:39. [PMID: 33596838 PMCID: PMC7889059 DOI: 10.1186/s12875-021-01390-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 02/09/2021] [Indexed: 12/05/2022]
Abstract
Background Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remains the imaging modality of choice. The current study assessed the competency of family medicine residents in the interpretation of chest X-rays for emergency conditions and to compare it with that of diagnostic radiology residents, general practitioners, and medical interns. Methods An online survey was distributed to 600 physicians, including family medicine residents, medical interns, general practitioners, and diagnostic radiology residents. The study included some background information such as gender, years in practice, training type, interest in pulmonary medicine and diagnostic radiology, and having adequate training on the interpretation of chest X-rays. The survey had 10 chest X-ray cases with brief clinical information. Participants were asked to choose the most likely diagnosis and to rate their degree of confidence in the interpretation of the chest X-ray for each case. Results The survey was completed by 205 physicians (response rate = 34.2%). The overall diagnostic accuracy was 63.1% with a significant difference between family medicine and radiology residents (58.0% vs. 90.5%; P < 0.001). The COVID-19 pneumonia (85.4%) and pneumoperitoneum (80.5%) cases had the highest diagnostic accuracy scores. There was a significant correlation between the diagnostic confidence and accuracy (rs = 0.39; P < 0.001). Multivariable regression analysis revealed that being diagnostic radiology residents (odds ratio [OR]: 13.0; 95% confidence interval [CI]: 2.5–67.7) and having higher diagnostic confidence (OR: 2.2; 95% CI: 1.3–3.8) were the only independent predictors of achieving high diagnostic accuracy. Conclusion The competency of family medicine residents in the interpretation of chest X-ray for emergency conditions was far from optimal. The introduction of radiology training courses on emergency conditions seems imperative. Alternatively, the use of tele-radiology in primary healthcare centers should be considered. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01390-3.
Collapse
Affiliation(s)
- Malak Al Shammari
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, Salmaniya Medical Complex, Manama, Bahrain.
| | - Nouf AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Sarah Alotaibi
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Manar Bamashmoos
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Amani Hakami
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Abdullatif Althunyan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Shymaa Basager
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Sameerah Motabgani
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Sawsan Aljubran
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Hind S Alsaif
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| |
Collapse
|
19
|
Woznitza N, Steele R, Hussain A, Gower S, Groombridge H, Togher D, Lofton L, Lainchbury J, Compton E, Rowe S, Robertson K. Reporting radiographer peer review systems: A cross-sectional survey of London NHS Trusts. Radiography (Lond) 2021; 27:173-177. [DOI: 10.1016/j.radi.2020.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 12/20/2022]
|
20
|
Stevens BJ. Reporting radiographers' interpretation and use of the British Society of Thoracic Imaging's coding system when reporting COVID-19 chest x-rays. Radiography (Lond) 2021; 27:90-94. [PMID: 32591286 PMCID: PMC7301077 DOI: 10.1016/j.radi.2020.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION The United Kingdom (UK) has experienced one of the worst initial waves of the COVID-19 pandemic. Clinical signs help guide initial diagnosis, though definitive diagnosis is made using the laboratory technique reverse transcription polymerase chain reaction (RT-PCR). The chest x-ray (CXR) is used as the primary imaging investigation in the United Kingdom (UK) for patients with suspected COVID-19. In some hospitals these CXRs may be reported by a radiographer. METHODS Retrospective review of CXR reports by radiographers for suspected COVID-19 patients attending the Emergency Department (ED) of a hospital in the UK. Interpretation and use of the British Society of Thoracic Imaging (BSTI) coding system was assessed. Report description and code use were cross-checked. Report and code usage were checked against the RT-PCR result to determine accuracy. Report availability was checked against the availability of the RT-PCR result. A confusion matrix was utilised to determine performance. The data were analysed manually using Excel. RESULTS Sample size was 320 patients; 54.1% male patients (n = 173), 45.9% female patients (n = 147). The correct code matched report descriptions in 316 of the 320 cases (98.8%). In 299 of the 320 cases (93.4%), the reports were available before the RT-PCR swab result. CXR sensitivity for detecting COVID-19 was 85% compared to 93% for the initial RT-PCR. CONCLUSION Reporting radiographers can adequately utilise and apply the BSTI classification system when reporting COVID-19 CXRs. They can recognise the classic CXR appearances of COVID-19 and those with normal appearances. Future best practice includes checking laboratory results when reporting CXRs with ambiguous appearances. IMPLICATIONS FOR PRACTICE Utilisation of reporting radiographers to report CXRs in any future respiratory pandemic should be considered a service-enabling development.
Collapse
Affiliation(s)
- Barry J Stevens
- Radiology, Manor Hospital, Walsall Healthcare NHS Trust, Moat Road, Walsall, West Midlands, WS2 9PS, UK.
| |
Collapse
|
21
|
Jha S. Navigating the Paradox of Scarcity-The Case for Physician Extenders. J Am Coll Radiol 2021; 18:148-150. [PMID: 33413891 DOI: 10.1016/j.jacr.2020.09.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 09/09/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Saurabh Jha
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
| |
Collapse
|
22
|
Mander G, Steffensen C, Munn Z. Evidence synthesis in radiography: current challenges and opportunities. JBI Evid Synth 2021; 19:1-3. [PMID: 33394818 DOI: 10.11124/jbies-20-00557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Gordon Mander
- Darling Downs Health, Toowoomba, QLD, Australia.,School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | | | - Zachary Munn
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| |
Collapse
|
23
|
Piper K, Mitchell M, Griffin K, Morgan T, Roy A, Thomas A, Pittock L, Woznitza N, Faruqui R, Sakel M. Concordance between a neuroradiologist, a consultant radiologist and trained reporting radiographers interpreting MRI head examinations: An empirical study. Radiography (Lond) 2020; 27:475-482. [PMID: 33218744 DOI: 10.1016/j.radi.2020.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study assessed agreement between MRI reporting radiographers and a consultant radiologist compared with an index neuroradiologist when reporting MRI head (brain/internal auditory meati [IAMs]) examinations. The effect on patient management of any discordant reports was also examined. METHODS Two trained MRI reporting radiographers (RRs), a consultant radiologist (CR) and an index neuroradiologist (INR) reported on a random sample of 210 MRI examinations. The radiographers reported during clinical practice and the radiologists in clinical practice conditions. Two independent consultant physicians (neuro-rehabilitation and neuropsychiatry) compared these reports with the index neuroradiologist report for agreement and the clinical importance of discrepant reports. RESULTS Overall observer agreement between the RRs and CR was comparable in relation to agreement with the INR: RR; 93/210 (44.3%); and the CR; 83/210 (39.4%) for all head MRI examinations (p = 0.32). For brain examinations the difference was similar: RR; 64/180 (35.6%); and CR; 54/190 (30.0%), p = 0.26. Agreement rates for the IAMs examinations were identical, 29/30 (97.7%). For all head MRI examinations (n = 210) there was a very small observed difference of <0.5% in mean agreement between the reporting radiographers and the consultant radiologist (p = 0.92) for examinations where a major disagreement would have been likely to have led to a change in patient management. CONCLUSION MRI reporting radiographers reported during clinical practice on MRI head examinations to a level of agreement comparable with a consultant radiologist. IMPLICATIONS FOR PRACTICE This is an area in which radiographers could provide additional reporting roles to the reporting service to increase capacity. Wider potential benefits include cost-effectiveness and role development/retention of radiographers.
Collapse
Affiliation(s)
- K Piper
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - M Mitchell
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK; Imaging Department, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, ME7 5NY, UK.
| | - K Griffin
- Imaging Department, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, ME7 5NY, UK.
| | - T Morgan
- Radiology Department, Northampton General Hospital NHS Trust, Northampton, NN1 5BD, UK; Diagnostic/Medical Imaging Department, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, PE29 6NT, UK.
| | - A Roy
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK.
| | - A Thomas
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - L Pittock
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - N Woznitza
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK; Radiology Department, University College London Hospitals, London, NW1 2PG, UK.
| | - R Faruqui
- Centre for Health Services Studies, University of Kent, Canterbury, CT2 7NH, UK.
| | - M Sakel
- NeuroRehabitation Service, East Kent University Hospitals NHS Foundation Trust, Canterbury, CT1 3NG, UK.
| |
Collapse
|
24
|
Wuni AR, Courtier N, Kelly D. Developing a policy framework to support role extension in diagnostic radiography in Ghana. J Med Imaging Radiat Sci 2020; 52:112-120. [PMID: 33082122 DOI: 10.1016/j.jmir.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A global shortage of radiologists is affecting the timely provision of imaging reports and thus healthcare delivery. This situation has been the main driving factor behind successful role extension by radiographers into areas that traditionally were within the scope of radiologists, including image interpretation and reporting. The shortage of radiologists is even worse in developing countries like Ghana. There is a need for policy to guide the introduction and implementation of role extension in Ghana. METHODS A qualitative, single case study with multiple sites across the country was used. A sample of 16 participants, including 8 radiographers, 3 radiologists, 3 medical officers, a senior official each from the Ministry of Health and the Allied Health Professions Council, were interviewed about role extension. RESULTS The findings indicate the need for a guiding policy of role extension to be spear headed by the Ministry of Health to gain the needed credibility. The findings suggest the policy should be made to meet the local needs of the country. It also established the policy should regulate education and training and the scope of practice. CONCLUSION The study established the need for policy to guide the introduction and practice of role extension in diagnostic radiography in Ghana. The study also established the need for a broad consultation of all key stakeholders based on an internationally accepted consensus building model.
Collapse
Affiliation(s)
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, UK
| |
Collapse
|
25
|
Saade C, Siblini L, Karout L, Khalife S, Hilal H, Abbas S, Salman R, Naffaa L. To repeat or not to repeat: Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate during mobile chest radiography. Radiography (Lond) 2020; 27:304-309. [PMID: 33023812 DOI: 10.1016/j.radi.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 07/27/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Radiologists and radiographers play a complementary role in providing an optimal image quality with decrease radiation dose and proper diagnosis during chest radiographs. We aim Investigate years of experience among radiologists and radiographers on perception of image quality and its impact on repeat rate when evaluating portable pediatric chest radiographs. METHODS IRB approved retrospective study consisted of randomly selected images (n = 131) of pediatric portable chest radiographs. Images were blindly assessed by four radiologists and four radiographers. Readers were asked to assess qualitative and quantitative image quality by rating: image quality, decision to repeat and image technique. All data was compared employing Pearson's Correlation, Visual grading characteristic (VGC) and Cohens' kappa analyses. RESULTS Image quality: Radiologists (88.4%) rated images as excellent significantly more than radiographers (11.6%), and radiographers (90.1%) as poor significantly more than radiologists (9.9%) (p < 0.05). Repeat: Radiologists (57%) decided not to repeat images significantly more than radiographers (43%) (p < 0.05). Image technique: Radiologists rated images as acceptable (65%) and excellent (97.7%) significantly more than radiographers (35% and 2.3% respectively) (p < 0.05), whereas radiographers (84%) assessed image technique as poor significantly more than radiologists (16%) (p < 0.05). VGC: radiographers had slightly better qualitative evaluation of image quality than radiologists. An association between image quality (p < 0.002) and repeat decision (p < 0.044) with years of experience was established when comparing years of experience with image assessment rubric, while no association was noted with image technique (p < 0.9). CONCLUSION Radiologists demonstrated more decisiveness than their fellow radiographers in reducing the repeat rate of portable pediatric chest radiographs. Interestingly, years of experience only seem to affect image technique and image quality assessment among radiologists. IMPLICATIONS FOR PRACTICE Continuous education of radiographers and close collaboration with radiologists is crucial to achieve optimal image quality and low radiation doses.
Collapse
Affiliation(s)
- C Saade
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - L Siblini
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - L Karout
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - S Khalife
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - H Hilal
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - S Abbas
- Faculty of Health Sciences, Medical Imaging Sciences, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - R Salman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
| | - L Naffaa
- Diagnostic Radiology Department, American University of Beirut Medical Center, P.O.Box: 11-0236 Riad El-Solh, Beirut, 1107 2020, Lebanon.
| |
Collapse
|
26
|
Shannon LM, Awan OA. Are Radiologist Assistants the Quintessential Solution for Modern Radiology Departments? Radiographics 2020; 40:1502-1503. [DOI: 10.1148/rg.2020190199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- LeAnn M. Shannon
- From the Department of Diagnostic Radiology, Vanderbilt University Medical Center, Nashville, Tenn (L.M.S.), and Department of Radiology, University of Maryland School of Medicine, 655 W Baltimore St, Baltimore, MD 21201 (O.A.A.)
| | - Omer A. Awan
- From the Department of Diagnostic Radiology, Vanderbilt University Medical Center, Nashville, Tenn (L.M.S.), and Department of Radiology, University of Maryland School of Medicine, 655 W Baltimore St, Baltimore, MD 21201 (O.A.A.)
| |
Collapse
|
27
|
Woznitza N, Steele R, Groombridge H, Compton E, Gower S, Hussain A, Norman H, O'Brien A, Robertson K. Clinical reporting of radiographs by radiographers: Policy and practice guidance for regional imaging networks. Radiography (Lond) 2020; 27:645-649. [PMID: 32814647 DOI: 10.1016/j.radi.2020.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Radiographer reporting is an essential component of imaging across the United Kingdom. Since the previous policy and practice guidance in 2004 the role and contribution of reporting radiographers has changed significantly. The move to imaging networks further reinforces the need for consistency in scope of practice and clinical governance for radiographer reporting. KEY FINDINGS This guidance provides a consistent, evidence-based template for planning a reporting service, resourcing, clinical governance, preceptorship, volume and frequency of reporting, a peer learning framework and expected standards. CONCLUSION Developed for North Central and East London, this framework and standards will help reduce unwarranted variation. IMPLICATIONS FOR PRACTICE Consistency in practice could help maximise the contribution of radiographer reporting.
Collapse
Affiliation(s)
- N Woznitza
- Radiology Department, Homerton University Hospital, UK; School of Allied and Public Health Professions, Canterbury Christ Church University, UK; North Central and East London Cancer Alliance, UK; Health Education England, London, UK.
| | - R Steele
- North Central and East London Cancer Alliance, UK; Radiology Department, University College London Hospitals, UK
| | - H Groombridge
- Radiology Department, University College London Hospitals, UK
| | - E Compton
- Radiology Department, Guys & St Thomas' Hospitals, UK
| | - S Gower
- Radiology Department, Kings College Hospitals, UK
| | - A Hussain
- North Central and East London Cancer Alliance, UK
| | - H Norman
- North Central and East London Cancer Alliance, UK
| | - A O'Brien
- Radiology Department, Kings College Hospitals, UK
| | - K Robertson
- NHS England and Improvement, London, UK; South East London Cancer Alliance, UK
| |
Collapse
|
28
|
Arm position on portable neonatal/infant ICU chest radiograph can mimic lamellar effusion. J Med Imaging Radiat Sci 2020; 51:624-628. [PMID: 32684501 DOI: 10.1016/j.jmir.2020.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/05/2020] [Accepted: 07/05/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION/BACKGROUND Arm malposition in neonatal ICU radiographs may result in overlap of the arm soft tissues and chest wall giving the appearance of lamellar effusions. We aimed to determine the frequency of arm malposition on portable neonatal/infant intensive care unit (N/IICU) chest radiographs and the proportion of these mimicking lamellar effusions. MATERIAL AND METHODS We evaluated a subgroup of supine portable chest radiographs performed at the N/IICU. Two reviewers, at a tertiary pediatric hospital located in the USA, evaluated each radiograph in consensus and classified arm position for either side independently as (1) acceptable: arm abducted and separated from the chest and (2) compromised: arm down and in contact with chest soft tissue. The compromised cases were evaluated regarding any overlap between soft tissues of the arm and chest of sufficient degree to mimic a lamellar effusion. RESULTS We reviewed 300 radiographs performed at the N/IICU (600 hemithoraces). The mean age was 1.8 ± 1.8 months. Of 600 hemithoraces, 233 (39%) showed arms down and in contact with the chest. In seven (1%) cases, the arm position was compromised and mimicked a lamellar effusion. We identified 32 (5%) true lamellar effusions in the whole sample; in 14 of the 32 cases with lamellar effusion, the radiographs were performed with the arms down. CONCLUSION Portable chest radiographs performed in the N/IICU without proper arm abduction represent a potential for misinterpretation of chest radiographs. Although the prevalence of mimickers of lamellar effusion is only around 1%, the prevalence of arms down on a portable chest radiograph is considerably high (39%).
Collapse
|
29
|
Sethole KM, Rudman E, Hazell LJ. Methods Used by General Practitioners to Interpret Chest Radiographs at District Hospitals in the City of Tshwane, South Africa. J Med Imaging Radiat Sci 2020; 51:271-279. [DOI: 10.1016/j.jmir.2019.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
|
30
|
Holland P, Spence H, Clubley A, Brooks C, Baldwin D, Pointon K. Reporting radiographers and their role in thoracic CT service improvement: managing the pulmonary nodule. BJR Open 2020; 2:20190018. [PMID: 33178958 PMCID: PMC7594904 DOI: 10.1259/bjro.20190018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 01/16/2020] [Accepted: 02/25/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The use of cross-sectional imaging in clinical medicine has been a major step forward in the management of many conditions but with that comes the increasing demand on resources and the detection of other potentially significant findings. This, in the context of a shortage of skilled radiologists, means that new ways of working are important. In thoracic CT, pulmonary nodules are a significant challenge because they are so common. Poor and inconsistent management can both cause harm to patients and waste resources so it is important that the latest guidelines are followed. The latter mandate the use of semi-automated volumetry that allows more precise management but is time-consuming. METHODS Reporting radiographers were iteratively trained in the use of semi-automated volumetry for pulmonary nodules by experienced thoracic radiologists. Once trained in this specific aspect, radiographers completed reporting of pulmonary nodules, checked by radiologists. RESULTS Radiographer reporting reduced radiologist time in reporting nodules and measuring their volume. Most of the volumetry was completed prior to the multidisciplinary meeting. This facilitated an increase in the number of patients discussed in 60 min from 15 to 22. Radiographers failed to detect few nodules, although a second read by radiologists is required in any case for other aspects of the reporting. CONCLUSION Reporting radiographers, working with radiologists in a supportive setting, can deliver the radiology in a lung nodule pathway, reducing the time commitment from radiologists and the pulmonary nodule multidisciplinary team members, whilst using this as an opportunity to conduct research.
Collapse
Affiliation(s)
- Paul Holland
- Department of Radiology, Nottingham City Hospital Campus, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Hazel Spence
- Department of Radiology, Nottingham City Hospital Campus, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Alison Clubley
- Department of Radiology, Nottingham City Hospital Campus, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Chantel Brooks
- Department of Radiology, Nottingham City Hospital Campus, Nottingham University Hospitals, Nottingham, United Kingdom
| | - David Baldwin
- Department of Respiratory Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Kate Pointon
- Department of Radiology, Nottingham City Hospital Campus, Nottingham University Hospitals, Nottingham, United Kingdom
| |
Collapse
|
31
|
Stevens B. A survey assessment of reporting radiographers' scope of practice in the West Midlands region of the United Kingdom. Radiography (Lond) 2019; 25:214-219. [DOI: 10.1016/j.radi.2019.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/14/2019] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
|
32
|
Image interpretation by radiographers in South Africa: A systematic review. Radiography (Lond) 2019; 25:178-185. [DOI: 10.1016/j.radi.2018.12.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 11/21/2022]
|
33
|
Culpan G, Culpan AM, Docherty P, Denton E. Radiographer reporting: A literature review to support cancer workforce planning in England. Radiography (Lond) 2019; 25:155-163. [DOI: 10.1016/j.radi.2019.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 10/27/2022]
|
34
|
Woznitza N, Steele R, Piper K, Burke S, Rowe S, Bhowmik A, Maughn S, Springett K. Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers. J Med Radiat Sci 2018; 65:200-208. [PMID: 29806102 PMCID: PMC6119729 DOI: 10.1002/jmrs.285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. METHODS An efficient and effective centralised model of workplace training support was designed for a cohort of trainee chest X-ray (CXR) reporting radiographers. A comprehensive schedule of tutorials was planned and aligned with the curriculum of a post-graduate certificate in CXR reporting. Trainees were supported via a hub and spoke model (centralised training model), with the majority of education provided by a core group of experienced CXR reporting radiographers. Trainee and departmental feedback on the model was obtained using an online survey. RESULTS Fourteen trainees were recruited from eight National Health Service Trusts across London. Significant efficiencies of scale were possible with centralised support (48 h) compared to traditional workplace support (348 h). Trainee and manager feedback overall was positive. Trainees and managers both reported good trainee support, translation of learning to practice and increased confidence. Logistics, including trainee travel and release, were identified as areas for improvement. CONCLUSION Centralised workplace training support is an effective and efficient method to create sustainable diagnostic capacity and support improvements in the lung cancer pathway.
Collapse
Affiliation(s)
- Nick Woznitza
- Radiology DepartmentHomerton University HospitalLondonUK
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Rebecca Steele
- Radiology DepartmentUniversity College London HospitalLondonUK
| | - Keith Piper
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Stephen Burke
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Susan Rowe
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Angshu Bhowmik
- Department of Respiratory MedicineHomerton University HospitalLondonUK
| | - Sue Maughn
- City and Hackney Clinical Commissioning GroupLondonUK
| | - Kate Springett
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| |
Collapse
|