The Influence of Image Interpretation Training on the Accuracy of Abnormality Detection and Written Comments on Musculoskeletal Radiographs by South African Radiographers

Using artificial intelligence to improve human performance: efficient retinal disease detection training with synthetic images

BACKGROUND

Artificial intelligence (AI) in medical imaging diagnostics has huge potential, but human judgement is still indispensable. We propose an AI-aided teaching method that leverages generative AI to train students on many images while preserving patient privacy.

METHODS

A web-based course was designed using 600 synthetic ultra-widefield (UWF) retinal images to teach students to detect disease in these images. The images were generated by stable diffusion, a large generative foundation model, which we fine-tuned with 6285 real UWF images from six categories: five retinal diseases (age-related macular degeneration, glaucoma, diabetic retinopathy, retinal detachment and retinal vein occlusion) and normal. 161 trainee orthoptists took the course. They were evaluated with two tests: one consisting of UWF images and another of standard field (SF) images, which the students had not encountered in the course. Both tests contained 120 real patient images, 20 per category. The students took both tests once before and after training, with a cool-off period in between.

RESULTS

On average, students completed the course in 53 min, significantly improving their diagnostic accuracy. For UWF images, student accuracy increased from 43.6% to 74.1% (p<0.0001 by paired t-test), nearly matching the previously published state-of-the-art AI model's accuracy of 73.3%. For SF images, student accuracy rose from 42.7% to 68.7% (p<0.0001), surpassing the state-of-the-art AI model's 40%.

CONCLUSION

Synthetic images can be used effectively in medical education. We also found that humans are more robust to novel situations than AI models, thus showcasing human judgement's essential role in medical diagnosis.

Preliminary image evaluation performance of radiographers in one New Zealand District: a 6-month prospective study

INTRODUCTION

Preliminary image evaluation (PIE) is a system where radiographers alert emergency department referrers to the presence or absence of abnormalities on acute extremity X-ray examinations. PIE and similar systems have been utilised in the United Kingdom (UK) and Australia due to a shortage of radiologists to provide a timely report. As New Zealand (NZ) faces a similar shortage, PIE should be considered to address the negative impact this has on patients. The aim of this study was to determine the effect of regular feedback and education on radiographers' performance when detecting and describing acute abnormalities on extremity X-ray examinations in ED.

METHODS

A prospective longitudinal study design was utilised for this study. The sensitivity, specificity, accuracy, and accuracy of PIEs performed by seven radiographers at a public provincial district in NZ were assessed over a 6-month period, with the participants provided monthly results along with regular e-mailed feedback on common errors.

RESULTS

The mean for sensitivity, specificity, and accuracy calculated with a 95% confidence interval over the 6-month period were 92.8% (89.9, 95.8), 94.9 (93.1, 96.8), and 94.2 (91.9, 96.5), respectively. When the month-to-month results were analysed, the results demonstrated an improvement in participants' sensitivity, specificity, and accuracy over the 6-month period.

CONCLUSION

The results of this study demonstrated that radiographers who participated in the study can perform PIE to a high standard that is comparable with the findings from international studies and demonstrated an improvement over 6 months. Therefore, PIE may be useful in NZ to aid ED clinicians in their clinical decisions when a radiology report is unavailable.

Preliminary clinical evaluation: Where are we? An international scoping review

BACKGROUND

The College of Radiographers' vision was that diagnostic radiographers in the UK would be writing preliminary clinical evaluations (PCE) on images. Their 2013 policy supporting the use of PCE has not been updated in a decade and it might be suggested PCE practices in the UK have not really moved on, though elsewhere it appears to have gained traction. The aim of this scoping review was to establish the current global status of the use of PCE.

METHOD

The Arksey and O'Malley scoping review framework and PRISMA-ScR guidelines were used to develop a protocol to identify studies between January 2013 to January 2024 using six databases. Collated literature was analysed using content analysis to identify themes.

RESULTS

52 relevant studies were identified for inclusion. Studies focused predominantly on evaluating accuracy, education, perceptions, and new initiatives. Themes identified a developing role in the use of PCE internationally, perhaps more than in the UK, and in a range of modalities and clinical settings though projectional radiography remains the mainstay. Barriers and drivers to the use of PCE were identified in addition to some quality mechanisms used to support PCE implementation, though impact of implementation was not well explored.

CONCLUSION

Considering PCE has been an aspiration for more than a decade, it remains relatively infrequently researched. There is growing scope internationally, particularly in Australia, yet there is no real evaluation of the impact and role that PCE may have.

IMPLICATIONS FOR PRACTICE

Until further research into the potential impact of PCE and barriers to its implementation, it is likely practices may not evolve with the risk AI technologies may supersede necessity for the practice.

The impact of intensive training in preliminary image evaluation (PIE) for radiographers in the emergency department of a regional hospital in New Zealand - A pilot study

INTRODUCTION

New Zealand has seen an increase in the X-ray examinations in the emergency departments (ED), and the radiology report is generally unavailable immediately. This requires practitioners managing the patient to take the responsibility of detecting any abnormalities in the images and using such information for the management of the patient. There is, therefore, a need for consideration of the contribution that radiographers could make in the accurate management of the patients in ED in New Zealand. The aim of this study was to assess if an intensive preliminary image evaluation (PIE) training course improved radiographer accuracy, sensitivity, and specificity on extremity X-ray examinations in a regional ED in New Zealand.

METHOD

A pre-post-intervention design was employed for this study. Seven radiographers working at a regional base hospital in New Zealand undertook image evaluation tests to evaluate their ability to detect and describe abnormalities prior to and following a 2-day intensive PIE training course. The training concentrated on acute extremity abnormalities. Tests were then scored to determine sensitivity, specificity, and accuracy.

RESULTS

Following an intensive PIE training course, the post-intervention test mean demonstrated an improved sensitivity by an average of 3.99% (89.01-93.0), specificity improved by an average of 6.13% (79.77-85.90%), and accuracy improved by an average of 3.33% (77.55-80.87%).

CONCLUSION

This study demonstrated that an intensive training course in PIE improved the participants' sensitivity, specificity, and accuracy when evaluating acute extremity X-ray examinations in ED at the study site, however further research is required to see if these results also represent clinical ability.

IMPLICATION FOR PRACTICE

The NZ healthcare system could benefit by the introduction of a radiographers' PIE system. It is therefore recommended that when introducing PIE into an ED in New Zealand, radiographers should undertake additional training to improve image evaluation sensitivity, specificity, and accuracy prior to participation.

Australian radiographer roles in the emergency department; evidence of regulatory compliance to improve patient safety - A narrative review

OBJECTIVES

Using a narrative approach, this paper aims to determine the extent of Australian radiographers' regulatory compliance to improve patient safety when performing appendicular X-ray and non-contrast brain computed tomography (CT) in the Emergency Department (ED).

KEY FINDINGS

A narrative review explored relevant literature and key regulatory policy. Ten documents were identified, three main themes were developed related to the radiographer roles in X-ray request justification, dose optimisation and preliminary image evaluation (PIE). Radiographers were equally aware of justification and optimisation pre and post the introduction of a Medical Code of Practice. The collective PIE accuracy of radiographers remained unaffected by changes in mode of PIE delivery and regulatory factors but varied based on the anatomical region.

CONCLUSION

While current Australian regulations mandate radiographer request justification, dose optimisation and PIE, the degree of compliance by Australian radiographers remains uncertain. Current literature provides evidence that radiographers can improve patient care and safety through justification, optimisation, and PIE delivery. Change in workplace practice, supported by key stakeholders including radiologists, is essential to integrate radiographers' functions into routine ED clinical practice. Further research is required to audit radiographers' regulatory compliance to improve patient safety.

IMPLICATIONS FOR PRACTICE

Patient safety in ED can be improved with timely and accurate diagnosis provided by radiographers. Radiographers have a professional obligation to adhere to the capabilities and standards for safe medical radiation practice defined by Australian regulations. Therefore, radiographers must justify the X-ray request, optimise the radiation dose where appropriate and communicate urgent or unexpected findings to the referrer.

The experiences of sonographers with regard to report writing and communicating their findings

BACKGROUND

Sonographers in South Africa are legally allowed to write their own reports; however, they often lack adequate training in providing a well-structured and coherent formal written report.

AIM

The aim of this study was to explore and describe how sonographers in the Gauteng province experience the responsibility of report writing and to develop recommendations that could assist sonographers in the execution of their duty.

SETTING

Focus group discussions (FGDs) with sonographers from private and public hospitals located in Gauteng province were conducted at neutral locations that were convenient for the sonographers.

METHODS

A qualitative phenomenological research design was used for this study. A two-stage sampling approach was employed to recruit information-rich sonographers to partake in this study. Purposeful sampling was used to select sonographers based on their first-hand experience of report writing, followed by snowball sampling which allowed the researcher access to new participants on the recommendation of previous sonographers. Thirteen female sonographers voluntarily participated in the study, and the FGDs continued until data saturation was reached. The views and opinions of the sonographers were analysed using content analysis.

RESULTS

Key findings of this study indicated that sonographers felt unprepared to describe ultrasound findings correctly in order to provide a coherent and well-structured formal written report.

CONCLUSION

Sonographers suggested the use of workshops or further training at higher educational institutions (HEIs) to support sonographers in their report-writing role.

CONTRIBUTION

The experiences identified by sonographers can assist HEIs to provide further training or workshops to support sonographers in communicating their findings effectively.

Changing the model of radiography practice: Challenges of role advancement and future needs for radiographers working in the UAE

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.

A pilot image interpretation teaching intervention to improve competence and confidence of radiographers to detect left ventricular thrombus in routine cardiac MRI scans

INTRODUCTION

Prompt diagnosis of left ventricular (LV) thrombus is clinically important, as it may require immediate anti-coagulation treatment. The aim of this study was to determine if a teaching intervention delivered by cardiovascular magnetic resonance (CMR) physicians would increase the CMR radiographers' ability to detect LV thrombus on a routine CMR scan.

METHODS

A cohort of 25 patients (14 with and 11 without LV thrombus) were identified. A multi-parametric CMR protocol had been performed in all patients. Ten radiographers reviewed the 25 randomised anonymised studies on a workstation, documenting the presence/absence of LV thrombus and their confidence level on a 7-point Likert scale. Two senior CMR fellows then delivered a focused teaching programme to the radiographers and all 25 randomised scans were reassessed 1 month after the teaching intervention.

RESULTS

Following dedicated training, there was a significant improvement in correct thrombus identification per radiographer (pre-training: 75 ± 6% vs post-training: 85 ± 6%, p = 0.009). The size of the thrombus was not associated with the likelihood of incorrectly identifying LV thrombus size prior to the training session (p = 0.2), but a trend was observed between smaller thrombus size and incorrect identifications post-training (p = 0.06). The radiographers' overall confidence in assessing the cases prior to the teaching session was high (5.6 ± 0.8 out of 7). Following the teaching session, self-reported confidence did not vary significantly (5.9 ± 0.7 out of 7, p = 0.42). When evaluating the teaching session, radiographers provided very positive feedback, rating the usefulness of the teaching intervention as highly educative (8.8 ± 0.4 out of 10).

CONCLUSIONS

This is the first study that has explored the ability and confidence of CMR radiographers in detecting LV thrombus on routine CMR scans as a result of the teaching intervention delivered by CMR physicians.

IMPLICATIONS FOR PRACTICE

A teaching intervention can improve CMR radiographers' diagnostic skills and diagnostic confidence.

Determining the Need for After-Hours Diagnostic Radiological Reporting in Emergency Departments at Public Hospitals in South Africa: Perceptions of Emergency Physicians in KwaZulu-Natal

BACKGROUND

Emergency departments in South African public hospitals have a high patient load after hours, with inadequate numbers of health care professionals available to satisfy patient influx. In addition, there is often no provision of after-hours diagnostic reporting services in public hospitals, to an extent that the emergency physician is responsible for interpreting all radiographic images requested themseves. Emergency physicians, in this study, can be described as any medical doctor registered with the Health Professions Council of South Africa and working in the emergency department as a registrar or consultant physician because there were no physicians specialized in emergency medicine working at the hospitals selected for this study.

AIM

The aim of this study was to determine the views of emergency physicians on whether there is a need for an after-hours diagnostic radiological reporting service in selected public hospitals in KwaZulu-Natal Province, South Africa.

METHODS

A descriptive cross-sectional quantitative research design was utilized, through means of a survey, to assess the emergency physicians' perceptions regarding the need for after-hours diagnostic radiological reporting. In addition, the study used a descriptive quantitative research design to record the number of conventional diagnostic radiographic examinations performed at the selected hospitals, after hours, and the proportional number of these radiographic examinations that were reported on by radiologists during office hours, the following day. The distribution of questionnaires and data collection, with regard to the number of examinations reported on, and those not reported on, were carried out simultaneously during the execution of this study. The study was conducted over a three-month period in 2017, at four public hospitals in KwaZulu-Natal-one of the nine provinces of South Africa.

RESULTS

This study found that, during the study period, between 0.1% and 0.6% of the conventional diagnostic radiographic examinations performed, after hours, were reported on by radiologists during office hours, the following day. The surveyed emergency physicians felt that the interpretation of diagnostic images took up valuable time that could be spent on patient management, and there was near-total agreement, whereby 92% (n = 36) of the physicians would have preferred after-hours reporting to be performed by a radiologist. Physicians agreed that having a radiologist or reporting radiographer to provide radiological reports would allow for more effective and efficient patient management.

CONCLUSION

The results of this study indicated that there is a need for after-hours radiographic reporting at the selected public hospitals and for the further training of emergency physicians in radiographic image interpretation. Based on the findings of this study, it is recommended that after-hours radiological reporting services be considered for public hospitals and that courses be offered to emergency physicians on the interpretation of diagnostic radiographic images. A hospital policy review may therefore be needed to adjust the focus of hospitals toward reducing the workload of emergency physicians, wherever possible, such as by incorporating support services like radiographic reporting and by providing further training on the interpretation of diagnostic radiographic images, which will both act to reduce the potential risk of misdiagnosis.

Accuracy of radiographer comment following a two-month experiential and blended learning in appendicular skeleton X-ray interpretation: The Singapore experience

INTRODUCTION

The value of combined blended and experiential learning on radiographer diagnostic comment has not been explored. This study aims to examine the accuracy of image interpretation comment of radiographers who received a period of blended and experiential learning in Radiographer Abnormality Detection Systems (RADS).

METHODS

We evaluated the diagnostic opinions of 13 radiographers who received a blended training and experiential learning (a process of self-learning and reflection) in RADS. Radiographers' opinions on 16,483 images were examined using the final radiologists' report as a reference standard. For each radiographer, we recorded the number of true positive, true negative, false positive and false negative opinions and MedCal® was used to calculate diagnostic performance and error rates. A t-test was used to assess whether the number of images read was associated with performance and whether the radiographers retained performance over time.

RESULTS

Sensitivity ranged from 87.4 (84.0-90.2) to 98.9 (97.5-99.7) with a mean of 94.3 (93.6-94.8). Specificity varied from 96.4 (94.8-97.5) to 99.9 (99.41-100.0) with a mean of 98.2 (97.9-98.4). Diagnostic accuracy ranged from 93.1 (91.5-94.4) to 99.5 (98.9-99.8) with a mean of 96.9 (96.6-97.1). The mean false positive rate was 0.018 (range: 0.010-0.031) with a false negative rate of 0.057 (range: 0.026-0.11). There were no differences in performance between the first and latter nine months of providing opinions and the number of images reviewed was not associated with performance.

CONCLUSION

Radiographers who received blended and experiential learning in RADS provide accurate diagnostic comments on plain emergency appendicular skeleton radiographs.

IMPLICATION FOR PRACTICE

A combined blended and experiential learning can equip radiographers to provide diagnostic opinion on plain appendicular skeleton radiographs.

Reducing risk in the emergency department: a 12-month prospective longitudinal study of radiographer preliminary image evaluations

INTRODUCTION

Innovations are necessary to accommodate the increasing demands on emergency departments whilst maintaining a high level of patient care and safety. Radiographer Preliminary Image Evaluation (PIE) is one such innovation. The purpose of this study was to determine the accuracy of radiographer PIE in clinical practice within an emergency department over 12 months.

METHODS

A total of 6290 radiographic examinations were reviewed from 15 January 2016 to 15 January 2017. The range of adult and paediatric examinations incorporated in the review included the appendicular and axial skeleton including the chest and abdomen. Each examination was compared to the radiologist's report this allowed calculated mean sensitivity and specificity values to indicate if the radiographer's PIE was of a true negative/positive or false negative/positive value. Cases of no PIE participation or series' marked as unsure for pathology by the radiographer were also recorded. This allowed mean sensitivity, specificity and diagnostic accuracy to be calculated.

RESULTS

The study reported a mean ± 95% confidence level (standard deviation) for sensitivity, specificity, accuracy, no participation and unsure of 71.1% ± 2.4% (6.1), 98.4% ± 0.04% (0.9), 92.0% ± 0.68% (1.9), 5.1% (1.6) and 3.6% (0.14) respectively.

CONCLUSIONS

This study has demonstrated that the participating radiographers provided a consistent PIE service while maintaining a reasonably high diagnostic accuracy. This form of image interpretation can complement an emergency referrer's diagnosis when a radiologist's report is unavailable at the time of patient treatment. PIE promotes a reliable enhancement of the radiographer's role with the multi-disciplinary team.

An audit of the polytrauma fracture detection rate of clinicians evaluating lodox statscan bodygrams in two South African public sector trauma units

BACKGROUND

Increasing global demand for specialized radiological investigations has resulted in delayed or non-reporting of plain trauma radiographs by radiologists. This is particularly true in resource-limited environments, where referring clinicians rely largely on their own radiographic interpretation. A wide accuracy range has been documented for non-radiologist reporting of conventional trauma radiographs. The Lodox Statscan whole-body digital X-ray machine is a relatively new technology that poses unique interpretive challenges. The fracture detection rate of trauma clinicians utilizing this modality has not been determined.

OBJECTIVE

An audit of the polytrauma fracture detection rate of clinicians evaluating Lodox Statscan bodygrams in two South African public-sector Trauma Units.

METHODS

A retrospective descriptive study of imaging data of Cape Town Level 1-equivalent public-sector Trauma Units during March-April 2015. Statscan bodygrams acquired for adult polytrauma triage were reviewed and correlated with follow-up imaging and patient records. Missed fractures were stratified by body part, mechanism of injury and ventilatory support. The fracture detection rate was determined with 95% confidence. The Generalised Fischer Exact Test assessed any association between the fracture site and failure of detection. Specialist orthopaedic review assessed the potential need for surgical management of missed fractures.

RESULTS

227 patients (male = 193, 85%; mean age: 33 years) were included; 195 fractures were demonstrated on the whole-body triage projections. Lower limb fractures predominated (n = 66, 34%). The fracture detection rate was 89% (95% CI = 86-93%), with the site of fracture associated with failure of detection (p = 0.01). Twelve of 21 undetected fractures (57%) involved the elbow or shoulder girdle. All elbow fractures (n = 3, 100%), more than half the shoulder girdle fractures (9/13,69%) and 12% (15/123) of extremity fractures were undetected. One missed fracture (1/21,4.7%) unequivocally required surgical management, while a further 7 (7/21, 33.3%) could potentially have benefitted from surgery, depending on follow-up imaging findings.

CONCLUSION

This is the first analysis of the accuracy of bodygram polytrauma fracture detection by clinicians. Particular review of the shoulder girdle, elbow and extremities for subtle fractures, in addition to standardized limb positioning, are recommended for improved diagnostic accuracy in this setting. These findings can inform clinician training courses in this domain.

Accuracy of appendicular radiographic image interpretation by radiographers and junior doctors in Ghana: Can this be improved by training?

INTRODUCTION

Access to image interpretation in Ghana remains a challenge with the limited number of radiologists. Radiographers with the right skills and knowledge in image interpretation could help address this challenge. The aims of the study were to determine and compare the ability (accuracy, sensitivity and specificity) of radiographers and junior doctors in interpreting appendicular trauma radiographs both before and after training.

METHODS

An action research study involving a pre and post training test was carried out to determine the level of accuracy, sensitivity and specificity in abnormality detection by radiographers after undergoing training when compared to junior doctors. Eight radiographers and twelve junior doctors were invited to interpret an image bank of 30 skeletal radiographs, both before and upon completion of an educational program. The participants' tests were scored against a reference standard provided by an experienced radiologist. Pre and post-test analysis were carried out for comparison.

RESULTS

Post training mean accuracy (radiographers 83.3% vs 68.8%, p = 0.017; doctors 81.9% vs 71.6%, p = 0.003), sensitivity (radiographers 83.3% vs 69.2%, p = 0.042; doctors 77.2% vs 67.8% p = 0.025) and specificity (radiographers 83.3% vs 68.3%, p = 0.011; doctors 86.7% vs 75.6% p = 0.005) of both groups significantly improved. No significant differences were recorded between the radiographers and doctors after the training event.

CONCLUSION

The study revealed that, with a well-structured training program, radiographers and junior doctors could improve on their accuracies in radiographic abnormality detection and commenting on trauma radiographs.

Improvement of radiographer commenting accuracy of the appendicular skeleton following a short course in plain radiography image interpretation: A pilot study

INTRODUCTION

Radiographers are at times required to provide preliminary information on plain radiography when significant findings are identified. The aim of the study was to evaluate the effectiveness of two short training modules to improve the accuracy of image interpretation of the appendicular skeleton amongst a group of radiographers.

METHODS

Eight radiographers volunteered to participate in the study. All undertook a pre-test and, following delivery of course materials, an immediate post-test for two consecutive modules. A retention test was undertaken 6 months later. Sensitivity (Sn), specificity (Sp) and accuracy (Acc) scores were evaluated against the "Gold Standard" radiologists' reports. Paired-samples t-tests were carried out to compare image interpretation scores between the start of module one to the end of module two, and between the end of module 2 and 6 months later. Summary receiver operating characteristics (SROC) scores on each of the participants' module two post-test study results were undertaken.

RESULTS

Significant improvements in scores were achieved between the mean (SD) scores of module 1 pre-test (77.5 (±3.9)) and the module 2 post-test (83.6 (±3.2) (P =0.022)). Sn, Sp and Acc scores increased from the start of module 1 pre-test to the end of module 2 post-test (Sn: 82.28-86.25%; Sp: 75.29-84.66%; Acc: 81.68-85.97%). The retention test revealed a non-significant reduction in mean scores (80.0 (±5.1)) when compared to post-test module 2 (83.6 (±3.2) (P =0.184)). SROC revealed an area under the curve of 0.90.

CONCLUSION

Participants achieved significant improvements in commenting accuracy on plain radiography of the appendicular skeleton after completion of the two modules. However, continuous application and ongoing professional development is essential in order to maintain and develop the skills acquired.

Image interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module

INTRODUCTION

The aim of the study was to evaluate the performance of radiographers in image interpretation of magnetic resonance imaging (MRI) brain, spine and knee examinations following a nine-month work based postgraduate MRI module.

METHODS

Twenty-seven participants each submitted 60 image commentaries taken from prospective clinical workloads. The image interpretations (n = 1620) comprised brain, spine, and knee MRI examinations. Prevalence of abnormal examinations approximated 53% (brain), 74% (spine), and 73% (knee), and included acute and chronic pathology, normal variants and incidental findings. Each image interpretation was graded against reference standard consultant radiologist definitive report.

RESULTS

The radiographer's performance on brain image interpretations demonstrated mean accuracy at 86.7% (95% CI 83.4-89.3) with sensitivity and specificity of 84% (95% CI 80.9-86.4) and 89.7% (95% CI 86.2-92.6) respectively. For spinal interpretations the mean accuracy was 86.4% (95% CI 83.4-89.0), sensitivity was 90.2% (95% CI 88.2-92), mean specificity was 75.3% (95% CI 69.4-80.4). The mean results for knee interpretation accuracy were 80.9% (95% CI 77.3-84.1), sensitivity was 83.3% (95% CI 80.8-85.5), with 74.3% specificity (95% CI 67.4-80.4).

CONCLUSIONS

The radiographer's demonstrated skills in brain, spine and knee MRI examination image interpretation. These skills are not to replace radiologist reporting but to meet regulating body standards of proficiency, and to assist decision making in communicating unexpected serious findings, and/or extend scan range and sequences. Further research is required to investigate the impact of these skills on adjusting scan protocols or flagging urgent findings in clinical practice.