Evaluating the effectiveness of intensive versus non‐intensive image interpretation education for radiographers: a randomised controlled trial

Self Cite

Introduction: Preliminary image evaluation (PIE) is a mechanism whereby radiographers provide a preliminary evaluation of whether pathology is present in their radiographs, typically acquired within the emergency department (ED). PIE provides referrers with a timely communication of pathology prior to the availability of a radiology report. The purpose of this study was to determine the most common radiographer PIE false-negative interpretations. Methods: Each month over a two-year period, 100 PIEs of adult and paediatric patients were randomly reviewed in a metropolitan hospital ED. The radiographer's PIE was compared with the radiologist's report and categorised into basic quality indicators; true positive, true negative, false positive and false negative. The anatomical regions which most commonly indicated a false-negative interpretation were further analysed. Results: 2402 cases were reviewed which resulted in an overall PIE accuracy of 88.7%. Wrists, hands, phalanges (upper), ankles, feet and phalanges (lower) reporting the highest false-negative or falsenegative/true-positive interpretations (60/116). Of the 60 false-negative PIEs, 68 pathologies were identified. 41.1% (28/68) of the pathology not identified were in the phalanges. Within these regions, examinations with multiple injuries commonly reported false negatives (17/60). Conclusions: This study demonstrated the most common false-negative radiographer PIEs were within the upper and lower distal extremities. Specifically, the phalanges and examinations demonstrating multiple injuries reported high levels of misinterpretation. The misinterpretation in multi-injury examinations could be attributed to 'Subsequent Search Miss (SSM)' error. These results provide valuable insights into areas of emphasis when providing image interpretation education.

Section: Introductionmentioning

confidence: 99%

An analysis of radiographer preliminary image evaluation – A focus on common false negatives

Alexander-Bates

Neep

Davis

et al. 2021

Self Cite

“…15,16 X-ray accounts for most examinations and is continuing to grow, but an increase in cross-sectional modalities has limited focus on service provision issues related to X-ray. 8,[15][16][17] In an ideal system, radiologists would be positioned to meet the imaging demand; however, growth in specialist numbers has fallen short of increases in imaging. 12 There has been a sustained shortage and maldistribution of radiologists, disproportionately affecting the public and rural healthcare sectors.…”

Section: Current Context Of Radiology Service In Australiamentioning

confidence: 99%

“…5,44 This impacts patients for whom delayed or inappropriate treatment diminishes outcomes and damages public trust in healthcare services. 8,40,41 Immediate radiological input is proposed to mitigate this. 8 A recent control trial compared the effect of immediate and delayed reporting on patient management, concluding that an immediate report reduced the number of false positives and false negatives, eliminated patient recalls and reduced the number of patients admitted.…”

Section: Error Reduction and Patient Managementmentioning

confidence: 99%

“…8,40,41 Immediate radiological input is proposed to mitigate this. 8 A recent control trial compared the effect of immediate and delayed reporting on patient management, concluding that an immediate report reduced the number of false positives and false negatives, eliminated patient recalls and reduced the number of patients admitted. 40 A survey conducted by the same author revealed significant support for quick reporting, considering it an essential tool for patient management.…”

Section: Error Reduction and Patient Managementmentioning

confidence: 99%

“…6 A comment is a brief description of urgent findings by the radiographer who interacted with the patient at the time of image acquisition and can be provided to other health practitioners involved in the patient's care through the electronic medical record. 7,8 Commenting is acknowledged as an interim measure to supplement the referrer's interpretation 9,10 and does not substitute a final report, which is the definitive medical diagnosis in clinical context. 11,12 PIE has been an expectation of standard practice in the UK since 2010 and is reported to provide numerous benefits to the healthcare system.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Formalising written preliminary image evaluation by Australian radiographers: a review of practice value

Tonks,

Varcoe,

Maurici

2023

The Medical Radiation Practice Board of Australia (MRPBA) minimum competency framework requires all Australian radiographers to identify significant pathology in radiological images and take appropriate action to alert these urgent findings and ensure patient safety. Despite professional bodies endorsing the provision of preliminary image evaluations (PIE) in written format, radiographer image interpretation often remains inconsistent, informal, or undocumented. The purpose of this narrative review was to assess the literature to determine if PIE in the form of written radiographer comments is of value to the Australian healthcare system. A structured search was completed using four health research databases: CINAHL, Medline, Scopus and Web of Science. Studies have suggested that there is a contextual need for commenting due to increased imaging service pressures, radiologist shortages and subsequent reporting delays. Radiographers appear well placed and willing to provide accurate initial input with evidence that this would be valued and appreciated within the multidisciplinary team. Radiographer commenting has also been shown to reduce diagnostic and communicative errors with the potential to improve patient management. Finally, it was shown that participation in image interpretation practices can enhance recruitment, retention and job satisfaction among radiographers. Therefore, the current literature supports implementation of radiographer commenting within the Australian healthcare system.

Radiographic image interpretation by Australian radiographers: a systematic review

Murphy

Ekpo

Steffens

et al. 2019

IntroductionRadiographer image evaluation methods such as the preliminary image evaluation (PIE), a formal comment describing radiographers’ findings in radiological images, are embedded in the contemporary radiographer role within Australia. However, perceptions surrounding both the capacity for Australian radiographers to adopt PIE and the barriers to its implementation are highly variable and seldom evidence‐based. This paper systematically reviews the literature to examine radiographic image interpretation by Australian radiographers and the barriers to implementation.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta‐Analyses were used to systematically review articles via Scopus, Ovid MEDLINE, PubMed, ScienceDirect and Informit. Articles were deemed eligible for inclusion if they were English language, peer‐reviewed and explored radiographic image interpretation by radiographers in the context of the Australian healthcare system. Letters to the editor, opinion pieces, reviews and reports were excluded.ResultsA total of 926 studies were screened for relevance, 19 articles met the inclusion criteria. The 19 articles consisted of 11 cohort studies, seven cross‐sectional surveys and one randomised control trial. Studies exploring radiographers’ image interpretation performance utilised a variety of methodological designs with accuracy, sensitivity and specificity values ranging from 57 to 98%, 45 to 98% and 68 to 98%, respectively. Primary barriers to radiographic image evaluation by radiographers included lack of accessible educational resources and support from both radiologists and radiographers.ConclusionAustralian radiographers can undertake PIE; however, educational and clinical support barriers limit implementation. Access to targeted education and a clear definition of radiographers’ image evaluation role may drive a wider acceptance of radiographer image evaluation in Australia.