Feasibility of an Audit System for Canadian Sonographers in Generalist Ultrasound

Dima, Robert; Vasile, Calin; Francio, Vinicius Tieppo

doi:10.1177/8756479317750108

Cited by 3 publications

(7 citation statements)

References 11 publications

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“…The high accuracy of sonographers’ diagnostic opinion has been documented in numerous studies across all subspecialties with sonographers often demonstrating comparable standard of diagnostic performance to that of radiologists . This raises important questions about the level of oversight that sonographers require by imaging specialists such as radiologists or other sonologists and the required staffing levels and departmental structures.…”

Section: Introductionmentioning

confidence: 99%

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Nečas

Shen

Ong

et al. 2020

Australas J Ultrason Med

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Introduction Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence. In Australasia, sonographers typically generate a preliminary report which is reviewed by the radiologist who issues a final report. The aim of this study was to determine whether radiologist's review is required in cases reported as normal by the sonographer. Methods This study was a retrospective review of 1000 abdominal US examinations considered normal by sonographers that were subsequently reported by radiologists. Any findings reported by radiologists that were not reported by sonographers were analysed and separated into errors or discrepancies according to commonly accepted definition. Results The 1000 abdominal examinations included 244 complete abdominal, 200 hepatobiliary, 506 urinary tract and 50 other abdominal examinations. Patients’ age ranged from < 1 to 94 years (mean = 35 years, median = 32 years). US examinations were performed by any one of 14 sonographers with 1–21 years (mean = 6 years, median = 7 years) of clinical experience. Two diagnostic errors were made by sonographers and two errors by radiologists. In no single case did the radiologist uncover a case of an acute or serious illness, illness requiring admission or urgent clinical review, nor did the radiologist identify the cause for the presenting symptoms. Eighteen discrepancies were found, but these were of trivial nature and most were rated by specialist clinicians as irrelevant. Conclusion Sonographers are accurate in distinguishing normal abdominal US examinations. The involvement of a radiologist in a second reading of normal abdominal US examinations is unnecessary.

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Section: Introductionmentioning

confidence: 99%

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Nečas

Shen

Ong

et al. 2020

Australas J Ultrason Med

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“…Previous audit methodologies described in the literature most often involved secondary reporting of previous scans conducted in radiological departments. [8][9][10] Typically, only the second investigator had access to the images stored and generated by the primary investigator. Criticism of this method surrounds the primary investigator; they may have failed to capture the optimal images, thereby making any secondary reporting flawed in analysis.…”

Section: Discussionmentioning

confidence: 99%

“…A review of audit strategies within MSK literature was undertaken, and there appeared to be a gap in the literature with very few published audits. [8][9][10][11] The audit methods that were described most often involved secondary reporting of previous scans conducted in radiological departments. [8][9][10] Reliance of methods demonstrating correlation against another imaging modality may be suboptimal for training and assurance purposes and for not measuring against the accepted 'gold standard' of surgery for shoulder conditions.…”

Section: Introductionmentioning

confidence: 99%

“…[8][9][10][11] The audit methods that were described most often involved secondary reporting of previous scans conducted in radiological departments. [8][9][10] Reliance of methods demonstrating correlation against another imaging modality may be suboptimal for training and assurance purposes and for not measuring against the accepted 'gold standard' of surgery for shoulder conditions. [12][13][14][15][16] A new audit method was deemed necessary to help fill the gap in the literature and to aid clinicians in demonstrating competency/assurance.…”

Section: Introductionmentioning

confidence: 99%

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Audit: sonographic report correlation against surgical findings during elective shoulder surgery

et al. 2021

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Introduction Musculoskeletal diagnostic ultrasound is an expanding clinical tool and increasingly used at point of care in clinical practice. Criticism around the accuracy of this modality is often attributed to operator dependence. This study evaluated the accuracy of a sonographer’s reporting against shoulder surgery. Methods A musculoskeletal sonographer performed same-day ultrasound scans prior to elective shoulder surgery procedures. The sonographer was blinded to clinical history and previous investigations. A brief physical examination of resisted external rotation and resisted abduction strength was performed prior to scanning. Scan results were reported using British Elbow and Shoulder Society (BESS) reporting criteria. The sonographer attended surgery to gain immediate visual feedback. Sonographic reports and magnetic resonance imaging (MRI) reports were graded (1= complete agreement; 2 = minor discrepancy unlikely to alter patient care; 3 = potentially significant discrepancy; 4 = definite, significant discrepancy) against surgical findings. The accuracy of sonographic reporting was correlated with patients’ body mass index (BMI). Results Fifty-four cases were compared and correlations evaluated. Grade 1 (complete agreement) was reported 87.0% ( n = 47), Grade 2 (minor discrepancy) 9.3% (n = 5) and Grade 3 (potentially significant discrepancy) 3.7% (n = 2). Sonographic reports closely correlated (Grade 1 or 2 scores) with surgical findings in 96% of cases. Conclusions The musculoskeletal sonographic reporting had a high correlation with surgery findings. Ultrasound was more accurate than MRI in reporting full thickness rotator cuff tears. Clinical weakness in resisted external rotation or abduction did not correlate with imaging. Ultrasound was found to be unreliable in detecting rotator cuff tears in participants with a BMI ≥ 35.

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“…Sonographers demonstrate a high standard of diagnostic performance and work with a considerable degree of professional independence 1 . The high accuracy of sonographers' diagnostic opinion has been documented in numerous studies across all subspecialties with sonographers demonstrating comparable diagnostic performance to radiologists 2–15 . A recent large study involving 1000 abdominal ultrasound (US) examinations reported as ‘normal’ by sonographers, demonstrated that sonographers have near perfect accuracy in distinguishing a normal examination and commit the same number of reporting errors as radiologists 15 .…”

Section: Introductionmentioning

confidence: 99%

The accuracy of sonographers in reporting abnormal ultrasound findings: A prospective study comparing sonographers' and radiologists' reports in 1000 hospital patients

et al. 2023

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Introduction:The aim of this study was to compare the ultrasound (US) findings independently reported by sonographers with final reports issued by radiologists in a complex working environment of an acute and inpatient US service in a large tertiary teaching hospital.Methods: This study was a prospective review of 1000 unique hospital patients who received 1142 US examinations. Sonographers performed the requested examinations and reported their findings independently before consulting with radiologists. Radiologists reviewed the sonographers' findings, consulted with sonographers, and issued their final reports. Any disagreements between the findings of the sonographer and radiologist were captured, analysed and separated into errors or discrepancies according to commonly accepted definitions. Patient outcomes were determined from electronic clinical records.Results: Examinations were performed by a team of 11 sonographers with a median of 9.5 years of experience and standard US qualifications. Sonographers independently reported 1484 abnormal findings in 268 categories. Radiologists were in complete agreement in 93.6% of cases, 5.3% cases included minor discrepancies and 1.1% of cases contained errors of which sonographers were responsible for 9 and radiologists 7. The severity of errors was comparable between sonographers and radiologists. Conclusion:Sonographers and radiologists demonstrate a high degree of agreement in reporting abnormal US findings. Sonographers and radiologists committed a comparable number of errors, and the error severity scores were also comparable. The customary, routine involvement of a radiologist in the second reading and reporting of all US examinations is unnecessary.

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Feasibility of an Audit System for Canadian Sonographers in Generalist Ultrasound

Cited by 3 publications

References 11 publications

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Do radiologists need to review abdominal ultrasound examinations reported as ‘normal’ by the sonographer?

Audit: sonographic report correlation against surgical findings during elective shoulder surgery

The accuracy of sonographers in reporting abnormal ultrasound findings: A prospective study comparing sonographers' and radiologists' reports in 1000 hospital patients

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