Pelvic ultrasounds referred from the emergency department: Agreement between sonographer findings and radiologists' reports

Abstract

Introduction: When radiologists are not available, sonographers may be able to provide an interim report, especially for patients referred from emergency or in remote clinics. The aim of this study was to compare the agreement of diagnostic findings between sonographers and radiologists for patients referred from the emergency department for pelvic ultrasound. Methods: Sonographer findings and corresponding radiologists' reports of consecutive pelvic ultrasound examinations referred from the emergency department were compared prospectively over a 7-month period. Paediatric cases were excluded. Diagnostic agreement was scored by an independent investigator into the following: grade 1-agree with radiologist report; grade 2-minor discrepancy, unlikely to impact patient management; grade 3-major discrepancy, likely to impact patient management but does not lead to adverse outcomes for the patient; and grade 4-major discrepancy, findings likely to result in significantly adverse outcome for the patient.

Comparison between radiographers with sonography education working in remote Australia and radiologists’ interpretation of ultrasound examinations

“…14 Another 2021 Australian study comparing agreement levels between radiologists and sonographer's pelvic ultrasound findings concluded that sonographers could provide accurate interim reports when radiologists reports are delayed. 17 Overseas studies support these findings. 15,[18][19][20] A European study reported that in the UK and Norway, radiographers provided full ultrasound definitive reports and also provided advice on further ultrasound investigations.…”

“…Information collected for the study included agreement rates, recommendations for further examinations, types of ultrasound examinations and clinical indications. The researcher scored the level of agreement by comparing the sonographic findings to those of the radiologists' reports by utilising four previously published diagnostic agreement scoring criteria 14,17 as follows:…”

“…Information collected for the study included agreement rates, recommendations for further examinations, types of ultrasound examinations and clinical indications. The researcher scored the level of agreement by comparing the sonographic findings to those of the radiologists’ reports by utilising four previously published diagnostic agreement scoring criteria 14, 17 as follows: Category 1: complete agreement/matching with teleradiologists reports; Category 2: minor discrepancy that would not impact patient management which included hedging terminology 21 and ambiguous differences, for example fatty versus moderate fatty liver; Category 3: major discrepancy that would likely have an impact/change on patient management but would not lead to an adverse outcome for the patient; and Category 4: major discrepancy that would impact patient management and lead to adverse outcomes for the patient. …”

“…For example, a 2014 Australian study reporting on abdominal ultrasound referrals from emergency departments achieved complete agreement of 84.9% and a further 14.0% only had minor discrepancy between sonographers and radiologists 14 . Another 2021 Australian study comparing agreement levels between radiologists and sonographer’s pelvic ultrasound findings concluded that sonographers could provide accurate interim reports when radiologists reports are delayed 17 . Overseas studies support these findings 15,18–20 .…”

Routine disclosure statements about ultrasound examinations during Covid‐19 pandemic are unhelpful and should be avoided

“…Sonographers are highly accurate diagnosticians whose diagnostic performance in US has been shown to be on a par with that of radiologists in a number of studies. [23][24][25][26][27][28][29][30] There is therefore no reason to suspect that under the additional pressure of a pandemic, the sonographer's diagnostic performance would somehow become compromised.…”