Radiographer Reporting: Discussion and Australian workplace trial

Abstract

This paper reports an investigation into the accuracy and effectiveness of two (2) senior Australian radiographers in the reporting of appendicular musculo‐skeletal radiographs in the adult trauma situation. and discusses the international debate on radiographer role extension into plain film reporting. The study of 540 patients referred to a large metropolitan emergency imaging department demonstrated high rates of diagnostic accuracy (sensitivity = 98.00% specificity = 99.11%) in the assessment of appendicular musculo‐skeletal radiographs. 294 out of 300 positive examinations were identified correctly (FPR=0.88%) as were 225 out of 227 negative or normal examinations (FNR=2.00%). A discussion on relevant statistical measures and their definitions is outlined. In the study radiologist reports are used as the comparative gold standard. The findings demonstrate an ability of clinically experienced radiographers to accurately and effectively provide diagnostic opinions on musculoskeletal radiographs. A formalised approach to radiographer reporting can be justified and a formal program to train appropriately experienced radiographers is recommended.

Evaluating the true clinical utility of the red dot system in radiograph interpretation

“…While the overall sensitivity of 80.5% in this study concurs with the current literature for identification of all appendicular skeletal fractures combined (ranging from 70%–98%), 2–7 it shows a markedly reduced sensitivity of 45.9% for cases of non‐displaced fractures and demonstrates the importance of an appropriately qualified radiologist report in all instances. Displaced fractures, which ought to be readily identifiable by referring clinicians, accounted for 16.5% of all radiographs, and only 9.3% of radiographs contained a fracture that may not have been readily apparent to the referring clinician.…”

“…Systems that promote models of non‐radiologist reporting of plain films do so as a strategy to satisfy demands for rapid reporting of clinically relevant findings while re‐prioritising resources 3,13 . Arguments that cite inadequate radiologist workforce numbers as justification for non‐radiologist reporting are less resonant in the Australian context where radiology trainee numbers have increased 76% between 2000 and 2010, and the growth in radiologist numbers has doubled the population growth over the last two decades 14 .…”

“…Systems that promote models of non-radiologist reporting of plain films do so as a strategy to satisfy demands for rapid reporting of clinically relevant findings while re-prioritising resources. 3,13 Arguments that cite inadequate radiologist workforce numbers as justification for non-radiologist reporting are less resonant in the Australian context where radiology trainee numbers have increased 76% between 2000 and 2010, and the growth in radiologist numbers has doubled the population growth over the last two decades. 14 Improvements to existing models that currently utilise radiologist reports for all emergency department radiographs within a clinically significant time frame should be preferred to strategies primarily motivated by cost reduction, which also threatens to erode the standard and the value of the task being undertaken.…”

The current status of radiographers as screen readers in breast screening units: applications for Australia

“…Furthermore, 'Government bodies involved in health care are acutely aware of the need for improved efficiency in the delivery of health care' 31 Within Australia the domestic demand for radiologists has outstripped supply and it is predicted that the demand will only increase leading to increased workloads. 28,29 Given the increasing radiologist shortages and an increased need for efficiency in the health system, it would seem appropriate to commence the introduction of non-radiologist screen readers for BreastScreen Australia.…”

“…'The fellow with the perceived bigger hip pocket is the one who is going to be done. ' '…it would be a concern you would have to make sure (that) you are well covered with insurance, ' Cook, et al 28 discuss medico-legal responsibility and state 'current legal restraints can be overcome by thorough documentation by the radiologist, radiographer and the employer as to the delegated roles and responsibilities in an endorsed proposal', so while medico-legal issues must be considered it would seem they are not insurmountable.…”