Radiographic image interpretation by Australian radiographers: a systematic review

Abstract

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.

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“…What audience are you trying to reach? For example, Andrew wrote a systematic review exploring radiographer image interpretation in Australia 5 , so he chose to submit to JMRS since it is an Australian journal as the matter impacts the Australian MRS profession. Most papers rejected before review are either not relevant to the profession or add anything new to the professional evidence base.…”

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“…The reason being the vast number of CATs that exist and each has its own properties and specific fit-forpurpose constructions [25]. The critical appraisal cut-off scores used by various authors are also not consistent; it seems this could be influenced by the tool used and their own interpretations of what is considered acceptable for their review studies [26][27][28]. It was noted that some authors consider 60% to 100% as moderate to high critical appraisal score that reflect more rigorous studies [20,27,28].…”

“…The critical appraisal cut-off scores used by various authors are also not consistent; it seems this could be influenced by the tool used and their own interpretations of what is considered acceptable for their review studies [26][27][28]. It was noted that some authors consider 60% to 100% as moderate to high critical appraisal score that reflect more rigorous studies [20,27,28]. Other authors further hold that one should be guided by the nature and quality of the available evidence to draw conclusions [29].…”

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“…The results of such studies, within their experimental setting, are impressive, and it is suggested that these algorithms will primarily be used as triaging tools to prioritize worklists by acuity [22]. Comparisons can be drawn to the concept behind radiographer alert systems used within the United Kingdom [23] and Australia [24], where abnormal images are flagged by the radiographer in an attempt to optimize the triaging process. However, unlike AI-led image triaging, frontline image interpretation by radiographers has been established and used in the clinical environment for many years [25][26][27] with measurable, positive outcomes [28,29].…”