Reject rate analysis in digital radiography: an Australian emergency imaging department case study

Atkinson, Samantha; Neep, Michael J.; Starkey, Debbie

doi:10.1002/jmrs.343

Cited by 36 publications

(74 citation statements)

References 18 publications

(108 reference statements)

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“…Radiographic positioning is very difficult to master, and considerable practical experience is required to improve this skill. In a digital radiography system, the main cause of image rejection/retaking in clinical environments has been revealed to be positioning errors [13][14][15][16][17]. Nol et al reported that positioning errors are largely associated with less experienced technologists and are mainly due to the rotation of body parts [17].…”

Section: Discussionmentioning

confidence: 99%

“…Nol et al reported that positioning errors are largely associated with less experienced technologists and are mainly due to the rotation of body parts [17]. While it is necessary to plan education and training for technologists in clinical facilities, educational institutions should also allow students to experience radiographic positioning in a manner close to that in clinical practice to improve their skills [13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

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Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

Nagamata¹,

Sekine²

2020

RDI

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When students learn radiographic positioning during radiography practical training in educational institutions, they adjust the angle of the body using positioning aids and angle gauges. In contrast, radiologic technologists position patients using their own hands in clinical environments. In recent years, virtual simulations have been used to help students improve their clinical skills. However, because the existing simulations use computer-generated virtual environments, students cannot actually position human bodies or anthropomorphic phantoms. Therefore, we developed a simulation using augmented reality to teach radiographic positioning. This simulation allows learners to simulate angle placement by using both hands without positioning aids and angle gauges by looking at a virtual object that demonstrates the angle. The objective of this study was to investigate whether this simulation can be applied as a learning tool for radiography practical training and to examine future development directions for this simulation. We introduced the simulation in radiography practical training. The lumbar spine oblique projection was chosen as a learning task in this study, and an anthropomorphic phantom was used for practice. A questionnaire survey was conducted to collect feedback from the students at the end of the semester (n = 41). The survey results indicated that the students could practice positioning the angle of the body using only their own hands, demonstrating that the simulation could be applied as a learning tool in radiography practical training. Ongoing work will be conducted to develop a simulation in which students can practice with a human body.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

Nagamata¹,

Sekine²

2020

RDI

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“…Examination types included chest, spine, upper and lower limbs, representing examinations shown to have high rejection rates. 10 Cases were divided into 3 categories; keep, could keep and reject. The main flaws in the quality of the images in the categories reject and could accept cases were suboptimal positioning (36.4%; one case of wrong extremity imaged), collimation (22.7%), exposure error (18.2%), centering (13.6%) and artifacts (9.1%).…”

Section: Methodsmentioning

confidence: 99%

“…Another consideration is the radiographers and radiologists' perception and attitude towards image quality. 10 Dunn & Rogers 11 found that radiologists kept 50% more of the images that showed positioning errors compared to radiographers. Indicating a difference in clinical judgement between the two groups.…”

Section: Introductionmentioning

confidence: 99%

To keep or reject, that is the question - A survey on radiologists and radiographers’ assessments of plain radiography images

2021

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Introduction: This study aimed to survey radiographers and radiologists' assessment of plain radiographs to identify the imaging clinicians' differences in acceptance of image quality. Method: An online, questionnaire was distributed among radiographers (n ¼ 116) and radiologists (n ¼ 76) in a hospital trust in Norway, including 30 clinical cases (one image and a short referral text) that were divided into 3 categories; keep, could keep and reject, based on European guidelines. When rejecting, the respondents identified the main reason by ticking a list (positioning, collimation, centering, artifact or exposure error). Group differences were explored using 2-tailed chi-squared test. Intersubjectivity was measured using Cohen's kappa for multi-rater sample. Results: In total, 36% of the radiographers (n ¼ 42) and 14% of the radiologists (n ¼ 14) responded to the survey. Total response rate was 30% (56/192). Analysis showed significant difference between radiographers and radiologists in the categories of Reject (c 2 ¼ 6.3, df ¼ 1, p ¼ 0.01), and Could keep (c 2 ¼ 6.3, df ¼ 1, p ¼ 0.01), identifying radiologists as keeping more images compared to radiographers. Agreement among radiographers (Cohen's k: 0,39; 95% CI: 0.30e0.48; p < 0.001) and radiologists (Cohen's k: 0,23; 95% CI: 0.09e0.37; p < 0.001) respectively, is fair. The most common reason for rejecting an image is suboptimal positioning. Suboptimal collimation constituted 15% of the rejected images among radiographers, compared to 5% among radiologists. Centering, artifacts and exposure error showed quite similar rates as reasons for rejection. Conclusion: Radiographers and radiologists seem to agree on the assessment of good quality images, however, radiographers seem more reluctant to accept images of lower quality than radiologists. Implications for practice: Further research on reasons for differences in image quality assessment between radiographers and radiologists is needed. This could enable reduction in reject rates and increase image quality in conventional X-ray examinations.

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“…A bit more complex to quantify and optimise are imaging aspects readily impacted by less controllable and quantifiable variables such as imaging skill, training and experience with respect to image acquisition; patient and anatomic variability that affect image quality and models for optimising treatment planning; judgement calls about when and how to image and conduct procedures; and increasingly the economics of health care as other papers in this special issue emphasise.…”

mentioning

confidence: 99%

Optimisation in daily practice – it's more than just radiation dose

Krupiński

2020

J of Medical Radiation Sci

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Reject rate analysis in digital radiography: an Australian emergency imaging department case study

Cited by 36 publications

References 18 publications

Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

Simulation Using Augmented Reality to Teach Body Angle Positioning for Radiography

To keep or reject, that is the question - A survey on radiologists and radiographers’ assessments of plain radiography images

Optimisation in daily practice – it's more than just radiation dose

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