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Estall MH. MRI reporting radiographers - Has there been a progression or regression in numbers and scope of practice? J Med Imaging Radiat Sci 2024:S1939-8654(24)00112-7. [PMID: 38704272 DOI: 10.1016/j.jmir.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 05/06/2024]
Abstract
INTRODUCTION The aim of this study was to determine whether there had been a progression or regression in the numbers and scope of practice of reporting radiographers in Magnetic Resonance Imaging (MRI) in the United Kingdom (UK), using data from a previous study conducted by the author in 2019/20 as a comparison. METHODS Data was gathered via a survey sent to multiple users and groups of MRI Radiographers in the UK. The survey consisted of a questionnaire, using both numerical and free text answers to enable the responders to elaborate on their scope of practice whilst also allowing numerical data to be easily analysed. The responses were analysed for patterns and comparison was made with the data from the previous survey. The questionnaire was based on three main themes of those in training, those trained and those in practice. RESULTS A total of 62 sites had radiographers in training (n =24) or trained (n = 125) in MRI reporting compared to 46 sites in the previous survey. The majority of responders were from England (n = 56/62) with only a few sites in Scotland (n = 4) and Wales (n = 2). There were 24 radiographers in training, a reduction compared to the previous survey and an increase in the number of radiographers trained (n = 80 to n = 125) and in practice (n = 57 to n = 84). Scope of practice had also increased with the addition of MRCPs, orbits and pituitary. CONCLUSION This survey provides evidence that the number and scope of practice of MRI reporting radiographers within the UK has progressed when compared to a previous survey from 2019/20. The numbers however are still low and there remain significant geographical variations. The continued predominance of single handed practice is a concern and the reasons behind this and the slow expansion of skill mix reporting in this modality needs further investigation. IMPLICATIONS FOR PRACTICE This study provides evidence of the number and scope of practice of the radiographer reporting of MRI examinations in the UK. It also demonstrates that there has been an increase in scope and number of radiographers reporting MRI scans, this will provide evidence and proof of concept for departments looking to initiate or increase this practice.
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Affiliation(s)
- Ms Helen Estall
- Imaging Department, University Hospitals of Leicester NHS Trust, Infirmary Close, Leicester, Leicestershire, UK.
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McDaid L, Eccles CL, Yorke J. An evaluation of radiographers' extended practice in the detection of brain metastases on magnetic resonance images. Radiography (Lond) 2024; 30:313-318. [PMID: 38118376 DOI: 10.1016/j.radi.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/22/2023]
Abstract
INTRODUCTION Patients who undergo magnetic resonance (MR) imaging to confirm or rule out metastatic brain disease are required to wait for image review by a radiologist before leaving the department at the institute where this study was carried out. The aim was to evaluate whether radiographers can review images and reduce waiting times in those patients without metastases. METHODS Prospective observational study of MR radiographers (n = 11) was undertaken. Radiographers commented on images to confirm whether the images showed evidence of metastatic disease, pathology but no metastases, or no pathology. Responses were compared to the radiological report (reference standard). Online questionnaires determined the views and opinions of radiographers (n = 8) and consultant radiologists (n = 6) towards radiographers expanding their scope of practice to include the confirmation or exclusion of brain metastases. RESULTS Despite a lack of formal training for image reviewing, overall level of agreement between the radiographer reviews and reference standard was 77.9 % (κ = 0.45). Pooled sensitivity and specificity were 88.6 % & 71.3 % respectively. Kendall's τ = -0.03 (bootstrap 95 % CI -0.73 to 0.61, p = 0.925). Positive predictive value (PPV) was 65.5 % (CI 59.2%-71.4 %) and negative predictive value (NPV) 91.1 % (CI 84.9%-94.9 %). Radiographers and radiologists surveyed demonstrated a willingness to engage with role expansion. CONCLUSION Based on our small study and interdisciplinary survey, local radiographers and radiologists agree, following a program of radiographer training, screening for brain metastases by radiographers could be implemented. IMPLICATIONS FOR PRACTICE With appropriate governance and training support, the introduction of formal radiographer screening for patients referred to exclude brain metastases could provide more efficient working practice.
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Affiliation(s)
- L McDaid
- Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester, UK.
| | - C L Eccles
- Department of Radiotherapy, The Christie NHS Foundation Trust, Manchester, UK; Division of Cancer Sciences, Faculty of Medicine, Biology and Health University of Manchester, UK
| | - J Yorke
- Department of Quality and Standards, The Christie NHS Foundation Trust, Manchester, UK
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Pedersen MRV, Jensen J, Senior C, Gale N, Heales CJ, Woznitza N. Reporting radiographers in Europe survey: An overview of the role within the European Federation of Radiographer Society (EFRS) member countries. Radiography (Lond) 2023; 29:1100-1107. [PMID: 37757677 DOI: 10.1016/j.radi.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Reporting radiographers undertake an important role in healthcare and for the radiographer profession in general. First introduced in the United Kingdom, reporting radiographers are now practicing in several other European countries. Our objective was to investigate the workforce of reporting radiographers across the European Federation of Radiographer Societies (EFRS) community. METHOD AND MATERIAL A voluntary anonymous 34 item electronic survey was distributed online using social media accounts such as Twitter, Facebook and LinkedIn covering a wide range of topics relating to professional role, advanced practice, education, and seniority. The questionnaire was distributed during a 12-week period in 2022. RESULT A total of 345 individual responses were received from 15 countries with majorities of respondent from United Kingdom (n = 245, 71%) and Denmark (n = 66, 19%). Mean age was 41.9 (S.D 9.8), similar for females, 42.5 (S.D 9.0) and men 40.9 years (S.D 9.7). Most reporting radiographers worked in public hospitals (90%). The vast majority of the respondents (n = 270, n = 94%) authored and signed their own clinical reports while a minority (n = 18, 6%) stated that their reports were checked by radiologists. CONCLUSION The survey highlights the scope of practice of reporting radiographers working in Europe. Reporting is becoming a career path for an increasing number of radiographers across Europe and there is assess to academic education and clinical support. IMPLICATION FOR PRACTICE Reporting radiographers fulfil an important role within the current demands of healthcare. This demand is likely to increase in the future, and therefore it is vital that there is some form of standardisation in the level of education that this group of healthcare professionals receive.
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Affiliation(s)
- M R V Pedersen
- Department of Radiology, Vejle Hospital - Part of Lillebaelt Hospital, Vejle, Denmark; Department of Radiology, Kolding Hospital - Part of Lillebaelt Hospital, Kolding, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - J Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Odense Denmark; Department of Radiology, Odense University Hospital, Odense, Denmark
| | - C Senior
- Dorset County Hospital NHS Foundation Trust, UK
| | - N Gale
- Medical Imaging, University of Exeter, UK
| | - C J Heales
- Medical Imaging, College of Medicine and Health, University of Exeter, UK
| | - N Woznitza
- University College London Hospitals, UK; Canterbury Christ Church University, UK
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Mitchell M, Lockwood P. An investigation into the clinical scope of practice of MRI reporting radiographers within the United Kingdom. Radiography (Lond) 2023; 29:489-495. [PMID: 36878158 DOI: 10.1016/j.radi.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/01/2023] [Accepted: 02/15/2023] [Indexed: 03/07/2023]
Abstract
INTRODUCTION Radiographers have been reporting Magnetic Resonance Imaging (MRI) examinations for over ten years, and there is an increasing body of evidence confirming the efficacy of this role expansion. However, little is known about the clinical scope of practice of radiographers undertaking this enhanced level of practice. The aim of this study was to investigate the clinical scope of practice of MRI reporting radiographers within the United Kingdom (UK). METHODS MRI reporting radiographers who are actively reporting within the UK were invited to participate in a short online survey investigating the anatomical areas reported, clinical referral pathways and onward referral practices they routinely undertake. The survey was distributed via social media channels with snowball sampling encouraged. RESULTS There were n = 14 responses received, with an estimated response rate of 21.5%. The majority (93% n = 13/14) practised in England, with one response from Scotland. All participants (n = 14/14) undertook reporting of general practitioner (GP) and community healthcare practitioner's referrals, with 93% reporting for outpatient referrers. There was statistically significant variation in the anatomical areas reported when compared against those qualified less than two years and those qualified over ten years (p = 0.003). No other statistically significant variation was seen. CONCLUSION There was no statistical difference in the implementation of MRI reporting by radiographers identified. All participants indicated reporting for GP and community healthcare practitioner referrers which align well with the implementation of community diagnostic centre rollout across the UK. IMPLICATION FOR PRACTICE This is believed to be the first study of its kind in the realm of MRI reporting. The study has suggested that MRI reporting radiographers are well placed to contribute to the rollout of community diagnostic centres within the UK.
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Affiliation(s)
- M Mitchell
- Canterbury Christ Church University, School of Allied and Public Health Professions, Faculty of Medicine, Health and Social Care, North Holmes Road, Canterbury CT1 1QU, UK.
| | - P Lockwood
- Canterbury Christ Church University, School of Allied and Public Health Professions, Faculty of Medicine, Health and Social Care, North Holmes Road, Canterbury CT1 1QU, UK
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Moth A, Benning J, Glover J, Brown V, Pittock L, Woznitza N, Piper K. Concordance between a gastrointestinal consultant radiologist, a consultant radiologist and qualified reporting radiographers interpreting abdominal radiographs. Radiography (Lond) 2023; 29:408-415. [PMID: 36791613 DOI: 10.1016/j.radi.2022.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/14/2022] [Accepted: 12/21/2022] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Radiographers can accurately report musculoskeletal and chest radiographs, but there is paucity of research comparing the performance of reporting radiographers (RRs) with consultant radiologists when interpreting and reporting abdominal radiographs. This study assessed interobserver agreement in the clinical setting between reporting radiographers and a consultant radiologist compared to an expert gastrointestinal radiologist in a District General Hospital. Major discordant reports affecting patient management were also examined. METHODS 126 abdominal radiographs reported by 3 RRs in clinical practice were randomly selected and reported by a consultant radiologist and index gastrointestinal radiologist. The reports of the RRs and consultant radiologist were compared against the reports made by the index radiologist for agreement by a colorectal consultant surgeon. All 126 reports were scored as being in either complete agreement, minor disagreement or major disagreement which would have resulted in a change to patient management. RESULTS There was no significant difference in overall agreement between the consultant radiologist (CR) and RRs when compared to the index radiologist (CR: n = 90/126, 71.4% and RRs: n = 94/126, 74.6%. p = 0.57). Major disagreements were found, but there was no significant difference between both groups (CR: n = 23/126, 18.3% and RRs: n = 17/126, 13.5%. p = 0.30). CONCLUSION RRs can report abdominal radiographs to a comparable level of agreement as a consultant radiologist in the clinical setting. There was no significant difference in reports deemed to affect patient management. IMPLICATIONS FOR PRACTICE This study addresses the gap in assessing the performance of RRs reporting abdominal radiographs. This small scale study indicates that radiographers could provide additional support in the reporting of abdominal radiographs. This would help to reduce radiologist workload and enhance the role of the reporting radiographer. CLASSIFICATION Agreement between reporting radiographers and radiologists interpreting and reporting abdominal radiographs.
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Affiliation(s)
- A Moth
- Radiology Department, Ashford and St Peter's Hospitals, St Peter's Hospital, Guildford Road, Chertsey, KT15 1JD, Surrey, UK.
| | - J Benning
- Radiology Department, Ashford and St Peter's Hospitals, St Peter's Hospital, Guildford Road, Chertsey, KT15 1JD, Surrey, UK.
| | - J Glover
- Radiology Department, Ashford and St Peter's Hospitals, St Peter's Hospital, Guildford Road, Chertsey, KT15 1JD, Surrey, UK.
| | - V Brown
- Surgical Department, Ashford and St Peter's Hospitals, St Peter's Hospital, Guildford Road, Chertsey, KT15 1JD, Surrey, UK.
| | - L Pittock
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - N Woznitza
- University College London Hospitals NHS Foundation Trust & Canterbury Christ Church University, Canterbury, UK.
| | - K Piper
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
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Cain G, Pittock LJ, Piper K, Venumbaka MR, Bodoceanu M. Agreement in the reporting of General Practitioner requested musculoskeletal radiographs: Reporting radiographers and consultant radiologists compared with an index radiologist. Radiography (Lond) 2022; 28:288-295. [PMID: 35000869 DOI: 10.1016/j.radi.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 12/05/2021] [Accepted: 12/07/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study assessed the inter-observer agreement of reporting radiographers and consultant radiologists compared with an index radiologist when reporting General Practitioner (GP) requested musculoskeletal radiographs. The potential effect of discordant reports on patient management and outcome was also examined. METHODS Three reporting radiographers, three consultant radiologists and an index radiologist reported on a retrospective randomised sample of 219 GP requested musculoskeletal radiographs, in conditions simulating clinical practice. A speciality doctor in radiology compared the observers' reports with the index radiologist report for agreement and assessed whether any discordance between reports was clinically important. RESULTS Overall agreement with the index radiologist was 47.0% (95% CI, 40.5-53.6) and 51.6% (95% CI, 45.0-58.1) for the consultant radiologists and reporting radiographers, respectively. The results for the appendicular and axial skeleton were 48.6% (95% CI, 41.3-55.9) and 40.9% (95% CI, 27.7-55.6) for the radiologists, and 52.6% (95% CI, 45.2-59.8) and 47.7% (95% CI, 33.8-62.1) for the radiographers, respectively. The difference in overall observer agreement between the two professional groups with the index radiologist was not statistically significant (p = 0.34). Discordance with the index radiologist's reports was judged to be clinically important in less than 10% of the observer's reports. CONCLUSION Reporting radiographers and consultant radiologists demonstrate similar levels of concordance with an index radiologist when reporting GP requested musculoskeletal radiographs. IMPLICATIONS FOR PRACTICE These findings contribute to the wider evidence base that selected radiographers with appropriate postgraduate education and training are proficient to report on musculoskeletal radiographs, irrespective of referral source.
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Affiliation(s)
- G Cain
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK.
| | - L J Pittock
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
| | - K Piper
- Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK
| | - M R Venumbaka
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK
| | - M Bodoceanu
- Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK
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Evans C, Poku B, Pearce R, Eldridge J, Hendrick P, Knaggs R, Blake H, Yogeswaran G, McLuskey J, Tomczak P, Thow R, Harris P, Conway J, Collier R. Characterising the outcomes, impacts and implementation challenges of advanced clinical practice roles in the UK: a scoping review. BMJ Open 2021; 11:e048171. [PMID: 34353799 PMCID: PMC8344309 DOI: 10.1136/bmjopen-2020-048171] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 06/23/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES In response to demographic and health system pressures, the development of non-medical advanced clinical practice (ACP) roles is a key component of National Health Service workforce transformation policy in the UK. This review was undertaken to establish a baseline of evidence on ACP roles and their outcomes, impacts and implementation challenges across the UK. DESIGN A scoping review was undertaken following JBI methodological guidance. METHODS 13 online databases (Medline, CINAHL, ASSIA, Embase, HMIC, AMED, Amber, OT seeker, PsycINFO, PEDro, SportDiscus, Osteopathic Research and PenNutrition) and grey literature sources were searched from 2005 to 2020. Data extraction, charting and summary was guided by the PEPPA-Plus framework. The review was undertaken by a multi-professional team that included an expert lay representative. RESULTS 191 papers met the inclusion criteria (any type of UK evidence, any sector/setting and any profession meeting the Health Education England definition of ACP). Most papers were small-scale descriptive studies, service evaluations or audits. The papers reported mainly on clinical aspects of the ACP role. Most papers related to nursing, pharmacy, physiotherapy and radiography roles and these were referred to by a plethora of different titles. ACP roles were reported to be achieving beneficial impacts across a range of clinical and health system outcomes. They were highly acceptable to patients and staff. No significant adverse events were reported. There was a lack of cost-effectiveness evidence. Implementation challenges included a lack of role clarity and an ambivalent role identity, lack of mentorship, lack of continuing professional development and an unclear career pathway. CONCLUSION This review suggests a need for educational and role standardisation and a supported career pathway for advanced clinical practitioners (ACPs) in the UK. Future research should: (i) adopt more robust study designs, (ii) investigate the full scope of the ACP role and (iii) include a wider range of professions and sectors.
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Affiliation(s)
- Catrin Evans
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Brenda Poku
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruth Pearce
- School of Education, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Jeanette Eldridge
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - Paul Hendrick
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Roger Knaggs
- School of Pharmacy, University of Nottingham, Nottingham, UK
| | - Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Gowsika Yogeswaran
- Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
| | - John McLuskey
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Philippa Tomczak
- School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Ruaridh Thow
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Peter Harris
- Health Education England East Midlands, Leicester, UK
| | - Joy Conway
- College of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK
| | - Richard Collier
- Centre for Advancing Practice, Health Education England, Leeds, UK
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Comparison of reporting radiographers' and medical doctors' performance in reporting radiographs of the appendicular skeleton, referred by the emergency department. Radiography (Lond) 2021; 27:1099-1104. [PMID: 34006443 DOI: 10.1016/j.radi.2021.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION There is an increasing trend towards deploying reporting radiographers in Danish hospitals who, among various professional groups, interpret and report skeletal radiographs from the emergency department (ED). This study aimed to compare the quality of the reports issued by reporting radiographers to three different groups of medical doctors (MDs) who interpret or report skeletal radiographs at the ED. METHODS Four professional groups (i.e. four reporting radiographers, two radiology trainees, two orthopaedic senior trainees, and two orthopaedic trainees) reported 100 radiographs of the appendicular skeleton. The Consequence of clinical Outcome score (CO-score), accuracy, sensitivity, and specificity of each group were compared. The relative risk of a false-negative, false-positive or wrong result, the risk of a serious error, as well as the odds ratio of a more severe CO-score for each of the three MD groups, were compared to the reporting radiographers. RESULTS There was a significant difference between the groups in reference to the CO-score (P ≤ 0.001), accuracy (P = .003), specificity (P = .022), and in the proportion of serious errors (P ≤ 0.001). Compared to the reporting radiographers, all three groups of MDs showed a significantly higher CO-score and a significantly increased risk of a wrong result. Moreover, two of the MD groups showed a significantly increased risk of a false-positive result and for severe errors. CONCLUSION Based on the CO-score, the relative risk of errors, which could potentially cause malpractice in treatment and patient recall, significantly decreased when the reports were completed by reporting radiographers. IMPLICATIONS FOR PRACTICE To explore the need for a 24-h radiographer reporting service to the EDs, an upscaled study, like the current, with more participants representing the professional groups is highly recommended.
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MRI reporting radiographers - A survey assessment of number and areas of practice within the United Kingdom. Radiography (Lond) 2020; 27:568-573. [PMID: 33339747 DOI: 10.1016/j.radi.2020.11.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The aim of this study was to determine a baseline assessment of the national picture of MRI reporting radiographers within the United Kingdom. METHOD A questionnaire was utilised using both open and closed questions, the twenty questions were based on four main themes of those in training, those trained, those no longer reporting and post qualification sign off and expectations. The questionnaire was sent out to multiple special interest and MRI specific groups. RESULTS Responses were received from 46 trusts (n = 46) between September 2019 and May 2020. The majority of respondents were from English Trusts (n = 40/46). 31 radiographers from 21 different trusts were training in MRI reporting with the majority of those training to report thoraco-lumbar spines and knees. 80 radiographers from 38 trusts had completed training with 77 of those being trained at one south of England University. 57 radiographers from 35 trusts were in practice with the majority of these reporting thoraco-lumbar spines and knees. CONCLUSION This survey provides an insight into the current status of MRI reporting radiographers in the UK. Although courses have been available since 2003, numbers are still low and there are significant geographical and working practice variations. Defined standards of practice and the implementation of a central register would benefit both those in practice and those looking to implement a MRI reporting radiographer service. IMPLICATIONS FOR PRACTICE This study gives some baseline evidence of the number and scope of practice of MRI reporting radiographers in the UK.
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Piper K, Mitchell M, Griffin K, Morgan T, Roy A, Thomas A, Pittock L, Woznitza N, Faruqui R, Sakel M. Concordance between a neuroradiologist, a consultant radiologist and trained reporting radiographers interpreting MRI head examinations: An empirical study. Radiography (Lond) 2020; 27:475-482. [PMID: 33218744 DOI: 10.1016/j.radi.2020.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/23/2020] [Accepted: 10/27/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study assessed agreement between MRI reporting radiographers and a consultant radiologist compared with an index neuroradiologist when reporting MRI head (brain/internal auditory meati [IAMs]) examinations. The effect on patient management of any discordant reports was also examined. METHODS Two trained MRI reporting radiographers (RRs), a consultant radiologist (CR) and an index neuroradiologist (INR) reported on a random sample of 210 MRI examinations. The radiographers reported during clinical practice and the radiologists in clinical practice conditions. Two independent consultant physicians (neuro-rehabilitation and neuropsychiatry) compared these reports with the index neuroradiologist report for agreement and the clinical importance of discrepant reports. RESULTS Overall observer agreement between the RRs and CR was comparable in relation to agreement with the INR: RR; 93/210 (44.3%); and the CR; 83/210 (39.4%) for all head MRI examinations (p = 0.32). For brain examinations the difference was similar: RR; 64/180 (35.6%); and CR; 54/190 (30.0%), p = 0.26. Agreement rates for the IAMs examinations were identical, 29/30 (97.7%). For all head MRI examinations (n = 210) there was a very small observed difference of <0.5% in mean agreement between the reporting radiographers and the consultant radiologist (p = 0.92) for examinations where a major disagreement would have been likely to have led to a change in patient management. CONCLUSION MRI reporting radiographers reported during clinical practice on MRI head examinations to a level of agreement comparable with a consultant radiologist. IMPLICATIONS FOR PRACTICE This is an area in which radiographers could provide additional reporting roles to the reporting service to increase capacity. Wider potential benefits include cost-effectiveness and role development/retention of radiographers.
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Affiliation(s)
- K Piper
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - M Mitchell
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK; Imaging Department, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, ME7 5NY, UK.
| | - K Griffin
- Imaging Department, Medway Maritime Hospital, Medway NHS Foundation Trust, Gillingham, ME7 5NY, UK.
| | - T Morgan
- Radiology Department, Northampton General Hospital NHS Trust, Northampton, NN1 5BD, UK; Diagnostic/Medical Imaging Department, Hinchingbrooke Hospital, North West Anglia NHS Foundation Trust, Huntingdon, PE29 6NT, UK.
| | - A Roy
- Radiology Department, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK.
| | - A Thomas
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - L Pittock
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK.
| | - N Woznitza
- School of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, CT1 1QU, UK; Radiology Department, University College London Hospitals, London, NW1 2PG, UK.
| | - R Faruqui
- Centre for Health Services Studies, University of Kent, Canterbury, CT2 7NH, UK.
| | - M Sakel
- NeuroRehabitation Service, East Kent University Hospitals NHS Foundation Trust, Canterbury, CT1 3NG, UK.
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Wuni AR, Courtier N, Kelly D. Developing a policy framework to support role extension in diagnostic radiography in Ghana. J Med Imaging Radiat Sci 2020; 52:112-120. [PMID: 33082122 DOI: 10.1016/j.jmir.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/23/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION A global shortage of radiologists is affecting the timely provision of imaging reports and thus healthcare delivery. This situation has been the main driving factor behind successful role extension by radiographers into areas that traditionally were within the scope of radiologists, including image interpretation and reporting. The shortage of radiologists is even worse in developing countries like Ghana. There is a need for policy to guide the introduction and implementation of role extension in Ghana. METHODS A qualitative, single case study with multiple sites across the country was used. A sample of 16 participants, including 8 radiographers, 3 radiologists, 3 medical officers, a senior official each from the Ministry of Health and the Allied Health Professions Council, were interviewed about role extension. RESULTS The findings indicate the need for a guiding policy of role extension to be spear headed by the Ministry of Health to gain the needed credibility. The findings suggest the policy should be made to meet the local needs of the country. It also established the policy should regulate education and training and the scope of practice. CONCLUSION The study established the need for policy to guide the introduction and practice of role extension in diagnostic radiography in Ghana. The study also established the need for a broad consultation of all key stakeholders based on an internationally accepted consensus building model.
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Affiliation(s)
| | | | - Daniel Kelly
- School of Healthcare Sciences, Cardiff University, UK
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Wuni AR, Courtier N, Kelly D. Opportunities for radiographer reporting in Ghana and the potential for improved patient care. Radiography (Lond) 2020; 26:e120-e125. [DOI: 10.1016/j.radi.2019.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 11/17/2022]
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Culpan G, Culpan AM, Docherty P, Denton E. Radiographer reporting: A literature review to support cancer workforce planning in England. Radiography (Lond) 2019; 25:155-163. [DOI: 10.1016/j.radi.2019.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/12/2019] [Accepted: 02/17/2019] [Indexed: 10/27/2022]
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Piper K, Pittock L, Woznitza N. Radiographer reporting of neurological magnetic resonance imaging examinations of the head and cervical spine: Findings of an accredited postgraduate programme. Radiography (Lond) 2018; 24:366-369. [DOI: 10.1016/j.radi.2018.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 04/25/2018] [Accepted: 05/19/2018] [Indexed: 11/25/2022]
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Lockwood P, Dolbear G. Image interpretation by radiographers in brain, spine and knee MRI examinations: Findings from an accredited postgraduate module. Radiography (Lond) 2018; 24:370-375. [PMID: 30292508 DOI: 10.1016/j.radi.2018.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/18/2018] [Accepted: 05/23/2018] [Indexed: 01/14/2023]
Abstract
INTRODUCTION The aim of the study was to evaluate the performance of radiographers in image interpretation of magnetic resonance imaging (MRI) brain, spine and knee examinations following a nine-month work based postgraduate MRI module. METHODS Twenty-seven participants each submitted 60 image commentaries taken from prospective clinical workloads. The image interpretations (n = 1620) comprised brain, spine, and knee MRI examinations. Prevalence of abnormal examinations approximated 53% (brain), 74% (spine), and 73% (knee), and included acute and chronic pathology, normal variants and incidental findings. Each image interpretation was graded against reference standard consultant radiologist definitive report. RESULTS The radiographer's performance on brain image interpretations demonstrated mean accuracy at 86.7% (95% CI 83.4-89.3) with sensitivity and specificity of 84% (95% CI 80.9-86.4) and 89.7% (95% CI 86.2-92.6) respectively. For spinal interpretations the mean accuracy was 86.4% (95% CI 83.4-89.0), sensitivity was 90.2% (95% CI 88.2-92), mean specificity was 75.3% (95% CI 69.4-80.4). The mean results for knee interpretation accuracy were 80.9% (95% CI 77.3-84.1), sensitivity was 83.3% (95% CI 80.8-85.5), with 74.3% specificity (95% CI 67.4-80.4). CONCLUSIONS The radiographer's demonstrated skills in brain, spine and knee MRI examination image interpretation. These skills are not to replace radiologist reporting but to meet regulating body standards of proficiency, and to assist decision making in communicating unexpected serious findings, and/or extend scan range and sequences. Further research is required to investigate the impact of these skills on adjusting scan protocols or flagging urgent findings in clinical practice.
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Affiliation(s)
- P Lockwood
- Clinical and Medical Sciences Research Hub, School of Allied Health Professions, Canterbury Christ Church University, Kent, UK.
| | - G Dolbear
- Clinical and Medical Sciences Research Hub, School of Allied Health Professions, Canterbury Christ Church University, Kent, UK
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Woznitza N, Steele R, Piper K, Burke S, Rowe S, Bhowmik A, Maughn S, Springett K. Increasing radiology capacity within the lung cancer pathway: centralised work-based support for trainee chest X-ray reporting radiographers. J Med Radiat Sci 2018; 65:200-208. [PMID: 29806102 PMCID: PMC6119729 DOI: 10.1002/jmrs.285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 05/01/2018] [Accepted: 05/04/2018] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Diagnostic capacity and time to diagnosis are frequently identified as a barrier to improving cancer patient outcomes. Maximising the contribution of the medical imaging workforce, including reporting radiographers, is one way to improve service delivery. METHODS An efficient and effective centralised model of workplace training support was designed for a cohort of trainee chest X-ray (CXR) reporting radiographers. A comprehensive schedule of tutorials was planned and aligned with the curriculum of a post-graduate certificate in CXR reporting. Trainees were supported via a hub and spoke model (centralised training model), with the majority of education provided by a core group of experienced CXR reporting radiographers. Trainee and departmental feedback on the model was obtained using an online survey. RESULTS Fourteen trainees were recruited from eight National Health Service Trusts across London. Significant efficiencies of scale were possible with centralised support (48 h) compared to traditional workplace support (348 h). Trainee and manager feedback overall was positive. Trainees and managers both reported good trainee support, translation of learning to practice and increased confidence. Logistics, including trainee travel and release, were identified as areas for improvement. CONCLUSION Centralised workplace training support is an effective and efficient method to create sustainable diagnostic capacity and support improvements in the lung cancer pathway.
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Affiliation(s)
- Nick Woznitza
- Radiology DepartmentHomerton University HospitalLondonUK
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Rebecca Steele
- Radiology DepartmentUniversity College London HospitalLondonUK
| | - Keith Piper
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
| | - Stephen Burke
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Susan Rowe
- Radiology DepartmentHomerton University HospitalLondonUK
| | - Angshu Bhowmik
- Department of Respiratory MedicineHomerton University HospitalLondonUK
| | - Sue Maughn
- City and Hackney Clinical Commissioning GroupLondonUK
| | - Kate Springett
- School of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
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Immediate reporting of chest X-rays referred from general practice by reporting radiographers: a single centre feasibility study. Clin Radiol 2017; 73:507.e1-507.e8. [PMID: 29246588 PMCID: PMC5903871 DOI: 10.1016/j.crad.2017.11.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 11/14/2017] [Indexed: 12/19/2022]
Abstract
Aim To investigate the feasibility of radiographer-led immediate reporting of chest radiographs (CXRs) referred from general practice. Materials and methods This 4-month feasibility study (November 2016 to March 2017) was carried out in a single radiology department at an acute general hospital. Comparison was made between CXRs that received an immediate and routine report to determine the number of lung cancers diagnosed, time to diagnosis of lung cancer, time to computed tomography (CT), and number of urgent referrals to respiratory medicine. Results Forty of 186 sessions (22%) were covered by radiographer immediate reporting. Of the 1,687 CXRs referred from general practice, 558 (33.1%) received an immediate report (radiographer or radiologist). Twenty-two (of 36) CT examinations performed were following an abnormal CXR with an immediate report (mean 0.8 scans/week). Time from CXR to CT was shorter in the immediate report group (n=22 mean 0.9 days SD=2.3) compared to routine reporting (n=14; mean 6.5 SD=3.2; F=27.883, p<0.0001). Time to multidisciplinary team (MDT) discussion was shorter in the immediate reporting group (mean 4.1 SD=2.9) compared to routine reporting (mean 10.6; SD=4.5; F=11.59, p<0.0001). No apparent difference was found for time to discussion at treatment MDT. Conclusion It is feasible to introduce a radiographer-led immediate CXR reporting service. Patients can be taken off the lung cancer pathway sooner with the introduction of radiographer immediate reporting of CXRs and this may improve outcomes for patients. A definitive study assessing outcomes is required to determine whether this will have an impact mortality and morbidity for patients. Early lung cancer diagnosis is often limited by insufficient radiology capacity. It is feasible to introduce immediate reporting of chest X-rays from general practice by radiographers. Time to diagnosis of lung cancer can be significantly shortened with immediate chest X-ray reporting.
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Expanding the role of radiographers in reporting suspected lung cancer: A cost-effectiveness analysis using a decision tree model. Radiography (Lond) 2017; 23:273-278. [DOI: 10.1016/j.radi.2017.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 07/20/2017] [Accepted: 07/22/2017] [Indexed: 11/24/2022]
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Exploring the Benefits of Magnetic Resonance Imaging Reporting by Radiographers: A UK Perspective. J Med Imaging Radiat Sci 2016; 47:194-203. [DOI: 10.1016/j.jmir.2015.12.083] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/19/2015] [Accepted: 12/21/2015] [Indexed: 11/20/2022]
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Taba ST, Atkinson SR, Lewis S, Chung KSK, Hossain L. A systems life cycle approach to managing the radiology profession: an Australian perspective. AUST HEALTH REV 2015; 39:228-239. [PMID: 25513717 DOI: 10.1071/ah14113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 10/06/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Although the medical system has expanded considerably over the past two decades in almost all countries, so too has the demand for health care. The radiology specialisation may be an early system indicator, being especially sensitive to changes in supply and demand in both rural and urban environments. The question is whether the new policies of increasing the number of radiologists can be a proper long-term solution for the imbalance of workforce supply and demand or not. METHODS Using system dynamics modelling, we present our integrated descriptive models for the supply and demand of Australian radiologists to find the actual gap. Followed by this, we pose a prescriptive model for the supply in order to lessen the identified imbalance between supply and demand. Our system dynamics models compare the demand and supply of Australian radiologists over 40 years between 2010 and 2050. RESULTS The descriptive model shows that even if the radiology training program grows at a higher rate than the medical training growth rate and its own historical growth, the system will never be able to meet demand. The prescriptive model also indicates that although changing some influential factors (e.g the intake rate) reduces the level of imbalance, the system will still stay unstable during the study period. CONCLUSION We posit that Australia may need to design a new system of radiology provision to meet future demands for high-quality medical radiation services. We also suggest some strategies, such as greater development of radiographers' role, are critical for enabling sustainable change over time. What is known about the topic? Long-term workforce planning for medical services at the national level has been very challenging for policy makers of the 21st century. The current demographic imbalance in the supply and demand of the Australian radiologist workforce makes it difficult to plan the effects of extra inflow of radiology students over time.
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Affiliation(s)
- Seyedamir Tavakoli Taba
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Simon Reay Atkinson
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Sarah Lewis
- Medical Imaging Optimisation and Perception Group (MIOPeG), Faculty of Health Sciences, Brain Mind Research Institute, University of Sydney, Sydney, NSW 2141, Australia. Email
| | - Kon Shing Kenneth Chung
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
| | - Liaquat Hossain
- Complex Systems Research Group, School of Civil Engineering, Faculty of Engineering and IT, University of Sydney, Sydney, NSW 2006, Australia.
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Woznitza N, Piper K, Burke S, Patel K, Amin S, Grayson K, Bothamley G. Adult chest radiograph reporting by radiographers: Preliminary data from an in-house audit programme. Radiography (Lond) 2014. [DOI: 10.1016/j.radi.2014.03.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Woznitza N. Radiographer reporting. J Med Radiat Sci 2014; 61:66-8. [PMID: 26229639 PMCID: PMC4175839 DOI: 10.1002/jmrs.51] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 04/08/2014] [Accepted: 04/09/2014] [Indexed: 11/25/2022] Open
Affiliation(s)
- Nick Woznitza
- Radiology Department, Homerton University HospitalLondon, United Kingdom
- Allied Health Department, Canterbury Christ Church UniversityKent, United Kingdom
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