Accuracy and diagnostic impact of radiographer chest x-ray reporting
Research type
Research Study
Full title
Establishing the diagnostic accuracy of radiographer chest x-ray reports and their influence on clinicians’ clinical reasoning: a comparison with consultant radiologists.
IRAS ID
111410
Contact name
Nicholas Woznitza
Contact email
Sponsor organisation
Homerton University Hospital NHS Foundation Trust
Research summary
Radiology investigations are frequently used by clinicians to aid in patient diagnosis. In response to ever-increasing demands, radiographer reporting is often used as a solution to manage radiology workloads while maintaining a patient focused service. Accurate image interpretation is of fundamental importance; however significant observer variation in chest x-ray interpretation is reported in the literature. There is little work which has examined the accuracy of reporting radiographer chest x-ray interpretation in clinical practice.
In order to appropriately influence patient care the radiology report needs to aid the clinician in arriving at an accurate diagnosis by influencing their diagnostic decision-making. A paucity of recent UK evidence which examines this aspect of chest x-ray interpretation, in general and specifically for radiographer produced chest x-ray reports, exists in the literature.A structured, step-wise assessment of diagnostic accuracy and influence on clinicians’ diagnostic thinking has been designed, modelled on the hierarchical framework proposed by Fryback & Thornbury[1]. Diagnostic accuracy (level 2 efficacy) will be examined through interpretation of an image bank, where a robust reference standard diagnosis is known, by consultant radiologists and reporting radiographers. This will be analysed using the free-response receiver operating characteristic paradigm. The influence that consultant radiologist and reporting radiographer chest x-ray reports have on the diagnostic decision-making of clinicians (level 3 efficacy) will be examined using the methodology developed by Tsushima[2].
A non-inferiority approach will be used when testing the hypotheses, consistent with the joint position of the Royal College of Radiologists and College of Radiographers that radiographers who extend their role to include image interpretation must perform at a level comparable to consultant radiologists[3].
References
1. Fryback DG, Thornbury JR. The efficacy of diagnostic imaging. Medical decision making 1991;11(2):88-94.
2. Tsushima Y, Aoki J, Endo K. Contribution of the diagnostic test to the physician’s diagnostic thinking: New method to evaluate the effect. Academic Radiology 2003;10:751-55.
3. Royal College of Radiologists & College of Radiographers. Team working in clinical imaging. London, 2012.REC name
London - Bromley Research Ethics Committee
REC reference
13/LO/0639
Date of REC Opinion
21 May 2013
REC opinion
Favourable Opinion