Reporting of fracture radiographs by radiographers: the impact of a training programme

Abstract

In order to determine what influence training would have on their ability to interpret skeletal radiographs from the accident and emergency department, a 6 months training programme was established for three radiographers in various aspects of the radiology of orthopaedics and skeletal trauma. During the study the radiographers reported on radiographs from the accident and emergency department and each month an evaluation of their accuracy was undertaken. The overall radiographer error rate for fracture detection (false positive and false negative) declined during the training period. This was highly significant (p < 0.001). The sensitivity for fracture detection improved from 81.1% at the commencement of the trial to 95.9% at the end. This was also highly significant (p < 0.001). Radiographer specificity for the exclusion of fractures also improved from 94.4% during the first 2 months to 96.6% in the final 2 months, and this was also significant (p < 0.05). The overall error rate of two of the three radiographers improved significantly (p < 0.001) but for one radiographer the improvement did not reach a level of statistical significance. The difference in sensitivity for fracture detection at the commencement of the trial period between radiologist and radiographer was highly significant (p < 0.001), but there was no statistically significant difference during the last two months of the trial. The difference in specificity between radiologist and radiographer remained highly significant both at the beginning and the end of the trial (p < 0.001). Experienced radiographers who receive supplementary training in the radiology of skeletal trauma can significantly improve their diagnostic skills and can report such radiographs with a high degree of accuracy. A programme of training and certification of radiographers in fracture reporting could help alleviate the diagnostic radiologists' workload of plain film reporting.

How good are emergency department Senior House Officers at interpreting X-rays following radiographers?? triage?

“…As they tend to stay in their posts for much longer than 6 months the radiographers could be part of a sustained training programme in diagnostic radiography. Following specific training radiographers are already permitted to report on skeletal X-rays, and studies have demonstrated their accuracy here [23,24]. An extension on this training could allow them to take responsibility for the X-ray interpretation when ordered by the junior doctors.…”

Expanding the role of radiographers in reporting suspected lung cancer: A cost-effectiveness analysis using a decision tree model

“…6 The reporting of imaging examinations by appropriately trained radiographers has been advocated for some time. [7][8][9] The joint position of the Royal College of Radiologists (RCR) and Society and College of Radiographers (SCOR) is that any radiographer undertaking clinical reporting must perform at a level comparable to that of a consultant radiologist. 10 There is extensive evidence that suggests this is achievable across a spectrum of modalities and anatomical regions.…”

“…7,9,[11][12][13][14][15] The majority of studies addressing clinical reporting by trained radiographers have focused on diagnostic accuracy. Excellent sensitivity and specificity has been reported for radiographer reporting of skeletal radiographs, 7,11,12 chest radiographs (CXR), 14,16 magnetic resonance imaging of the knee and lumbar spine, 13,17 and screening mammography. 15 Limited evidence exists on the cost effectiveness of radiographer reporting.…”

The accuracy of radiology speech recognition reports in a multilingual South African teaching hospital

“…It has been suggested that 95% accuracy be the standard of care for specialist radiological reporting in the emergency setting [18]. We recommend that similar standards apply for transcription services, whether SR or DT.…”