Accuracy of radiographer preliminary clinical evaluation of skeletal trauma radiographs,in clinical practice at a district general hospital |
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| Affiliation: | 1. Radiology Department, Colchester Hospital, Turner Road, Colchester CO4 5JL, UK;2. Faculty of Medicine, Health and Social Care, Canterbury Christ Church University, North Holmes Road, Canterbury CT1 1QU, UK;1. School of Allied Health Professions & Sport, Faculty of Health Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK;2. Department of Radiology, Mid Yorkshire Hospitals NHS Trust, UK;1. Radiology Department, Queen Elizabeth University Hospital, Glasgow, United Kingdom;2. Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Road, Clayton, VIC 3800, Australia;3. Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, C129, Level 1, 10 Chancellors Walk, Clayton Campus, Wellington Road, Clayton, VIC 3800, Australia;1. Walsall Healthcare NHS Trust, UK;2. University of Salford, UK;3. University Hospitals of Morecambe Bay NHS Foundation Trust, UK |
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| Abstract: | IntroductionError in interpretation of trauma radiographs by referrers is a problem which has detrimental effects on the patient and causes unnecessary repeat attendances. Radiographers can reduce errors by offering their opinion at the time of imaging. The Society and College of Radiographers have a longstanding recommendation that Red Dot (RD) schemes should be replaced by Preliminary Clinical Evaluation (PCE). The purpose of the study was to evaluate radiographer interpretation of skeletal trauma radiographs in clinical practice, determine if there was any difference in ability to interpret appendicular and axial studies, and evaluate appropriateness of PCE implementation.MethodsA convenience sample of 23 self-selecting radiographers provided RD and PCE on 762 examinations. Each case was compared against the verified report and assigned a true negative/positive or false negative/positive value. Accuracy, sensitivity and specificity were calculated and performance measures between RD versus PCE, and appendicular versus axial were compared using Two-sample Z-Tests. Error analysis was performed and inter-observer consistency determined.ResultsOverall RD and PCE accuracy, sensitivity and specificity for the study were 90%, 72% and 97% (RD), and 92%, 80% and 97% (PCE) respectively. Significant difference was demonstrated for sensitivity with PCE more sensitive than RD (p-value 0.03) and appendicular more sensitive than axial (RD p-value <0.02, PCE p-value <0.0001). Most errors were false negatives. Inter-observer consistency was evaluated by review of 128 cases and no difference between reviewers was established.ConclusionRadiographers without specific training were able to provide RD and PCE to a high standard. Radiographers interpreted positive findings more accurately using PCE than RD, and positive findings on appendicular cases were interpreted more accurately than those on axial cases.Implications for practiceThis study supports local PCE implementation, contributes to the wider evidence base to justify transition towards PCE and identifies the necessity for local axial image interpretation training. |
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| Keywords: | Preliminary clinical evaluation Image interpretation Red dot Trauma Radiography abnormality detection systems Radiographer |
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