Adult chest radiograph reporting by radiographers: Preliminary data from an in-house audit programme

Journal article

Woznitza, N., Piper, K., Burke, S., Patel, K., Amin, S., Grayson, K. and Bothamley, G. 2014. Adult chest radiograph reporting by radiographers: Preliminary data from an in-house audit programme. Radiography. 20 (3), pp. 223-229. https://doi.org/10.1016/j.radi.2014.03.002
AuthorsWoznitza, N., Piper, K., Burke, S., Patel, K., Amin, S., Grayson, K. and Bothamley, G.
Abstract

Aim
To examine the adult chest radiograph (CXR) reporting performance of a reporting radiographer in clinical practice using different audit systems; single radiologist and two radiologists, with clinical review of discordant cases.

Materials and methods
100 chest radiographs (CXRs) were drawn randomly from a consecutive series of 4800 CXRs which had been reported during a nine month period at a district general hospital by a radiographer after two years of training. Diagnostic outcomes were normal or abnormal, and agreement with the reporting radiographer or not. There was 50% duplication of CXRs reported between three radiologists. Concordance rates were determined for the radiographer-radiologist and inter-radiologist interpretations. Independent clinical review of discordant cases was performed to establish the final diagnosis.

Results
Ninety-nine cases were reviewed, with 40 cases deemed abnormal by at least one radiologist. Consensus was found with the radiographers report in 59 normal and 33 abnormal CXRs reviewed by two radiologists (96.7% and 86.8% respectively). Seven CXR reports were discrepant with clinical review: mediastinal lymphadenopathy was missed by both radiologist and radiographer; linear atelectasis was reported by two radiologists but not the radiographer. Three cases were over-interpreted and on two occasions at least one radiologist agreed with the radiographer. There was very high concordance between the radiographer and each radiologist, 96%, 96% and 92% respectively.

Conclusions
This study suggested that regular audit, which incorporates case note review and discrepant reporting within a multidisciplinary setting, should contribute to safe practice.

KeywordsRadiographer reporting; Clinical competence; Advanced practice; Radiography; Thoracic; Audit
Year2014
JournalRadiography
Journal citation20 (3), pp. 223-229
PublisherElsevier
ISSN1078-8174
Digital Object Identifier (DOI)https://doi.org/10.1016/j.radi.2014.03.002
Related URLhttp://www.radiographyonline.com/article/S1078-8174(14)00016-9/abstract
Publication dates
PrintAug 2014
Publication process dates
Deposited13 Feb 2015
Output statusPublished
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Woznitza, N., Piper, K., Burke, S. and Bothamley, G. 2016. Chest x-ray interpretation by radiographers: diagnostic accuracy and influence on diagnostic reasoning.
Diagnostic accuracy of radiographer chest x-ray reporting
Woznitza, N., Piper, K., Burke, S. and Bothamley, G. 2016. Diagnostic accuracy of radiographer chest x-ray reporting.
The diagnostic accuracy of reporting radiographer chest x-ray interpretations and their influence on clinicians’ diagnostic decision-making: a comparison with consultant radiologists
Woznitza, N. 2016. The diagnostic accuracy of reporting radiographer chest x-ray interpretations and their influence on clinicians’ diagnostic decision-making: a comparison with consultant radiologists. PhD Thesis Canterbury Christ Church University School of Allied Health Professions
The radiography workforce: current challenges and changing needs
Beardmore, C., Woznitza, N., Goodman, S. and Society & College of Radiographers 2016. The radiography workforce: current challenges and changing needs. College of Radiographers.
Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study
Lockwood, P., Pittock, L., Lockwood, C., Jeffery, C. and Piper, K. 2015. Intraorbital foreign body detection and localisation by radiographers: a preliminary JAFROC observer performance study. Radiography. 2015, pp. 1-5. https://doi.org/10.1016/j.radi.2015.06.005
AFROC analysis of reporting radiographer’s performance in CT head interpretation
Lockwood, P. and Piper, K. 2015. AFROC analysis of reporting radiographer’s performance in CT head interpretation. Radiography. 21 (3), pp. e90-e95. https://doi.org/10.1016/j.radi.2015.04.001
CT head reporting by radiographers: Findings of an accredited postgraduate programme
Lockwood, P. and Piper, K. 2013. CT head reporting by radiographers: Findings of an accredited postgraduate programme.
Chest reporting by radiographers: Findings of an accredited postgraduate programme.
Piper, K., Cox, S., Paterson, A., Thomas, A., Thomas, N., Jeyagopal, N. and Woznitza, N. 2014. Chest reporting by radiographers: Findings of an accredited postgraduate programme. Radiography. 20 (2), pp. 94-99. https://doi.org/10.1016/j.radi.2014.01.003
Optimizing patient care in radiology through team-working: A case study
Woznitza, N., Piper, K., Rowe, S. and West, C. 2014. Optimizing patient care in radiology through team-working: A case study. Radiography. 20 (3), pp. 258-263. https://doi.org/10.1016/j.radi.2014.02.007
Chest x-ray agreement: comparative analysis between consultant radiologists, reporting radiographers and expert chest radiologists
Woznitza, N., Piper, K., Burke, S., Ellis, S. and Bothamley, G. 2015. Chest x-ray agreement: comparative analysis between consultant radiologists, reporting radiographers and expert chest radiologists.
Conceptualisation of the characteristics of advanced practitioners in the medical radiation profession
Smith, Tony, Harris, J., Woznitza, N., Marese, S. and Sale, C. 2015. Conceptualisation of the characteristics of advanced practitioners in the medical radiation profession. Journal of Medical Radiation Sciences. 62 (3), pp. 204-211. https://doi.org/10.1002/jmrs.115
CT head reporting by radiographers: results of an accredited postgraduate programme
Lockwood, P., Piper, K. and Pittock, L. 2015. CT head reporting by radiographers: results of an accredited postgraduate programme. Radiography. 21 (3), pp. e85-e89. https://doi.org/10.1016/j.radi.2014.12.001
e-Learning for Healthcare – Image Interpretation Project
Woznitza, N., e-Learning for Healthcare and College of Radiographers 2012. e-Learning for Healthcare – Image Interpretation Project. e-Learning for Healthcare.
An unusual cause of respiratory distress
Woznitza, N., Datsopolous, S., Shukla, R. and Aladangady, N. 2012. An unusual cause of respiratory distress. Archives of Disease in Childhood. 97, pp. A12-A13. https://doi.org/10.1136/archdischild-2012-301885.30
Chest X-Ray interpretation: agreement between consultant radiologists and a reporting radiographer in clinical practice in the United Kingdom
Woznitza, N., Piper, K., Burke, S., Patel, K., Amin, S. and Grayson, K. 2013. Chest X-Ray interpretation: agreement between consultant radiologists and a reporting radiographer in clinical practice in the United Kingdom.
Radiographer clinical reporting
Woznitza, N. 2014. Radiographer clinical reporting.
Commentary: radiographer reporting
Woznitza, N. 2014. Commentary: radiographer reporting. Journal of Medical Radiation Sciences. 61 (2), pp. 66-68. https://doi.org/10.1002/jmrs.51
Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations
Woznitza, N., Piper, K., Bothamley, G. and Burke, S. 2014. Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations.
Optimizing patient care in radiology through team-working: audit data
Woznitza, N. 2014. Optimizing patient care in radiology through team-working: audit data.
Optimizing neonatal X-ray quality: results of an audit
Woznitza, N., Hayes, N., Malshava, N. and McGuinness, D. 2014. Optimizing neonatal X-ray quality: results of an audit.
Agreement in neonatal x-ray interpretation: a comparison between consultant paediatric radiologists and a reporting radiographer
Woznitza, N., Piper, K., Aladangady, N., Iliadis, K., Prakash, R. and Santos, R. 2014. Agreement in neonatal x-ray interpretation: a comparison between consultant paediatric radiologists and a reporting radiographer.
Advanced radiographic practice in adult chest imaging
Woznitza, N. 2014. Advanced radiographic practice in adult chest imaging.
The implementation of a radiographic reporting service for trauma examinations of the skeletal system in 4 NHS trusts. NHS Executive South Thames funded research project
Piper, K., Paterson, A. and Ryan, C. 1999. The implementation of a radiographic reporting service for trauma examinations of the skeletal system in 4 NHS trusts. NHS Executive South Thames funded research project. Canterbury Christ Church University.
Interpretation of clinical imagingexaminations by radiographers:a programme of research
Piper, K. 2014. Interpretation of clinical imagingexaminations by radiographers:a programme of research. PhD Thesis Canterbury Christ Church University Faculty of Health and Wellbeing
Observer agreement in the reporting of knee and lumbar spine Magnetic Resonance (MR) Imaging examinations: selectively trained MR radiographers and consultant radiologists compared with an index radiologist
Brealey, S., Piper, K., King, D., Bland, M., Caddick, J., Gibbon, A., Highland, A., Jenkins, N., Petty, D. and Warren, D. 2013. Observer agreement in the reporting of knee and lumbar spine Magnetic Resonance (MR) Imaging examinations: selectively trained MR radiographers and consultant radiologists compared with an index radiologist. European Journal of Radiology. 82 (10). https://doi.org/10.1016/j.ejrad.2013.05.024
Skeletal reporting by radiographers: a review of 27800 cases
Piper, K. 2012. Skeletal reporting by radiographers: a review of 27800 cases.
ABCs of preliminary plain film image assessment
Williams, I. and Piper, K. 2012. ABCs of preliminary plain film image assessment.
Variation in accident and emergency musculoskeletal appendicular radiographic reports and the development of a report template
Paterson, A., Piper, K. and Ryan, C. 2001. Variation in accident and emergency musculoskeletal appendicular radiographic reports and the development of a report template. British Journal of Radiology. 74 (Supp.), p. 46.
Accuracy of radiographer reporting of magnetic resonance imaging for suspected acoustic neuroma
Gillmore, K., Piper, K., Byrne, J., Jeffree, M. and Millar, J. 2001. Accuracy of radiographer reporting of magnetic resonance imaging for suspected acoustic neuroma. British Journal of Radiology. 74 (S), p. 4.
The implementation of a radiographic reporting service for trauma examinations of the skeletal system
Piper, K. and Ryan, C. 1998. The implementation of a radiographic reporting service for trauma examinations of the skeletal system.
The development of a postgraduate diploma in Clinical Reporting (Radiography)
Davies, S., Piper, K., McKay, L. and Paterson, A. 1994. The development of a postgraduate diploma in Clinical Reporting (Radiography).
Using MRI for ankylosing spondylitis
Estall, H., Rennie, W. and Piper, K. 2012. Using MRI for ankylosing spondylitis. Imaging & Therapy Practice, Jan.
Clinical reporting in radiography: invited presentation
Piper, K. 1995. Clinical reporting in radiography: invited presentation.
The accuracy of radiographers' reports in accident and emergency examinations of the skeletal system
Piper, K. 1997. The accuracy of radiographers' reports in accident and emergency examinations of the skeletal system.
The accuracy of radiographers' reports in examinations of the skeletal system
Piper, K. 1997. The accuracy of radiographers' reports in examinations of the skeletal system.
Reporting by radiographers: findings of an accredited postgraduate skeletal reporting programme in the UK
Piper, K. 1997. Reporting by radiographers: findings of an accredited postgraduate skeletal reporting programme in the UK.
UK forges ahead with radiographer reporting
Thomas, A., Manning, D. and Piper, K. 2004. UK forges ahead with radiographer reporting. Diagnostic Imaging Europe.
The implementation of a radiographic reporting service for skeletal trauma
Paterson, A. and Piper, K. 1999. The implementation of a radiographic reporting service for skeletal trauma.
The implementation of a radiographic reporting service for skeletal trauma
Paterson, A. and Piper, K. 2000. The implementation of a radiographic reporting service for skeletal trauma.
The implementation of a radiographic reporting service
Piper, K. 2000. The implementation of a radiographic reporting service.
Abnormality detection in the appendicular skeleton: a practical workshop on professional responsibilities and subtle abnormalities
Piper, K. and Paterson, A. 2002. Abnormality detection in the appendicular skeleton: a practical workshop on professional responsibilities and subtle abnormalities.
MRI reporting by radiographers: the construction of an objective structured examination
Piper, K. 2007. MRI reporting by radiographers: the construction of an objective structured examination.
Chest reporting by radiographers
Piper, K. and Cox, S. 2011. Chest reporting by radiographers.
Can reporting radiographers produce clinically relevant reports?
Woznitza, N. and Piper, K. 2011. Can reporting radiographers produce clinically relevant reports?
Clinical reporting by radiographers in the UK
Piper, K. 2009. Clinical reporting by radiographers in the UK.
MRI reporting by radiographers: findings of an accredited postgraduate programme
Piper, K. and Thomas, N. 2008. MRI reporting by radiographers: findings of an accredited postgraduate programme.
MRI reporting by radiographers: findings of an accredited postgraduate programme
Piper, K., Buscall, K. and Thomas, N. 2010. MRI reporting by radiographers: findings of an accredited postgraduate programme. Radiography. 16 (2), pp. 136-142. https://doi.org/10.1016/j.radi.2009.10.017
Reporting by radiographers: Neurological magnetic resonance imaging examinations of the head and cervical spine
Piper, K. 2009. Reporting by radiographers: Neurological magnetic resonance imaging examinations of the head and cervical spine.
Principles of image interpretation and search strategies
Williams, I. and Piper, K. 2010. Principles of image interpretation and search strategies.
Workshop to launch: ''Web-based short course in initial image interpretation of the appendicular skeleton''
Williams, I. and Piper, K. 2010. Workshop to launch: ''Web-based short course in initial image interpretation of the appendicular skeleton''.
Rationale for computed tomography head radiographer reporting
Williams, I. and Piper, K. 2010. Rationale for computed tomography head radiographer reporting.
Pre-testing of initial image interpretation skills
Williams, I. and Piper, K. 2010. Pre-testing of initial image interpretation skills.
Radiographer role development and image interpretation skills
Williams, I. and Piper, K. 2010. Radiographer role development and image interpretation skills.
Reporting for radiographers
Piper, K. and Field-Boden, Q. 1996. Reporting for radiographers. The Radiographer.
Clinical reporting in radiography
Piper, K. 1998. Clinical reporting in radiography.
ST funded research report - Implementation of a radiographic reporting service in four NHS Trusts: Initial findings
Piper, K. 1998. ST funded research report - Implementation of a radiographic reporting service in four NHS Trusts: Initial findings.
Accuracy of radiographers' reports in the interpretation of radiographic examinations of the skeletal system: a review of 6796 cases
Piper, K., Paterson, A. and Godfrey, R. 2005. Accuracy of radiographers' reports in the interpretation of radiographic examinations of the skeletal system: a review of 6796 cases. Radiography. 11 (1), pp. 27-34. https://doi.org/10.1016/j.radi.2004.05.004
A case study of a Baker's cyst
Piper, K. and Mitchell, M. 2007. A case study of a Baker's cyst. Synergy.
Initial image interpretation of appendicular skeletal radiographs: A comparison between nurses and radiographers
Piper, K. and Paterson, A. 2009. Initial image interpretation of appendicular skeletal radiographs: A comparison between nurses and radiographers. Radiography. 15 (1), pp. 40-48. https://doi.org/10.1016/j.radi.2007.10.006
Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers
Coleman, L. and Piper, K. 2009. Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers. Radiography. 15 (3), pp. 196-202. https://doi.org/10.1016/j.radi.2007.12.001
MRI reporting by radiographers: The construction of an objective structured examination
Piper, K. and Buscall, K. 2008. MRI reporting by radiographers: The construction of an objective structured examination. Radiography. 14 (2), pp. 78-89. https://doi.org/10.1016/j.radi.2007.02.003
Factors influencing the development and implementation of advanced and consultant radiographer practice – a review of the literature
Kelly, J., Piper, K. and Nightingale, J. 2008. Factors influencing the development and implementation of advanced and consultant radiographer practice – a review of the literature. Radiography. 14 (s1), pp. e71-e78. https://doi.org/10.1016/j.radi.2008.11.002