Chest X-Ray interpretation: agreement between consultant radiologists and a reporting radiographer in clinical practice in the United Kingdom

Conference poster

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.
AuthorsWoznitza, N., Piper, K., Burke, S., Patel, K., Amin, S. and Grayson, K.
TypeConference poster
Description

Rationale: Driven by developing technology and an ageing population, radiology has witnessed an unprecedented rise in workload. One response to this in the United Kingdom has been to train radiographers to undertake clinical reporting. Accurate interpretation of imaging is crucial to allow clinicians' to correctly manage and treat patients.

Methods: A random sample of cases (n=100) was selected from a consecutive series of 1,000 chest x-ray reports produced by a radiographer in clinical practice using a simple computer generated algorithm. Due to the high level of observer variation which is apparent when interpreting chest x-rays, three consultant radiologists were also included to establish the rate of inter-observer variation between radiologists, which was then used as the baseline. Fifty images were interpreted by each radiologist who examined the radiographer report for accuracy and agreement, with 50% duplication of cases between radiologists to determine inter-radiologist variation. The radiologists performed their evaluation independently and blinded to the proportion of cases receiving multiple radiologist opinions. Inter-observer agreement analysis using Kappa was performed to determine consistency among observers.

Results: Disagreement was found between the radiologist and radiographer in 7 cases, which in three instances showed agreement between one radiologist and the radiographer. Inter-observer agreement (Kappa statistic) between the three radiologists and the reporting radiographer was found to be almost perfect, K=0.91, 95% confidence interval (0.79,1.0), K=0.91 (0.78,1.0) and K=0.83 (0.68,0.99) respectively. Inter-radiologist agreement was also almost perfect, K=0.82 (0.57,1.0) and K=0.91 (0.75,1.0).

Conclusion: The level of inter-observer agreement between radiologist and reporting radiographer chest x-ray interpretation compares favourably with inter-radiologist variation.

Year2013
ConferenceAmerican Thoracic Society Congress
Related URLhttp://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2013.187.1_MeetingAbstracts.A2229
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Deposited16 Sep 2014
Output statusPublished
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PrintMay 2013
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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
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
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