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INTRODUCTION: Chest X-rays (CXR) are routinely used to diagnose lung and heart conditions. AI based Bone suppression imaging (BSI) aims to enhance accuracy in identifying chest anomalies by eliminating bony structures such as the ribs, clavicles, and scapula from CXRs. The aim of this retrospective study was to assess the clinical value of BSI in detecting pneumonia. METHODS: Ninety-nine emergency patients with suspected pneumonia underwent erect postero-anterior CXRs. The BSI processing system was used to generate corresponding bone-suppressed images for the 99 radiographs. Each patient had undergone a computed tomography (CT) examination within 48 h, considered the standard of reference. Two blinded readers separately analyzed images, indicating confidence levels regarding signs of pneumonia for each lung separated in three fields, first with standard images, then with BSI. Sensitivity, specificity, predictive values, and readers' certitude were calculated, and inter-reader agreement was evaluated with the kappa statistic. RESULTS: Out of the 99 included cases, 39 cases of pneumonia were diagnosed (39.4%). Of the remaining 60 patients, 14 presented only pleural effusions (14.1%). BSI images led to a significant increase in false positives (+251%) and significantly affected one reader's diagnosis and certitude, decreasing accuracy (up to 17%) and specificity (up to 14%). Sensitivity increased by 66% with BSI. Inter-reader agreement ranged from weak to moderate (0.113-0.53) and did not improve with BSI. For both readers, BSI images were read with significantly lesser certitude than standard images. CONCLUSION: BSI did not add clinical value in pneumonia detection on CXR due to a significant increase in false positive results and a decrease one readers' certitude. IMPLICATION FOR PRACTICE: The study emphasizes the importance of proper clinical training before implementing new post-processing and artificial intelligence (AI) tools in clinical practice.
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INTRODUCTION: Radiographers' profession is constantly evolving, which demands adaptation of education and training programs to build up medical imaging and radiation therapy professionals (MIRTPs) that provide healthcare to improve patient experience and outcomes. This study aimed to map radiographers' practices, competences, and autonomy level in Western Switzerland. METHODS: Data was collected by 2 cross-sectional online surveys targeting Alumni, radiographers, clinical placement tutors and medical imaging equipment specialists from industry, with opened and closed-end questions. Descriptive statistics and thematic analysis were used to analyse the data. RESULTS: 81 Alumni and 93 Chief-Radiographers, clinical tutors, practitioner-radiographers and industry answered the questionnaires. The competences considered as the most "acquired or completely acquired" by the Alumni were: adopt a reflective posture on practice (90.1 %; 73/81), adopt ethical behaviour (90.1 %; 73/81), carrying out and providing radiological services for diagnostic, therapeutic and preventive purposes (81.5 %; 68/81), adapting communication to the other surrounding persons (81.5 %; 66/81), and check compliance of procedures with standards (69.1 %; 56/81). Similar results were referred by Employers. The autonomy of the participant radiographers was considered as average, and it focuses only the preparation of the patient and the protocol optimisation. The development and integration of research is weak as well as the application of competences regarding professionalism. CONCLUSIONS: A better link between educational institutions and clinical practice can help on the integration of research and evidence-based on practice, necessary to progress the radiographers' profession in Western Switzerland. The autonomy needs to be further developed and leadership courses must be integrated in the curricula to facilitate the implementation of new approaches to reinforce radiographer's profession. IMPLICATIONS FOR PRACTICE: Practice must be revised to integrate evidence-based; to facilitate research development, the managers need to increase support.
