Radiographer reporting: A literature review to support cancer workforce planning in England.

OBJECTIVE: Clinical Imaging contributes to screening, diagnosis, planning and monitoring of treatment and surveillance in cancer care. This literature review summarises evidence about radiographer reporting to help imaging service providers respond to Health Education England's 2017 Cancer Workforce Plan project to expand radiographer reporting in clinical service provision. KEY FINDINGS: Papers published between 1992 and 2018 were reviewed (n = 148). Evidence related to dynamic examinations (fluoroscopy, ultrasound) and mammography was excluded. Content was analysed and summarised using the following headings: clinical scope of practice, responsibilities, training, assessment, impact in practice and barriers to expansion. Radiographer reporting is well established in the United Kingdom. Scope of practice varies individually and geographically. Deployment of appropriately trained reporting radiographers is helping the NHS maintain high quality clinical imaging service provision and deliver a cost-effective increase in diagnostic capacity. CONCLUSION: Working within multiprofessional clinical imaging teams, within a defined scope of practice and with access to medical input when required, reporting radiographers augment capacity in diagnostic pathways and release radiologist time for other complex clinical imaging responsibilities.

Strictures of the sigmoid colon: barium enema evaluation.

PURPOSE: To assess the accuracy of radiologic interpretation, in the absence of clinical information, in the differentiation of benign and malignant sigmoid strictures at barium enema examination. MATERIALS AND METHODS: On two occasions, four independent observers retrospectively assessed examination findings in 78 patients with documented sigmoid strictures (43 benign, 35 malignant). Each stricture was graded by using a five-point scale (definitely malignant to definitely benign). RESULTS: No significant difference existed between the areas under the receiver operating characteristic curves for the two assessments with any observer. Consensus findings indicated agreement among at least three of the four observers in 68 (87%) and 66 (85%) cases at the first and second assessments, respectively. One benign stricture was called malignant at both assessments. When consensus existed, the positive predictive value for malignant strictures was 96% at both assessments (sensitivity, 63% and 66%). Nine malignant strictures were called benign, three at both assessments. When consensus existed, the positive predictive value for benign strictures was 84% and 88% at the first and second assessments, respectively (sensitivity, 88% and 86%, respectively). CONCLUSION: The differentiation between a benign and a malignant sigmoid stricture can be made in most cases at barium enema examination. When a stricture appears malignant, the diagnosis is usually correct, but caution is advised when a stricture appears benign.

Interpretation of selected accident and emergency radiographic examinations by radiographers: a review of 11000 cases.

Two specially trained radiographers took part in the radiologists' rota for "cold" reporting skeletal radiographs of patients who attended the Accident and Emergency (A&E) Department at times when there was no "hot" reporting service operating, and who were not admitted for treatment or referred to fracture clinics for follow-up. These radiographs had initially been seen by A&E medical staff. At the end of an 18 month period during which the two radiographers reported on 11,322 skeletal examinations, a retrospective search was made to detect interpretive errors. The radiological history of all 11,322 patients was reviewed over a follow-up period of at least 3 months subsequent to the attendance reported by the radiographers. 48% of patients did not re-attend, 42% re-attended for unrelated examinations, and 10% re-attended for repeat examinations of the same anatomical area, or for different procedures (bone scintigraphy or CT) related to the original injury. The second (or subsequent) report was discrepant with that of the first attendance in only 29 cases out of 1103. Of these 29 patients, 13 had occult fractures which were undetectable at first attendance even in retrospect, six had new injuries accounting for the new findings, six had been the subject of false positive calls at an earlier visit, one had a fracture of the hamate missed at first attendance, and in three cases no consensus could be reached as to the cause of the discrepancy, owing to incomplete films or insufficient clinical data. Analysis of the patients' postcodes showed at least 89% were of local origin and only 1% were from outside Yorkshire, suggesting that the review should have identified the great majority of erroneous reports. It is concluded that appropriately trained and supervised radiographers can successfully undertake diagnostic reporting of selected skeletal examinations on A&E patients.