Developing the evidence base for image interpretation and descriptive evaluation by radiographers.

Stevens, Barry

Abstract

Introduction
This thesis provides evidence to support the notion of radiographers interpreting radiographic images and providing descriptive evaluations. The role of radiographers providing first line radiographic image interpretation has progressed greatly over recent years with reporting radiographers providing key assistance to managing reporting backlogs and also the development of the preliminary clinical evaluation system evolving from the red dot abnormality detection system. This thesis aims to collate the key findings from nine peer-reviewed and published papers to provide new and original evidence to support radiographers interpreting radiographic images and providing descriptive evaluations, which strengthen the continual development of the evidence base relative to clinical reporting and Preliminary Clinical Evaluation (PCE).

Methods
The salient findings from the results and discussion sections from the nine papers submitted were extracted via thematic analysis, in line with the aim of the thesis. A confirmatory thematic analysis approach was utilised with initial pre-determined themes, given the author’s prior knowledge and understanding of the research and the theoretical foundations of the submitted works.

Results
The significant findings from each of the papers generated three key themes covering radiographers’ ability to provide a PCE, guidance for provision of PCE and a report, and illustrating the impact of radiographers interpreting and describing abnormalities in PCE and clinical reporting. A number of areas for further investigation in PCE are recommended following the critical analysis. The papers provide new information in areas of practice that had not previously been investigated, including some novel methodology which had previously not been used in studies evaluating PCE.

Discussion
The critical analysis has shown that radiographers are capable of interpreting and describing radiographic abnormalities in the context of PCE, including traumatic chest X-ray presentations. However, it is acknowledged that improvements in PCE performance can be made with specific focussed sessions covering subtle pathologies, comment structure and content. The impact of PCE was illustrated by positively affecting referrers’ treatment decisions and reducing false negatives. The progression of reporting radiographers was also demonstrated with greater allocation of reporting time and an increased number of radiographers reporting CXRs.
The findings from the works included have been pivotal in introducing a policy change in the forthcoming updated PCE guidance document produced by the Society and College of Radiographers (SCoR). The document will be published this year and will provide guidance to aid departmental and practice changes. It is clear within the document where the works have shaped the guidance. For example, reiterating the impact and benefits of PCE (paper 3), advocating the implementation of abnormality detection training during preceptorship periods (paper 1), the use of bullet points (paper 6) and short comments (paper 4), comment structure (paper 6), and providing evidence supporting the expansion of PCE into extra-skeletal anatomical areas (paper 8). Evidence of research impact is demonstrated through the number of citations and reads of the papers, and the replication of one of the studies in different modalities introduces translatability of research. The potential wider service and societal implications of these findings are considered to be the enhancement of services offered by radiographers relating to the interpretation of radiographic images, which in turn will improve the service provided by referring clinicians, ultimately improving the experience of patients with improved quality of care. With a more insular view, these studies may increase the worth of radiographers amongst other health professional groups possibly helping to foster improved inter-professional relationships.

Citation

Stevens, B. (2024). Developing the evidence base for image interpretation and descriptive evaluation by radiographers. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: May 23, 2024
• Publicly Available Date: Jul 1, 2024
• Award Date: May 31, 2024