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N Woznitza - One of the best experts on this subject based on the ideXlab platform.
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p78 the role of computer assisted Radiographer reporting in lung cancer screening programmes
Thorax, 2019Co-Authors: H Hall, M Ruparel, Samantha L Quaife, J Dickson, C Horst, S Tisi, J Batty, N Woznitza, Asia Ahmed, S BurkeAbstract:Introduction and objectives The success of lung cancer screening (LCS) with low-dose CT (LDCT) depends critically on delivering timely, accurate radiology reports. Its anticipated widespread introduction will place a significant burden on current thoracic radiologist capacity, mandating innovative solutions. We explored the role that trained Radiographers, using computer-assisted nodule detection (CADe) software, might have in LCS reporting pathways. Methods 770 LDCTs performed as part of the Lung Screen Uptake trial (LSUT) were retrospectively reported by two Radiographers (R1 and R2) using the Veolity™ CADe software. Radiographers could request the opinion of the study radiologist about uncertain findings. The original radiologists’ reports (read without CADe) were considered the reference standard. Studies were categorised as ‘positive’ (nodule or mass requiring nodule surveillance or MDT referral), ‘negative’ (no intrapulmonary findings requiring further imaging) or ‘ill-defined’ (indistinct focal abnormality requiring surveillance, e.g. consolidation). Reported outcomes were compared to the reference standard, with any discrepant (i.e. Radiographer-only reported) nodules re-reviewed by both study radiologist and a second independent radiologist, and verified as either ‘true’ or ‘false positive’ (figure 1). Secondary outcomes included scan-reading times and identification of incidental findings. Results The reference standard dataset included 163 ‘positive’, 35 ‘ill-defined’, and 572 ‘negative’ studies, and 34 confirmed lung cancers. R1 and R2 requested radiologist confirmation for 6.5% and 10.4% of studies respectively. Following verification of discrepant nodules, reporting sensitivity varied significantly between Radiographers at 67.3% (R1) and 74.0% (R2) for all ‘positive’ studies (OR 2.27, p=0.03): 77.4% and 93.9% for confirmed cancers. The majority of ‘missed’ lesions arose from inappropriate rejection of CADe-detected findings rather than being missed altogether. The Radiographer plus CADe reading combination highlighted ten nodules previously dismissed by the study radiologist, that were subsequently recalled for further surveillance. Allowing for these, the rates of false positive reporting were 7.9% (R1) and 6.2% (R2). Conclusions Individual performance varied significantly between the two Radiographers, but the overall results suggest inadequate sensitivity to recommend this strategy. As per previous observations elsewhere, using CADe software in LCS reporting pathways is likely to reduce reporting times whilst increasing reader sensitivity.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox
Lung Cancer, 2019Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Introduction Rapid and early diagnosis is are important factors in determining outcomes in lung cancer. The aim of this study was to investigate the impact of immediate reporting of chest X-rays from primary care by reporting Radiographers on the time to diagnosis of lung cancer. Methods A 12 month, block randomised trial was conducted at a single centre in London, UK. Half of the sessions per week (5) were randomised to an immediate or routine chest X-ray (CXR) report by a reporting Radiographer, with an immediate CT where indicated. Time taken to diagnosis of lung cancer or discharge from the lung cancer pathway was determined and Mann-Whitney test used. Results During this study 8,732 patients were recruited and a total of 9,137 CXRs were performed with 4,128 (45.1%) CXRs in the immediate Radiographer reporting arm. A total of 49 lung cancers were diagnosed, 26 in the immediate arm. Time to diagnosis of lung cancer for patients in the immediate arm was a median of 21.5 days (mean 26.0) compared with 30 days (mean 41.6) in the routine CXR arm (p=0.012). For patients with a suspicious CXR, diagnosis of lung cancer was achieved in a median of 18 days (mean 24.3) compared with 32 days (mean 42.6) in the routine arm (p=0.0375). Conclusion At a single centre, immediate reporting of CXRs referred from primary care by Radiographers reduced time to diagnosis of lung cancer by a median of 14 days where the CXR was suspicious and by a median of 8.5 days for all patients. This has significant implications for patient outcome and adherence to new cancer targets.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox study protocol for a randomised control trial
Trials, 2017Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce inappropriate urgent respiratory medicine referral for suspected cancer (2WW) referrals. The aim of radioX is to examine the impact of immediate reporting by Radiographers of CXRs requested by general practice (GP) on lung cancer patient pathways. A two-way comparative study that will compare the time to diagnosis of lung cancer for patients. Internal comparison will be made between those who receive an immediate Radiographer report of a GP CXR compared to standard Radiographer GP CXR reporting over a 12-month period. External comparison will be made with a similar, neighbouring hospital trust that does not have Radiographer CXR reporting. Primary outcome is the effect on the speed of the lung cancer pathway (diagnosis of cancer or discharge). Secondary outcomes include the effect of the pathway on efficiency including the number of repeat CXRs performed in a timely fashion for suspected infection and the effect of immediate reporting of GP CXRs on patient satisfaction. The radioX trial will examine the hypothesis that immediate reporting of CXRs referred from GP reduces the time to diagnosis of lung cancer or discharge from the lung cancer pathway. International Standard Randomised Controlled Trial Number ISRCTN21818068 . Registered on 20 June 2017.
David R Baldwin - One of the best experts on this subject based on the ideXlab platform.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox
Lung Cancer, 2019Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Introduction Rapid and early diagnosis is are important factors in determining outcomes in lung cancer. The aim of this study was to investigate the impact of immediate reporting of chest X-rays from primary care by reporting Radiographers on the time to diagnosis of lung cancer. Methods A 12 month, block randomised trial was conducted at a single centre in London, UK. Half of the sessions per week (5) were randomised to an immediate or routine chest X-ray (CXR) report by a reporting Radiographer, with an immediate CT where indicated. Time taken to diagnosis of lung cancer or discharge from the lung cancer pathway was determined and Mann-Whitney test used. Results During this study 8,732 patients were recruited and a total of 9,137 CXRs were performed with 4,128 (45.1%) CXRs in the immediate Radiographer reporting arm. A total of 49 lung cancers were diagnosed, 26 in the immediate arm. Time to diagnosis of lung cancer for patients in the immediate arm was a median of 21.5 days (mean 26.0) compared with 30 days (mean 41.6) in the routine CXR arm (p=0.012). For patients with a suspicious CXR, diagnosis of lung cancer was achieved in a median of 18 days (mean 24.3) compared with 32 days (mean 42.6) in the routine arm (p=0.0375). Conclusion At a single centre, immediate reporting of CXRs referred from primary care by Radiographers reduced time to diagnosis of lung cancer by a median of 14 days where the CXR was suspicious and by a median of 8.5 days for all patients. This has significant implications for patient outcome and adherence to new cancer targets.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox study protocol for a randomised control trial
Trials, 2017Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce inappropriate urgent respiratory medicine referral for suspected cancer (2WW) referrals. The aim of radioX is to examine the impact of immediate reporting by Radiographers of CXRs requested by general practice (GP) on lung cancer patient pathways. A two-way comparative study that will compare the time to diagnosis of lung cancer for patients. Internal comparison will be made between those who receive an immediate Radiographer report of a GP CXR compared to standard Radiographer GP CXR reporting over a 12-month period. External comparison will be made with a similar, neighbouring hospital trust that does not have Radiographer CXR reporting. Primary outcome is the effect on the speed of the lung cancer pathway (diagnosis of cancer or discharge). Secondary outcomes include the effect of the pathway on efficiency including the number of repeat CXRs performed in a timely fashion for suspected infection and the effect of immediate reporting of GP CXRs on patient satisfaction. The radioX trial will examine the hypothesis that immediate reporting of CXRs referred from GP reduces the time to diagnosis of lung cancer or discharge from the lung cancer pathway. International Standard Randomised Controlled Trial Number ISRCTN21818068 . Registered on 20 June 2017.
Beverly Snaith - One of the best experts on this subject based on the ideXlab platform.
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Radiographer reporting in the uk is the current scope of practice limiting plain film reporting capacity
British Journal of Radiology, 2016Co-Authors: Robert C Milner, Gary Culpan, Beverly SnaithAbstract:Objective:To update knowledge on individual Radiographer contribution to plain-film reporting workloads; to assess whether there is scope to further increase Radiographer reporting capacity within this area.Methods:Reporting Radiographers were invited to complete an online survey. Invitations were posted to every acute National Health Service trust in the UK whilst snowball sampling was employed via a network of colleagues, ex-colleagues and acquaintances. Information was sought regarding the demographics, geographical location and anatomical and referral scope of practice.Results:A total of 259 responses were received. 15.1% and 7.7% of respondents are qualified to report chest and abdomen radiographs, respectively. The mean time spent reporting per week is 14.5 h (range 1–37.5). 23.6% of Radiographers report only referrals from emergency departments whilst 50.6% of Radiographers have limitations on their practice.Conclusion:The scope of practice of reporting Radiographers has increased since previous st...
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Radiographer reporting in the uk a longitudinal analysis
Radiography, 2015Co-Authors: Beverly Snaith, Maryann Hardy, Emily F LewisAbstract:Introduction: Radiographer reporting of plain film radiographs is an established role in the UK. Despite this previous research has demonstrated widespread inconsistencies in implementation, scope and utilisation. Method: A cross-sectional postal survey was undertaken to provide a longitudinal insight into changes in Radiographer reporting practice. The sample comprised all individual hospital sites in the UK, Channel Islands and Isle of Man with both a radiology and trauma service Results: A response rate of 63.7% (n ¼ 325/510) was achieved. Reporting Radiographers were in place at 179 sites (55.1%) but less likely to be employed at sites with a minor injury unit rather than a full emergency department ( c 2 ¼ 71.983; p < 0.001; d.f. ¼ 1). Radiographer utilisation has increased since
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developing Radiographer roles in the context of advanced and consultant practice
Journal of Medical Radiation Sciences, 2013Co-Authors: Lisa Field, Beverly SnaithAbstract:Skill-mix initiatives have provided opportunities for Radiographers to develop roles and achieve their potential, thus contributing to Radiographer retention rates and increased job satisfaction. This reflective article explores two radiographic roles within an interprofessional context including the implications for confidence, competence, and future sustainability. These were reporting roles which extended into two modalities, one into bone densitometry and another into ultrasound. This article discusses how successful skill mix can benefit the individual, their department, and NHS organization and that role expansion can develop a more dynamic and resourceful workforce with transferability of skills and attributes.
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the impact of Radiographer immediate reporting on patient outcomes and service delivery within the emergency department designing a randomised controlled trial
Radiography, 2011Co-Authors: Maryann Hardy, Beverly SnaithAbstract:Designing a large research trial to comprehensively evaluate the impact of a service initiative can be daunting but it is not beyond the skills and abilities of Radiographers and non-medical professionals. This paper describes the development of a protocol and operational aspects of a multi-centre randomised controlled trial of Radiographer immediate reporting. While the focus of the research is specific, the research design stages are transferable and not context dependent and therefore can be applied to different clinical fields. The intention of this paper is to make transparent and explicit the steps in the design and operation of this research and by doing so, offer an objective reflection on each phase of the process to enhance professional understanding of the practicalities of operating a clinical trial.
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Radiographer interpretation of trauma radiographs issues for radiography education providers
Radiography, 2009Co-Authors: Maryann Hardy, Beverly SnaithAbstract:Abstract Background The role of Radiographers with respect to image interpretation within clinical practice is well recognised. It is the expectation of the professional, regulatory and academic bodies that upon qualification, Radiographers will possess image interpretation skills. Additionally, The College of Radiographers has asserted that its aspiration is for all Radiographers to be able to provide an immediate written interpretation on skeletal trauma radiographs by 2010. This paper explores the readiness of radiography education programmes in the UK to deliver this expectation. Method A postal questionnaire was distributed to 25 Higher Education Institutions in the UK (including Northern Ireland) that provided pre-registration radiography education as identified from the Society & College of Radiographers register. Information was sought relating to the type of image interpretation education delivered at pre- and post-registration levels; the anatomical range of image interpretation education; and education delivery styles. Results A total of 19 responses ( n =19/25; 76.0%) were received. Image interpretation education was included as part of all Radiographer pre-registration programmes and offered at post-registration level at 12 academic centres ( n =12/19; 63.2%). The anatomical areas and educational delivery methods varied across institutions. Conclusion Radiography education providers have embraced the need for image interpretation education within both pre- and post-registration radiography programmes. As a result, UK education programmes are able to meet the 2010 College of Radiographers aspiration.
Angshu Bhowmik - One of the best experts on this subject based on the ideXlab platform.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox
Lung Cancer, 2019Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Introduction Rapid and early diagnosis is are important factors in determining outcomes in lung cancer. The aim of this study was to investigate the impact of immediate reporting of chest X-rays from primary care by reporting Radiographers on the time to diagnosis of lung cancer. Methods A 12 month, block randomised trial was conducted at a single centre in London, UK. Half of the sessions per week (5) were randomised to an immediate or routine chest X-ray (CXR) report by a reporting Radiographer, with an immediate CT where indicated. Time taken to diagnosis of lung cancer or discharge from the lung cancer pathway was determined and Mann-Whitney test used. Results During this study 8,732 patients were recruited and a total of 9,137 CXRs were performed with 4,128 (45.1%) CXRs in the immediate Radiographer reporting arm. A total of 49 lung cancers were diagnosed, 26 in the immediate arm. Time to diagnosis of lung cancer for patients in the immediate arm was a median of 21.5 days (mean 26.0) compared with 30 days (mean 41.6) in the routine CXR arm (p=0.012). For patients with a suspicious CXR, diagnosis of lung cancer was achieved in a median of 18 days (mean 24.3) compared with 32 days (mean 42.6) in the routine arm (p=0.0375). Conclusion At a single centre, immediate reporting of CXRs referred from primary care by Radiographers reduced time to diagnosis of lung cancer by a median of 14 days where the CXR was suspicious and by a median of 8.5 days for all patients. This has significant implications for patient outcome and adherence to new cancer targets.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox study protocol for a randomised control trial
Trials, 2017Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce inappropriate urgent respiratory medicine referral for suspected cancer (2WW) referrals. The aim of radioX is to examine the impact of immediate reporting by Radiographers of CXRs requested by general practice (GP) on lung cancer patient pathways. A two-way comparative study that will compare the time to diagnosis of lung cancer for patients. Internal comparison will be made between those who receive an immediate Radiographer report of a GP CXR compared to standard Radiographer GP CXR reporting over a 12-month period. External comparison will be made with a similar, neighbouring hospital trust that does not have Radiographer CXR reporting. Primary outcome is the effect on the speed of the lung cancer pathway (diagnosis of cancer or discharge). Secondary outcomes include the effect of the pathway on efficiency including the number of repeat CXRs performed in a timely fashion for suspected infection and the effect of immediate reporting of GP CXRs on patient satisfaction. The radioX trial will examine the hypothesis that immediate reporting of CXRs referred from GP reduces the time to diagnosis of lung cancer or discharge from the lung cancer pathway. International Standard Randomised Controlled Trial Number ISRCTN21818068 . Registered on 20 June 2017.
K Piper - One of the best experts on this subject based on the ideXlab platform.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox
Lung Cancer, 2019Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Introduction Rapid and early diagnosis is are important factors in determining outcomes in lung cancer. The aim of this study was to investigate the impact of immediate reporting of chest X-rays from primary care by reporting Radiographers on the time to diagnosis of lung cancer. Methods A 12 month, block randomised trial was conducted at a single centre in London, UK. Half of the sessions per week (5) were randomised to an immediate or routine chest X-ray (CXR) report by a reporting Radiographer, with an immediate CT where indicated. Time taken to diagnosis of lung cancer or discharge from the lung cancer pathway was determined and Mann-Whitney test used. Results During this study 8,732 patients were recruited and a total of 9,137 CXRs were performed with 4,128 (45.1%) CXRs in the immediate Radiographer reporting arm. A total of 49 lung cancers were diagnosed, 26 in the immediate arm. Time to diagnosis of lung cancer for patients in the immediate arm was a median of 21.5 days (mean 26.0) compared with 30 days (mean 41.6) in the routine CXR arm (p=0.012). For patients with a suspicious CXR, diagnosis of lung cancer was achieved in a median of 18 days (mean 24.3) compared with 32 days (mean 42.6) in the routine arm (p=0.0375). Conclusion At a single centre, immediate reporting of CXRs referred from primary care by Radiographers reduced time to diagnosis of lung cancer by a median of 14 days where the CXR was suspicious and by a median of 8.5 days for all patients. This has significant implications for patient outcome and adherence to new cancer targets.
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impact of Radiographer immediate reporting of chest x rays from general practice on the lung cancer pathway radiox study protocol for a randomised control trial
Trials, 2017Co-Authors: N Woznitza, A Devaraj, Sam M Janes, Stephen W Duffy, S Rowe, Angshu Bhowmik, Sue Maughn, K Piper, David R BaldwinAbstract:Diagnostic capacity and suboptimal logistics are consistently identified as barriers to timely diagnosis of cancer, especially lung cancer. Immediate chest X-ray (CXR) reporting for patients referred from general practice is advocated in the National Optimal Lung Cancer Pathway to improve time to diagnosis of lung cancer and to reduce inappropriate urgent respiratory medicine referral for suspected cancer (2WW) referrals. The aim of radioX is to examine the impact of immediate reporting by Radiographers of CXRs requested by general practice (GP) on lung cancer patient pathways. A two-way comparative study that will compare the time to diagnosis of lung cancer for patients. Internal comparison will be made between those who receive an immediate Radiographer report of a GP CXR compared to standard Radiographer GP CXR reporting over a 12-month period. External comparison will be made with a similar, neighbouring hospital trust that does not have Radiographer CXR reporting. Primary outcome is the effect on the speed of the lung cancer pathway (diagnosis of cancer or discharge). Secondary outcomes include the effect of the pathway on efficiency including the number of repeat CXRs performed in a timely fashion for suspected infection and the effect of immediate reporting of GP CXRs on patient satisfaction. The radioX trial will examine the hypothesis that immediate reporting of CXRs referred from GP reduces the time to diagnosis of lung cancer or discharge from the lung cancer pathway. International Standard Randomised Controlled Trial Number ISRCTN21818068 . Registered on 20 June 2017.