Radiograph report style preferences of referrers at a district general hospital in the West Midlands, England, UK.

INTRODUCTION: Many articles and guidelines have been published proposing suggestions for the optimal radiology report style; it is likely that different referrers will prefer different styles owing to a number of clinical variables. The aim of this study is to assess the x-ray report style preferences of referrers at a district general hospital. METHOD: This electronic survey study used convenience sampling. An email invitation was sent to all referrers who had requested imaging examinations in the six months prior to the study start date. Participants were asked their opinions on the inclusion of recommendations and advice and to indicate their preferences of mock reports with combinations of the following; short/long, in-depth/brief and paragraph/bullet points. Manual analysis was undertaken in Excel. RESULTS: There were 114 participants from the identified population of 356, giving a response rate of 32%. Nearly all participants find the inclusion of recommendations and advice to be useful (n = 109, 96%). Seventy-nine participants (69.3%) request skeletal x-ray examinations, and 100 (87.7%) request chest x-ray examinations. More than half of skeletal referrers (n = 42, 53.2%) and the majority of chest referrers (n = 45, 45%) prefer reports with short sentences, brief, bullet point format. CONCLUSION: The most preferred report style for skeletal and chest x-ray reports is short sentences, brief with bullet-point format. These findings add to the current knowledge base and provide different report style options. Tailoring report styles could optimise service users' experience depending on clinical variables and might improve reporting workflow. IMPLICATIONS FOR PRACTICE: Potential differences in style preferences may exist between community and hospital referrers. Consequently, focussed research regarding the report style preferences of GPs is recommended as an area for further research.

Reporting radiographers' interpretation and use of the British Society of Thoracic Imaging's coding system when reporting COVID-19 chest x-rays.

INTRODUCTION: The United Kingdom (UK) has experienced one of the worst initial waves of the COVID-19 pandemic. Clinical signs help guide initial diagnosis, though definitive diagnosis is made using the laboratory technique reverse transcription polymerase chain reaction (RT-PCR). The chest x-ray (CXR) is used as the primary imaging investigation in the United Kingdom (UK) for patients with suspected COVID-19. In some hospitals these CXRs may be reported by a radiographer. METHODS: Retrospective review of CXR reports by radiographers for suspected COVID-19 patients attending the Emergency Department (ED) of a hospital in the UK. Interpretation and use of the British Society of Thoracic Imaging (BSTI) coding system was assessed. Report description and code use were cross-checked. Report and code usage were checked against the RT-PCR result to determine accuracy. Report availability was checked against the availability of the RT-PCR result. A confusion matrix was utilised to determine performance. The data were analysed manually using Excel. RESULTS: Sample size was 320 patients; 54.1% male patients (n = 173), 45.9% female patients (n = 147). The correct code matched report descriptions in 316 of the 320 cases (98.8%). In 299 of the 320 cases (93.4%), the reports were available before the RT-PCR swab result. CXR sensitivity for detecting COVID-19 was 85% compared to 93% for the initial RT-PCR. CONCLUSION: Reporting radiographers can adequately utilise and apply the BSTI classification system when reporting COVID-19 CXRs. They can recognise the classic CXR appearances of COVID-19 and those with normal appearances. Future best practice includes checking laboratory results when reporting CXRs with ambiguous appearances. IMPLICATIONS FOR PRACTICE: Utilisation of reporting radiographers to report CXRs in any future respiratory pandemic should be considered a service-enabling development.

The value of preliminary clinical evaluation for decision making in injuries of the hand and wrist.

Introduction: Recent research suggests that up to 20% of minor trauma patients admitted to the emergency department (ED) will suffer from non-specific chronic conditions over the subsequent several months. Thus, the present study assessed the correlates of symptoms that persisted at 4 months after an ED visit and, in particular, evaluated the associations between these symptoms and self-reported stress levels at ED admission and discharge. Method: This study was a prospective observational investigation conducted in the ED of Bordeaux University Hospital that included patients admitted for minor trauma. All participants were contacted by phone 4 months after presentation at the ED to assess the occurrence of post-concussion-like symptoms (PCLS). Results: A total of 193 patients completed the follow-up assessment at 4 months; 5.2% of the participants suffered from post-traumatic stress disorder (PTSD) and 24.5% suffered from PCLS. A multivariate analysis revealed an association between PCLS and stress level at discharge from the ED (odds ratios [OR]: 2.85, 95% confidence interval [CI]: 1.10­7.40). Conclusions: The risk of PCLS at 4 months after an ED visit for a minor injury increased in association with the level of stress at discharge from the ED. These results may improve the quality of life for the millions of patients who experience a stressful injury event every year.

The impact of focused training on abnormality detection and provision of accurate preliminary clinical evaluation in newly qualified radiographers.

INTRODUCTION: Preliminary clinical evaluation (PCE) can be a useful initial assessment of traumatic abnormalities by frontline radiographers; new graduates are expected to have the skills and knowledge required to provide this initial interpretation. This study evaluates the abnormality detection performance and accuracy of PCE commenting in newly qualified radiographers. METHOD: Four newly qualified radiographers completed a fracture/dislocation detection task consisting of 58 cases, including providing a PCE for each suspicious area. Following this, an 8-week training program was completed to improve competence in recognizing abnormalities and providing an accurate PCE. Equally weighted jackknife alternative free-response receiver operating characteristic (wJAFROC) analysis was performed; a difference between pre- and post-training would be considered significant at a test alpha of less than 0.05. RESULTS: Fracture/dislocation detection was significantly better in the post-training evaluation for fixed observers and random cases (F (1,57) = 4.48, p = 0.0387). The reader averaged wJAFROC FOM and 95% CIs for pre- and post-training were 0.619 (0.516, 0.737) and 0.703 (0.622, 0.852). A paired t-test demonstrated a significant difference in PCE scores in favour of the post-training evaluation p = 0.0006. This small cohort demonstrated difficulty in recognising undisplaced fractures and buckle fractures. CONCLUSION: An 8-week training program had a positive impact on participants' ability to localise and accurately describe fractures. Implementation of abnormality detection training should be considered during preceptorship periods. Due to the small sample size, it is inappropriate to suggest these findings are representative of all graduate radiographers.

Improving Continuing Professional Development opportunities for radiographers: A single centre evaluation.

PURPOSE: This study aimed to identify current barriers to CPD and generate ideas for strategies to overcome these issues. Further aims were to gather an overview of respondents' understanding and opinions of CPD. METHODS: An online survey was used to acquire information from departmental band 5 and band 6 radiographers. Descriptive statistical analysis and thematic analysis were performed to understand demographics and individuals' behaviours and experiences. FINDINGS: Radiographers (n = 33) were sent an invitation via email providing a response rate of 75.8% (n = 25), with 20 females (80%) and 5 males (20%). 52% (n = 13) dedicate less than three hours a month. Participants highlighted time restraint as their biggest barrier to CPD. They also indicated a reluctance to use their own time to undertake work-related learning, despite exhibiting positive attitudes towards CPD. Radiographers see CPD as a vital and necessary, career-long learning process and they recognise the impacts on service provision. The notion of dedicated study time was unanimously suggested as the best approach to increase commitment to CPD. CONCLUSION: Radiographers demonstrated positive opinions of CPD, yet it was evident that many are not undertaking activities during their own time and it was acknowledged that opportunities during work time are limited. The provision of study time in work was suggested as an approach to improve radiographer's opportunities to complete CPD. Training sessions underlining the necessity of CPD in maintaining registration, what constitutes CPD and reinforcement of the benefits of systematic recording of CPD should be provided.