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The history of radiographer reporting

 

Introduction

The issue of radiographer reporting of images is not a recent one.  The debate surrounding the reporting of images by non-medically trained individuals has been rolling since the introduction of x-ray technology in 1895.  In the very beginning of radiographic imaging there was no individual profession whose sole purpose was to undertake radiographic imaging and report on the resultant images.  Amongst the individuals using x-ray technology in the early days were engineers, photographers, physicists and medical practitioners amongst others.  However, individual professions were eager to lay claim to the sole right to use x-ray technology in order to forge a career and maintain a living. The fight to determine a profession who could lay claim to the ‘ownership’ of rights to undertake radiography and report on resultant images had begun.  Two eminent groups had formed, the medical radiographer, known today as the radiologist and the non-medical radiographer, the diagnostic radiographer of today.  The non-medical radiographer group still at this point included engineers, photographers etc whereas the medical-radiographer included only those individuals with medical qualification.  The debate regarding the right to report the resultant images rumbled on through the early 1900’s into the 1920’s.  Medical radiographers did not have issue with ‘lay-people’ undertaking the technical aspect of image production, however they sought to have the right to report x-ray images removed from the lay-people to ensure that the reports only came from medical professionals.  In the 1920’s the Society of Radiographers was formed and for the first time, the professional group of radiographers was identified. 

 

Debate

Many research papers have focussed upon the issue of radiographers reporting plain film radiographs, mainly analysing the accuracy of the reports generated by radiographers in comparison with radiologist reports.  However, it is important to note that despite there being a lot of research available on the topic of radiographer reporting accuracy a lot of the research was undertaken by radiographers and published in low impact radiography journals.  Therefore it is hard not to assume a level of bias due to invested interest in the progression of the profession.  A number of the aforementioned studies have compared radiographer report accuracy against that of radiologist accuracy, accepting the radiologist report as the gold standard.  However, why must the radiologist report be accepted as the reference for the analysis?  In some articles, there have been incidences of radiologist error where the radiographer has picked up an abnormality missed by the radiologist.  Therefore, the accuracy of results cannot be guaranteed if one of the variables being compared doubles up as the reference standard.

  

References

 

Blakeley C, Hogg P (2009) An evaluation of a radiographer-led reporting service for Accident and Emergency referrals.  Rad Magazine 35(415): 25-26.

 

Blakeley C, Hogg P, Heywood J (2008) Effectiveness of UK Radiographer Image Reading.  Radiologic Technology 79(3): 221-226.

 

Brealey S, Hewitt C, Scally A, Hahn S, Godfrey C, Thomas N (2009) Bivariate meta-analysis of sensitivity and specificity of radiographers’ plain radiograph reporting in clinical practice.  The British Journal of Radiology 82: 600-604.

 

Brealey S, Scally A, Hahn S, Thomas N, Godfrey C, Coomarasamy A (2005)  Accuracy of radiographer plain radiograph reporting in clinical practice: a meta-analysis.  Clinical Radiology 60: 232-241.

 

Coleman L, Piper K (2009) Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers.  Radiography 15: 196-202.

 

Cook AP, Oliver T, Ramsey L (2004) Radiographer Reporting: Discussion and Australian workplace trial.  The Radiographer 51: 61-66.

 

Cunningham DA (1997) Special Interest Group in Radiographer Reporting.  The British Journal of Radiology 70: 873-874.

 

Donovan T,  Manning DJ (2006) Successful reporting by non-medical practitioners such as radiographers, will always be task-specific and limited in scope.  Radiography 12: 7-12.

Ford P (2010) The role of the consultant radiographer – Experience of appointees. Radiography 16: 189-197.

 

Forsyth LJ, Robertson EM (2007) Radiologist perceptions of radiographer role development in Scotland.  Radiography 13: 51-55.

 

Hardy M, Snaith B (2009) Radiographer interpretation of trauma radiographs: Issues for radiography education providers.  Radiography 15: 101-105.

 

Hardy M, Snaith B, Smith T (2008) Radiographer reporting of trauma images: United Kingdom experience and the implications for evolving international practice.  The Radiographer 55(1): 16-19.

 

Hardy M, Spencer N, Snaith B (2008) Radiographer emergency department hot reporting: An assessment of service quality and feasibility.  Radiography 14: 301-305.

 

Jones HC, Manning D (2008) A survey to assess audit mechanisms practised by skeletal reporting radiographers.  Radiography 14: 201-205.

 

Kelly J, Piper K, Nightingale J (2008) Factors influencing the development and implementation of advanced and consultant radiographer practice – A review of the literature.  Radiography 14: e71-e78.

 

Lancaster A, Hardy M (2011) An investigation into the opportunities and barriers to participation in a radiographer comment scheme, in a multi-centre NHS trust.  Radiography

 

Paterson AM, Price RC, Thomas A, Nuttall L (2004) Reporting by radiographers: A policy and practice guide.  Radiography 10: 205-212.

 

Piper K, Buscall K, Thomas N (2010) MRI reporting by radiographers: Findings of an accredited postgraduate programme.  Radiography 16: 136-142.

 

Price RC (2001) Radiographer reporting: origins, demise and revival of plain film reporting.  Radiography 7: 105-117.

 

Rudd P (2003) The development of radiographer reporting 1965-1999. Radiography 9: 7-12

 

Smith TN, Baird M (2007) Radiographers’ role in radiological reporting: a model to support future demand.  The Medical Journal of Australia 186: 629-631.

 

Smith S, Reeves P (2009) The extension of the role of the diagnostic

radiographer in the UK National Health Service over the period 1995-2009.  European Journal of Radiography 1: 108-114.

 

Williams I (2009) Reporting trauma and emergency plain film radiographs:

Radiologists’ support for role extension of South African radiographers. The South African Radiographer 47(1): 15-1

 

 

 

 

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