Measuring the effects of image interpretation: an evaluative framework.

The relaxing of restrictions on reporting films has resulted in radiographers and other health care professionals becoming increasingly involved in the interpretation of images in areas such as mammography, ultrasound and plain film radiography. However, errors and variation in the interpretation of images now represents the weakest area of clinical imaging. This has been highlighted by the difficulty of establishing standards to measure the film reading performance of radiographers as part of role extension initiatives. Despite a growing literature of studies that evaluate the film reading performance of different health care professionals, there is a paucity of evidence of the subsquent effects on the referring clinician's diagnosis, management plans and patient outcome. This paper proposes an evaluative framework that can be used to measure the chain of events from the initial technical assessment of observers' potential to interpret images using search behaviour techniques, through to the potential costs and benefits to society. Evaluating the wider implications of alternative or complementary reporting policies is essential for generating the evidence base to comprehensively underpin policy and practice and direct future research. Brealey, S.(2001). Clinical Radiology56, 341-347.