Lewis Kim, Mdletshe Sibusiso, Doubleday Andrea, Pieterse Tracey
Radiology Department, Te Whatu Ora Taranaki, New Plymouth, New Zealand.
Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
J Med Radiat Sci. 2024 Dec;71(4):582-590. doi: 10.1002/jmrs.810. Epub 2024 Aug 26.
Preliminary image evaluation (PIE) is a system where radiographers alert emergency department referrers to the presence or absence of abnormalities on acute extremity X-ray examinations. PIE and similar systems have been utilised in the United Kingdom (UK) and Australia due to a shortage of radiologists to provide a timely report. As New Zealand (NZ) faces a similar shortage, PIE should be considered to address the negative impact this has on patients. The aim of this study was to determine the effect of regular feedback and education on radiographers' performance when detecting and describing acute abnormalities on extremity X-ray examinations in ED.
A prospective longitudinal study design was utilised for this study. The sensitivity, specificity, accuracy, and accuracy of PIEs performed by seven radiographers at a public provincial district in NZ were assessed over a 6-month period, with the participants provided monthly results along with regular e-mailed feedback on common errors.
The mean for sensitivity, specificity, and accuracy calculated with a 95% confidence interval over the 6-month period were 92.8% (89.9, 95.8), 94.9 (93.1, 96.8), and 94.2 (91.9, 96.5), respectively. When the month-to-month results were analysed, the results demonstrated an improvement in participants' sensitivity, specificity, and accuracy over the 6-month period.
The results of this study demonstrated that radiographers who participated in the study can perform PIE to a high standard that is comparable with the findings from international studies and demonstrated an improvement over 6 months. Therefore, PIE may be useful in NZ to aid ED clinicians in their clinical decisions when a radiology report is unavailable.
初步影像评估(PIE)是一种系统,放射技师通过该系统提醒急诊科转诊医生急性肢体X光检查中是否存在异常。由于放射科医生短缺,无法及时提供报告,PIE及类似系统已在英国和澳大利亚得到应用。由于新西兰(NZ)也面临类似的短缺情况,应考虑采用PIE来解决这对患者产生的负面影响。本研究的目的是确定定期反馈和教育对放射技师在急诊科肢体X光检查中检测和描述急性异常情况时的表现的影响。
本研究采用前瞻性纵向研究设计。在6个月的时间里,评估了新西兰一个省级公共地区的7名放射技师进行的PIE的敏感性、特异性、准确性和精确性,每月向参与者提供结果,并通过电子邮件定期反馈常见错误。
在6个月期间,以95%置信区间计算的敏感性、特异性和准确性的平均值分别为92.8%(89.9,95.8)、94.9(93.1,96.8)和94.2(91.9,96.5)。对逐月结果进行分析时,结果表明参与者在6个月期间的敏感性、特异性和准确性有所提高。
本研究结果表明,参与研究的放射技师能够以高标准进行PIE,这与国际研究结果相当,并且在6个月内有所改善。因此,在新西兰,当无法获得放射学报告时,PIE可能有助于急诊科临床医生做出临床决策。