Computed tomography colonography: Radiographer independent preliminary clinical evaluation for intraluminal pathology

This is the author accepted manuscript; the final version is available from Elsevier via the DOI in this recordIntroduction: We evaluated the reporting competency of radiographers providing preliminary clinical evaluations (PCE) for intraluminal pathology of computed tomography colonography (CTC). Method: Following validation of a suitable tool, audit was undertaken to compare radiographer PCE against radiology reports. A database was designed to capture radiographer and radiologist report data. The radiographer's PCE of intraluminal pathology was given a score, the “pathology discrepancy and significance” (PDS) score based on the pathology present, any discrepancy between the PCE and the final report, and the significance of that discrepancy on the management of the patient. Agreement was assessed using percentage agreement and Kappa coefficient. Significant discrepancies between findings were compared against endoscopy and pathology reports. Results: There was agreement or insignificant discrepancy between the radiographer PCE and the radiology report for 1736 patients, representing 97.0% of cases. There was a significant discrepancy between findings in 2.8% of cases and a major discrepancy recorded for 0.2% of cases. There was a 98.4% agreement in the 229 cases where significant pathologies were present. Conclusion: From a database of 1815 studies acquired over three years and representing work done in a clinical environment, this study indicates a potential for trained radiographers to provide a PCE of intraluminal pathology

“It's what's behind the mask”: Psychological diversity in compassionate patient care

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record Introduction: The Francis Report recommended an increased focus on compassion in healthcare, and recognition and non-judgmental acceptance of diversity is fundamental in compassionate patient care. The aim of this study was to achieve a wider understanding of diversity that includes individual patient needs, expectations, perceptions and feelings during diagnostic imaging. Methods: Using thirty-four semi-structured interviews with individual patients, this qualitative study explored their experiences of undergoing diagnostic radiography examinations and asked what compassionate care meant to them and how it is perceived and manifested in the brief, task-focussed and highly technical diagnostic projection imaging encounter. Data were analysed using Thematic Analysis. Results: Four key themes were identified from the analysis; these were: feelings and vulnerability; hidden emotions; professionalism and valued qualities and communication. Conclusion: Diversity is defined not only in terms of socio-cultural differences but also psychological ones, i.e. individual emotional and attitudinal characteristics, some of which may be consciously or unconsciously concealed. In order that patients are treated equitably and all of their care needs met, recommendations include a broader focus in education and training to include adapting communication skills and techniques in perception and expression of non-verbal cues. Further research into the pressures specific to the time-pressured, task-focussed, highly technical and rapid turnover environment of projection imaging radiography and how this impacts upon compassionate patient care would make a useful contribution to the field

The effect of counseling on willingness to use a hypothetical medication and perceptions of medication safety.

BACKGROUND: Poor medication adherence is an ongoing issue, and contributes to increased hospitalizations and healthcare costs. Although most adverse effects are rare, the perceived risk of adverse effects may contribute to low adherence rates. OBJECTIVES: The objective of this study was to determine how adverse effect likelihood and pharmacist counseling on adverse effect prevention affects individuals': (1) willingness to use a hypothetical medication and (2) perceptions of medication safety. METHODS: This study used a 3 × 3 experimental design. Participants (n = 601) viewed a hypothetical scenario asking them to imagine being prescribed an anti-asthma medication that could cause fungal infections of the throat. Participants were randomized to 1 of 9 scenarios that differed on: probability of developing an infection (5%, 20%, no probability mentioned) and whether they were told how to reduce the risk of infection (no prevention strategy discussed, prevention strategy discussed, prevention strategy discussed with explanation for how it works). Participants were recruited through Amazon Mechanical Turk. RESULTS: Participants were less willing to take the medication (F = 12.86, p < 0.0001) and considered it less safe (F = 13.11, p < 0.0001) when the probability of fungal infection was presented as 20% compared to 5% or when no probability information was given. Participants were more willing to take the medication (F = 11.78, p < 0.0001) and considered it safer (F = 11.17, p < 0.0001) when a prevention strategy was given. Finally, there was a non-statistically significant interaction between the probability and prevention strategy information such that provision of prevention information reduced the effect of variation in the probability of infection on both willingness to use the medication and perceived medication safety. CONCLUSIONS: Optimal risk communication involves more than informing patients about possible adverse effects. Pharmacists could potentially improve patient acceptance of therapeutic recommendations, and allay medication safety concerns, by counseling about strategies patients can implement to reduce the perceived risk of adverse effects

The academic radiography workforce: Age profile, succession planning and academic development.

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Introduction: Academia is one area of practice in which radiographers can specialise; they compile approximately 2% of the total radiography profession in the UK, but are highly influential and essential for the education and development of the workforce in addition to undertaking research. However, the academic environment is very different to clinical practice and a period of transition is required. Methods: Data were collated to explore the age and retirement profile of the academic radiography workforce in the UK; to understand the research time allocated to this workforce; the time required to develop a clinical radiographer into an academic and the mentorship and succession planning provisions nationally. An online UK wide survey was conducted and sent to all 24 Universities delivering radiography education within the UK. Results: Eighteen out of 24 Universities in the UK responded to the survey. Approximately 30% of radiography academics are due to retire over the next ten years, with over 25% of radiographers who currently hold a doctorate qualification included within this figure. Those entering academia have notably lower qualifications as a group than those who are due to retire. Developing clinical radiographers into academics was thought to take 1-3 years on average, or longer if they are required to undertake research. Conclusion: There is vulnerability in the academic radiography workforce. Higher education institutions need to invest in developing the academic workforce to maintain research and educational expertise, which is underpinned by master’s and doctorate level qualifications

Is the teaching of skeletal image-interpretation at undergraduate level effective in preparing students for practice?

Poster presentatio

Short-term Precision Error in Dual Energy X-Ray Absorptiometry, Bone Mineral Density and Trabecular Bone Score Measurements; and Effects of Obesity on Precision Error.

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.Introduction: Bone mineral density (BMD) measured by dual energy x-ray absorptiometry (DXA) is the primary screening tool for diagnosis of osteopenia and osteoporosis. BMD alone does not provide information regarding the structural characteristics of bone and this limitation has been a driver for the development of techniques, including trabecular bone score (TBS) software, to assess bone microarchitecture. Precision error in DXA is important for accurately monitoring changes in BMD and it has been demonstrated that BMD precision error increases with increasing body mass index (BMI). Information on in vivo precision error for TBS is very limited. This study evaluated short-term precision error (STPE) of lumbar spine BMD & TBS measurement, and investigated the effect of obesity on DXA precision error. Method: DXA lumbar spine scans (L1-L4) were performed using GE Lunar Prodigy. STPE was measured in ninety-one women at a single visit by duplicating scans with repositioning in-between. Precision error was calculated as the percentage coefficient of variation. Participants were sub-divided into four groups based on BMI to assess the effect of obesity on STPE. Results: STPE is poorer for TBS than for BMD. STPE is adversely affected for both BMD and TBS measurements by increasing BMI but this effect is mitigated for TBS in the highest BMI category where use of the thick scanning mode improves signal to noise ratio. Conclusion: Results from serial BMD and TBS measurements should take account of differences in precision error in the two techniques and in different BMI categories.Society and College of Radiographers Industry Partnership Scheme (CORIPS

Understanding student radiographer attrition: Risk factors and strategies

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordIntroduction Diagnostic student radiographer attrition is reported at 14%, 6% higher than the average for higher education, however, little research has been undertaken on this subject. This study explored risk factors for attrition and strategies that enabled these to be overcome. Methods A two-phase study was undertaken. Phase one: data for 579 former student diagnostic radiographers (468 completers and 111 non-completers) from 3 English universities were analysed. Logistic regression was used to estimate odds ratios and 95% confidence intervals for completion based on individual characteristics. Phase two: content analysis of data from an online survey of 186 current UK student diagnostic radiographers exploring their experiences was undertaken. Results Phase one: Attrition was 19%. Increased age, non A-level entry qualifications and poor academic performance were predictors of attrition (p < 0.005). Phase two: Challenges reported by groups identified as ‘at risk’ showed that for mature students and those with non-traditional entry qualifications, external responsibilities/pressures and financial pressures were likely to be the greatest cause of attrition and for younger students with traditional qualifications, academic difficulty and excessive workload were most significant. Scientific learning and academic writing were identified as the most common academic difficulties by all groups. Poor mental health may also be a risk factor. Conclusion Although characteristics were identified that increased the chance of attrition, the study concluded that attrition is most likely to be multi-factorial. Academic and personal support were identified as key in students continuing their studies when they considered leaving. Clinical placement experience is likely to influence continuation decisions. Implications for practice Transparency around course expectations and academic requirements together with ensuring high quality clinical placements may assist in reducing attrition.University of ExeterNational Institute for Health Research (NIHR

The development and evaluation of an audit tool for measuring reporting accuracy of radiographers compared with radiologists for intra-luminal pathology detected at computed tomography colonography (CTC)

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this record.Objective: To design and test an audit tool to measure the reporting accuracy of radiographers using radiologist reports as the gold standard. Design: A database was designed to capture radiographer and radiologist report data. The radiographer preliminary evaluation of intraluminal pathology was given a score (PDS score) by the reporting radiologist based on the pathology present, the discrepancy between the preliminary evaluation and the final report and the significance of that discrepancy on the clinical management of the patient. To test the reliability of this scoring system, 30 randomly selected cases (n=1815) were retrospectively compared and assessed for accuracy using the PDS score by 3 independent practitioners. Inter rater reliability was assessed using percentage agreement and kappa scores. Results: There was 100% agreement between participants for all significant pathologies. Inter rater agreement was 80-93% for normal studies and insignificant pathologies. Conclusion: Results indicate that the tool provides a practical, easy to use and reliable method to record, monitor and evaluate a preliminary evaluation of the colon by radiographers