Accident and emergency radiological interpretation using the Radiographer Opinion Form (ROF)

Abstract

The red dot system of radiographer opinion giving about the result of an x-ray examination in the accident and emergency (A and E) department has been around for about 15 years in various forms. However, it does not require that the radiographer accurately identify the site and nature of the suspected pathology. In developing a study to measure the ability of radiographers to interpret plain A and E radiographs a new data collection instrument was successfully used, the Radiographer Opinion Form (ROF). The ROF allows radiographers to indicate firstly whether they suspect a pathology or not, and secondly what they the suspected pathology is in their opinion. In a study of 820 A and E cases undertaken at the John Hunter Hospital (JHH) using the ROF radiographers had an overall accuracy of 93 per cent in identifying the presence or absence of pathology compared to the 100 per cent gold standard of the radiologists' reports. Even taking into account a positive selection bias recognised in the study this was comparably with results found in previous studies both in Australia and overseas. The radiographers performed better in less complex anatomical regions, such as the upper extremity (96.3 per cent), compared to other examinations like the chest (90.7 per cent) and the abdomen (87.5 per cent), where the anatomy is more complex and the differential diagnosis is more varied. The ROF proved a useful research tool, however, it may also have valuable clinical applications as a means of conveying the radiographers opinion about suspected abnormalities to referring doctors in the first instance, and ultimately to the reporting radiologists. (author abstract)

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