Comparing radiologists and radiographers’ assessment of MRI referrals for low back pain: Insights from two imaging centres in Norway

Abstract

Introduction

This study aimed to evaluate the differences in MRI referral assessments for low back pain (LBP) between radiologists and in-house trained radiographers.

Methods

This is the second part of a retrospective study where MRI referrals for LBP conducted within two imaging centres in Norway were assessed for justification and referral quality. This study examines differences in how the recruited assessors (four radiologists and two radiographers) evaluated the referrals. The collected data was sorted in Microsoft Excel version 2021. Stata Statistical Software (Release 18) was used for data analysis. Mixed model analysis was used to compare the radiographers and radiologists' assessment of justification and referral quality. Gwet's agreement coefficient AC1/AC2 was used to determine the variation of agreements between the assessors in justification, and Gwet's AC2 between the assessor in referral quality. Kappa statistics was used to assess the interrater reliability between the two professions. A p-value of < 0.05 was considered statistically significant.

Results

A total n = 300 patients' MRI referrals for LBP from the two imaging centres were collected and assessed. The two radiographers and one radiologist assessed 75 % of the referrals as justified, while the other radiologists had an overall justification rate ranging from 50 to 60 %. In general, radiographers more frequently assigned referrals as being of good and intermediate quality compared to radiologists. The study showed a statistically significant difference (p < .001) between radiographers and radiologists ‘assessment of justification and quality of MRI referrals for LBP.

Conclusion

Radiographers assessed a higher proportion of referrals as justified and of good quality compared to radiologists, highlighting the need for targeted training to enhance radiographers' referral assessment skills.

Implications for practice

Radiographers are assigned tasks to justify imaging in radiology departments; however, targeted training is essential to ensure consistent and accurate referral assessments, ultimately enhancing patient care and optimising the use of resources.