Journal of Medical Radiation Sciences最新文献

This editorial summarises the evolution and positive impact that radiographer preliminary image evaluation has on patient care. It also highlights the importance of using consistent and clear terminology when referring to when radiographers alert significant pathology to the referring clinical team and radiologists.

Radiology services in New Zealand are under significant pressure. Preliminary image evaluation (PIE) by radiographers can have a significant positive impact on patient care in this constrained environment and should be supported.

Introduction: Simulation-based learning (SBL) is widely used in healthcare education to provide a safe environment for students to practice clinical scenarios without causing patient harm. While established in developed countries, SBL's implementation is new in South Africa; there is a lack of research addressing sonography students' experiences. This study aimed to explore and describe the experiences of Bachelor of Science (BSc) second-year sonography students using SBL for clinical training at a local University of Technology (UoT).

Method: An exploratory, qualitative and descriptive research study was conducted in 2020, with virtual one-on-one interviews due to COVID-19 restrictions. Eight BSc second-year sonography students, who had undergone SBL in their first year, participated. Data saturation was achieved, and interviews were audio recorded and transcribed verbatim.

Results: Thematic analysis revealed three themes: (1) Enhancing preparedness for the clinical environment, (2) Limitations of the tissue-equivalent phantom and (3) Suggestions for improving simulation. While students expressed positive feedback and enjoyment of the simulation tool, they also highlighted limitations, such as unrealistic representations of real patient scanning conditions.

Conclusion: This study provides valuable insights into sonography students' experiences with SBL. Positive influence of SBL on clinical training was observed. To enhance SBL for future sonography students, consideration for high-fidelity simulators with advanced software is recommended. Funding options to invest in such simulators should be explored by radiography educators to promote more realistic training experiences.

Introduction: Medical imaging's critical role in diagnosis requires prompt and precise image interpretation. Numerous radiology departments, especially in low-resourced settings, encounter challenges such as a shortage of radiologists in their operational setup. This study explored the perceptions of radiographers and radiologists from low-resourced departments in a single country regarding operational challenges and potential solutions in image interpretation.

Methods: A qualitative approach was utilised, involving heads of departments, senior radiographers, and radiologists with a minimum of 5 years of experience, from three major state referral hospitals. Face-to-face, semi-structured interviews were conducted in November 2022, using an interview guide that included questions on the challenges encountered during image interpretation and the proposed solutions. Data analysis was conducted using Atlas.ti version 9.0, following the four-step content analysis method. All participants willingly provided consent to participate in the study.

Results: Ten participants, comprising two radiologists and eight radiographers participated in the study. The research identified three main themes: image interpretation pathways, image interpretation operational challenges and proposed solutions for image interpretation. In addition, a total of 10 subthemes were generated from the three main themes.

Conclusion: The study revealed critical challenges and the need to explore the formal inclusion of radiographers in image interpretation, as a way to improve efficiency. However, a comprehensive assessment of the image interpretation system, encompassing radiographers' knowledge and competence, is recommended for context-specific, empirical-based modifications to enhance service provision.

Introduction: In medical radiation science (MRS), radiology information systems (RISs) record patient information such as name, gender and birthdate. The purpose of RISs is to ensure the safety and well-being of patients by recording patient data accurately. However, not all RISs appropriately capture gender, sex or other related information of transgender and gender-diverse (TGD) patients, resulting in non-inclusive and discriminatory care. This review synthesises the research surrounding the limitations of RISs preventing inclusivity and the features required to support inclusivity and improve health outcomes.

Methods: Studies were retrieved from three electronic databases (Scopus, PubMed and Embase). A quality assessment was performed using the Johns Hopkins Nursing Evidence-Based Practice Research and Non-Research Evidence Appraisal Tools. A thematic analysis approach was used to synthesise the included articles.

Results: Eighteen articles were included based on the predetermined eligibility criteria. The pool of studies included in this review comprised primarily of non-research evidence and reflected the infancy of this research field and the need for further empirical evidence. The key findings of this review emphasise how current systems do not record the patient's name and pronouns appropriately, conflate sex and gender and treat sex and gender as a binary concept.

Conclusion: For current systems to facilitate inclusivity, they must implement more comprehensive information and data models incorporating sex and gender and be more flexible to accommodate the transient and fluid nature of gender. However, implementation of these recommendations is not without challenges. Additionally, further research focused on RISs is required to address the unique challenges MRS settings present to TGD patients.

Introduction: Cancers around the eye are often treated using orthovoltage machines or by plastic surgery, neither of which are widely available in regional Australia. External beam radiation therapy (EBRT) using electrons and an internal eye shield is an alternative, relatively underreported technique which can provide similar cosmetic and functional outcomes. This report aimed to describe the process for the use of internal eye shields at GenesisCare Fraser Coast Radiation Oncology (GCFCRO) and the associated clinical outcomes and patient perceptions of the delivery and results of this procedure.

Methods: This project was conducted in two phases. Phase I was an audit of the departmental technique and short-term clinical outcomes of 17 patients who received EBRT for skin cancer near the eyes at GCFCRO in partnership with Wide Bay Hospital and Health Service (WBHHS). Phase II was a survey of nine of those patients to elicit the patient perspective of the delivery and long-term outcomes of the treatment.

Results: Phase I revealed the departmental procedures for simulation, planning and treatment at GCFCRO are consistent with other departments published protocols. Phase II results detailed positive patient perspectives regarding cosmetic outcomes and receipt of EBRT for skin cancer near their eyes.

Conclusion: EBRT with an internal eye shield is an acceptable alternative modality to surgery for squamous cell carcinomas (SCC) and basal cell carcinomas (BCC) around the eye in the definitive and adjuvant setting. This is particularly important in regional locations to facilitate patients receiving high-quality care and outcomes locally.

The rate of obesity is increasing in the Australian population, and this also includes patients with cancer. The safety and dignity of this cohort of patients is paramount as well as the timely acquisition of equipment required to assist patients with obesity to complete a course of radiation therapy (RT). The design and manufacture of equipment used in most RT departments is not suitable for the weight or BMI of all patients presenting for treatment. RT also operates under a unique set of circumstances that differs from the routine hospital environment which prompted the design of an RT bariatric protocol for use in our department. The protocol is based on the mapping of a patient's pathway from simulation and treatment. Treatment technique and equipment limitations as well as information relating to a patient with high BMI are used as trigger points that direct a patient pathway. The bariatric protocol provides the RT team with decision-making support for appropriate resource utilisation ensuring safe and efficient treatment delivery for both the patient and staff. This paper will outline how the RT bariatric protocol was developed and implemented in our department, highlighting areas that required more attention due to the RT-specific environment.

Introduction: Increases in computed tomography (CT) use may not always reflect clinical need or improve outcomes. This study aimed to demonstrate how population level data can be used to identify variations in care between patient groups, by analysing system-level changes in CT use around the diagnosis of new conditions.

Methods: Retrospective repeated cross-sectional observational study using West Australian linked administrative records, including 504,723 adults diagnosed with different conditions in 2006, 2012 and 2015. For 90 days pre/post diagnosis, CT use (any and 2+ scans), effective dose (mSv), lifetime attributable risk (LAR) of cancer incidence and mortality from CT, and costs were assessed.

Results: CT use increased from 209.4 per 1000 new diagnoses in 2006 to 258.0 in 2015; increases were observed for all conditions except neoplasms. Healthcare system costs increased for all conditions but neoplasms and mental disorders. Effective dose increased substantially for respiratory (+2.5 mSv, +23.1%, P < 0.001) and circulatory conditions (+2.1 mSv, +15.4%, P < 0.001). The LAR of cancer incidence and mortality from CT increased for endocrine (incidence +23.4%, mortality +18.0%) and respiratory disorders (+21.7%, +23.3%). Mortality LAR increased for circulatory (+12.1%) and nervous system (+11.0%) disorders. The LAR of cancer incidence and mortality reduced for musculoskeletal system disorders, despite an increase in repeated CT in this group.

Conclusions: Use and costs increased for most conditions except neoplasms and mental and behavioural disorders. More strategic CT use may have occurred in musculoskeletal conditions, while use and radiation burden increased for respiratory, circulatory and nervous system conditions. Using this high-level approach we flag areas requiring deeper investigation into appropriateness and value of care.

Maximise your CPD by reading the following selected article and answer the five questions. Please remember to self-claim your CPD and retain your supporting evidence. Answers will be available via the QR code and published in JMRS – Volume 71, Issue 4, December 2024.

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Introduction: Despite a demonstrated high accuracy and reported successful implementations, radiographer preliminary image evaluation (PIE) has been slow and infrequent in its rollout across Australia. A key barrier reported to hamper radiographer PIE service implementation is lack of adequate time to review radiographs and provide an accurate interpretation. This study sought to conduct a correlational analysis between radiographer imaging workload and PIE service accuracy.

Methods: A total of 45,373 exams and 1152 PIE comments evenly distributed each month from January 1, 2022, to December 31, 2022, were reviewed. PIE comments were assessed for consistency with the radiologist's report. The imaging workload (average exams completed per hour) was separated into three, eight-hour 'shifts' based on time of imaging. Correlational analysis was performed using linear regression models and assessed for normality using the Shapiro-Wilks test.

Results: The study reported no significant linear association between increasing average workload and reduced service accuracy (P = 0.136). It was however noted that when the average workload increased beyond 7 exams/hour, average service accuracy for PIE was always below 85%.

Conclusion: This study has demonstrated that, although perceived, there is no statistically significant correlation between x-ray imaging workload and radiographer PIE service accuracy. Consideration of this correlation to be a significant barrier to participation in such a service was not reported at this site.