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Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial

The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The aim of this study was to determine the impact of immediate reporting of CXRs requested by primary care by radiogr...

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Autores principales: Woznitza, Nick, Ghimire, Bhagabati, Devaraj, Anand, Janes, Sam M, Piper, Keith, Rowe, Susan, Bhowmik, Angshu, Hayes, Natasha, Togher, Daniel, Arumalla, Nikita, Skyllberg, Erik, Au-Yong, Iain T H, Geary, Susan, George, Bindu, Sheard, Sarah, Ellis, Stephen, Shah, Zoheb, Maughn, Sue, Duffy, Stephen W, Baldwin, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447363/
https://www.ncbi.nlm.nih.gov/pubmed/36351688
http://dx.doi.org/10.1136/thorax-2022-219210
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author Woznitza, Nick
Ghimire, Bhagabati
Devaraj, Anand
Janes, Sam M
Piper, Keith
Rowe, Susan
Bhowmik, Angshu
Hayes, Natasha
Togher, Daniel
Arumalla, Nikita
Skyllberg, Erik
Au-Yong, Iain T H
Geary, Susan
George, Bindu
Sheard, Sarah
Ellis, Stephen
Shah, Zoheb
Maughn, Sue
Duffy, Stephen W
Baldwin, David
author_facet Woznitza, Nick
Ghimire, Bhagabati
Devaraj, Anand
Janes, Sam M
Piper, Keith
Rowe, Susan
Bhowmik, Angshu
Hayes, Natasha
Togher, Daniel
Arumalla, Nikita
Skyllberg, Erik
Au-Yong, Iain T H
Geary, Susan
George, Bindu
Sheard, Sarah
Ellis, Stephen
Shah, Zoheb
Maughn, Sue
Duffy, Stephen W
Baldwin, David
author_sort Woznitza, Nick
collection PubMed
description The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The aim of this study was to determine the impact of immediate reporting of CXRs requested by primary care by radiographers on the time to diagnosis of lung cancer. METHOD: People referred for CXR from primary care to a single acute district general hospital in London attended sessions that were prerandomised to either immediate radiographer (IR) reporting or standard radiographer (SR) reporting within 24 hours. CXRs were subsequently reported by radiologists blind to the radiographer reports to test the reliability of the radiographer report. Radiographer and local radiologist discordant cases were reviewed by thoracic radiologists, blinded to reporter. RESULTS: 8682 CXRs were performed between 21 June 2017 and 4 August 2018, 4096 (47.2%) for IR and 4586 (52.8%) for SR. Lung cancer was diagnosed in 49, with 27 (55.1%) for IR. The median time from CXR to diagnosis of lung cancer for IR was 32 days (IQR 19, 70) compared with 63 days (IQR 29, 78) for SR (p=0.03). 8258 CXRs (95.1%) were reported by both radiographers and local radiologists. In the 1361 (16.5%) with discordance, the reviewing thoracic radiologists were equally likely to agree with local radiologist and radiographer reports. CONCLUSIONS: Immediate reporting of CXRs from primary care reduces time to diagnosis of lung cancer by half, likely due to rapid progress to CT. Radiographer reports are comparable to local radiologist reports for accuracy. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number ISRCTN21818068. Registered on 20 June 2017.
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spelling pubmed-104473632023-08-25 Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial Woznitza, Nick Ghimire, Bhagabati Devaraj, Anand Janes, Sam M Piper, Keith Rowe, Susan Bhowmik, Angshu Hayes, Natasha Togher, Daniel Arumalla, Nikita Skyllberg, Erik Au-Yong, Iain T H Geary, Susan George, Bindu Sheard, Sarah Ellis, Stephen Shah, Zoheb Maughn, Sue Duffy, Stephen W Baldwin, David Thorax Lung Cancer The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The aim of this study was to determine the impact of immediate reporting of CXRs requested by primary care by radiographers on the time to diagnosis of lung cancer. METHOD: People referred for CXR from primary care to a single acute district general hospital in London attended sessions that were prerandomised to either immediate radiographer (IR) reporting or standard radiographer (SR) reporting within 24 hours. CXRs were subsequently reported by radiologists blind to the radiographer reports to test the reliability of the radiographer report. Radiographer and local radiologist discordant cases were reviewed by thoracic radiologists, blinded to reporter. RESULTS: 8682 CXRs were performed between 21 June 2017 and 4 August 2018, 4096 (47.2%) for IR and 4586 (52.8%) for SR. Lung cancer was diagnosed in 49, with 27 (55.1%) for IR. The median time from CXR to diagnosis of lung cancer for IR was 32 days (IQR 19, 70) compared with 63 days (IQR 29, 78) for SR (p=0.03). 8258 CXRs (95.1%) were reported by both radiographers and local radiologists. In the 1361 (16.5%) with discordance, the reviewing thoracic radiologists were equally likely to agree with local radiologist and radiographer reports. CONCLUSIONS: Immediate reporting of CXRs from primary care reduces time to diagnosis of lung cancer by half, likely due to rapid progress to CT. Radiographer reports are comparable to local radiologist reports for accuracy. TRIAL REGISTRATION: International Standard Randomised Controlled Trial Number ISRCTN21818068. Registered on 20 June 2017. BMJ Publishing Group 2023-09 2022-11-08 /pmc/articles/PMC10447363/ /pubmed/36351688 http://dx.doi.org/10.1136/thorax-2022-219210 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Lung Cancer
Woznitza, Nick
Ghimire, Bhagabati
Devaraj, Anand
Janes, Sam M
Piper, Keith
Rowe, Susan
Bhowmik, Angshu
Hayes, Natasha
Togher, Daniel
Arumalla, Nikita
Skyllberg, Erik
Au-Yong, Iain T H
Geary, Susan
George, Bindu
Sheard, Sarah
Ellis, Stephen
Shah, Zoheb
Maughn, Sue
Duffy, Stephen W
Baldwin, David
Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title_full Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title_fullStr Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title_full_unstemmed Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title_short Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial
title_sort impact of radiographer immediate reporting of x-rays of the chest from general practice on the lung cancer pathway (radiox): a randomised controlled trial
topic Lung Cancer
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10447363/
https://www.ncbi.nlm.nih.gov/pubmed/36351688
http://dx.doi.org/10.1136/thorax-2022-219210
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