![RADIOLOGYLETTER TO THE EDITOR
Is radiographer commenting the answer?
Dear Editor,
Re: Article in Journal of Medical Imaging and Radiation
Oncology, Volume 56, 2012, p. 510513, by Brown and
Leschke, Evaluating the true clinical utility of the red dot
system in radiograph interpretation.
The authors have referenced a document written by
United Kingdoms College of Radiographers.1
In doing so
they gave the impression that non-radiologists providing
written reports on plain radiographs were initiated due to
the success of the red dot system. That document
essentially identi鍖es current practices in radiography in
the United Kingdom.
The authors appear to be confusing the red dot system
as a basic version of plain radiographic reporting. They
infer from their research results that due to the red dot
systems inability to reliably detect undisplaced fractures
that role extension into plain radiographic reporting by
non-radiologists has the potential to yield a less accurate
interpretation. The red dot and reporting of plain radio-
graphs are two very different concepts and should be
treated as such. A red dot or equivalent abnormality
detection system is a voluntary initiative in the emer-
gency setting that requires no formally recognised addi-
tional training. Such a system involves a radiographer
highlighting an acute abnormality to the referring emer-
gency clinician by placing a red dot or equivalent (e.g.
asterisk) on the digital image. On the other hand, the
development of formalised radiographer reporting in the
1990s in the United Kingdom requires a radiographer to
complete an accredited postgraduate university program
in image interpretation. I would encourage the authors to
acknowledge the many differences between a red dot
and a formalised diagnostic report, especially the fact that
no additional training is required for radiographers to
participate in a red dot system.
What the authors have failed to discuss is the recent
development of a radiographic comment. A radiographic
comment is where an educated and accredited radiog-
rapher not only highlights trauma pathology at the point
of care but provides a brief description. A radiographic
comment does not replace a radiologists report. It pro-
vides a brief, educated interpretation of a radiograph in
a clinically useful time frame, further enhancing patient
safety in the emergency health care setting. Recent
literature has acknowledged the bene鍖ts of a radiogra-
pher commenting system over the red dot system.2,3
The authors suggest that improvements are required
to existing models to achieve the reporting of plain
radiographs in a clinically useful time frame without an
increase in cost. They have not acknowledged recently
published documents calling attention to not only the
delay in radiology reports4
but the rising concern of the
number of unreported radiographs within Australia,5
ulti-
mately leading to an increase in patient risk. With the
recent implementation of the National Emergency
Admission Targets requiring that patients are discharged
from an emergency department within 4 hours, now is
the best time to consider innovative models of care to
improve service delivery and enhance patient care,
rather than devaluing a current successful patient safety
mechanism such as red dot.
Kind regards,
MICHAEL J. NEEP
A/Team Leader Radiographer, Emergency Department, Princess
Alexandra Hospital, Brisbane, Queensland, Australia
doi: 10.1111/1754-9485.12053
References
1. College of Radiographers. Radiography role developed
revisited: the research evidence 2003. 2003. [Cited 9
Nov 2012.] Available from URL: http://www.
improvement.nhs.uk/documents/18weeks/
Role-development-revisited.pdf
2. Hardy M, Culpan G. Accident and emergency
radiography: a comparison of radiographer
commenting and red dotting. Radiography 2007; 13:
6571.
3. McConnell JR, Webster AJ. Improving radiographer
highlighting of trauma 鍖lms in the Accident and
Emergency department with a short course of study
an evaluation. Br J Radiol 2000; 73: 60812.
4. Queensland Government. Queensland Health Radiology
Services Pro鍖le 20092010. 2010; 5: 24.
5. Patty A. Reviews needed on mountain of backlogged
X-rays, says professor. Sydney Morning Herald; 16
May 2012.
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息 2013 The Author
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- 1. RADIOLOGYLETTER TO THE EDITOR Is radiographer commenting the answer? Dear Editor, Re: Article in Journal of Medical Imaging and Radiation Oncology, Volume 56, 2012, p. 510513, by Brown and Leschke, Evaluating the true clinical utility of the red dot system in radiograph interpretation. The authors have referenced a document written by United Kingdoms College of Radiographers.1 In doing so they gave the impression that non-radiologists providing written reports on plain radiographs were initiated due to the success of the red dot system. That document essentially identi鍖es current practices in radiography in the United Kingdom. The authors appear to be confusing the red dot system as a basic version of plain radiographic reporting. They infer from their research results that due to the red dot systems inability to reliably detect undisplaced fractures that role extension into plain radiographic reporting by non-radiologists has the potential to yield a less accurate interpretation. The red dot and reporting of plain radio- graphs are two very different concepts and should be treated as such. A red dot or equivalent abnormality detection system is a voluntary initiative in the emer- gency setting that requires no formally recognised addi- tional training. Such a system involves a radiographer highlighting an acute abnormality to the referring emer- gency clinician by placing a red dot or equivalent (e.g. asterisk) on the digital image. On the other hand, the development of formalised radiographer reporting in the 1990s in the United Kingdom requires a radiographer to complete an accredited postgraduate university program in image interpretation. I would encourage the authors to acknowledge the many differences between a red dot and a formalised diagnostic report, especially the fact that no additional training is required for radiographers to participate in a red dot system. What the authors have failed to discuss is the recent development of a radiographic comment. A radiographic comment is where an educated and accredited radiog- rapher not only highlights trauma pathology at the point of care but provides a brief description. A radiographic comment does not replace a radiologists report. It pro- vides a brief, educated interpretation of a radiograph in a clinically useful time frame, further enhancing patient safety in the emergency health care setting. Recent literature has acknowledged the bene鍖ts of a radiogra- pher commenting system over the red dot system.2,3 The authors suggest that improvements are required to existing models to achieve the reporting of plain radiographs in a clinically useful time frame without an increase in cost. They have not acknowledged recently published documents calling attention to not only the delay in radiology reports4 but the rising concern of the number of unreported radiographs within Australia,5 ulti- mately leading to an increase in patient risk. With the recent implementation of the National Emergency Admission Targets requiring that patients are discharged from an emergency department within 4 hours, now is the best time to consider innovative models of care to improve service delivery and enhance patient care, rather than devaluing a current successful patient safety mechanism such as red dot. Kind regards, MICHAEL J. NEEP A/Team Leader Radiographer, Emergency Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia doi: 10.1111/1754-9485.12053 References 1. College of Radiographers. Radiography role developed revisited: the research evidence 2003. 2003. [Cited 9 Nov 2012.] Available from URL: http://www. improvement.nhs.uk/documents/18weeks/ Role-development-revisited.pdf 2. Hardy M, Culpan G. Accident and emergency radiography: a comparison of radiographer commenting and red dotting. Radiography 2007; 13: 6571. 3. McConnell JR, Webster AJ. Improving radiographer highlighting of trauma 鍖lms in the Accident and Emergency department with a short course of study an evaluation. Br J Radiol 2000; 73: 60812. 4. Queensland Government. Queensland Health Radiology Services Pro鍖le 20092010. 2010; 5: 24. 5. Patty A. Reviews needed on mountain of backlogged X-rays, says professor. Sydney Morning Herald; 16 May 2012. bs_bs_banner Journal of Medical Imaging and Radiation Oncology 57 (2013) 206 息 2013 The Author Journal of Medical Imaging and Radiation Oncology 息 2013 The Royal Australian and New Zealand College of Radiologists206