No / The College of Radiographers has called for ‘Red Dot’ schemes to evolve and has recommended the development of radiographer commenting. The implementation of a radiographer comment scheme assumes that radiographers previously participating in ‘red dot’ schemes have been accurately recognising radiographic abnormalities and are, therefore, able to comment upon, and describe, such radiographic appearances. Research evidence to support such an assumption is sparse. This study compares the ability of radiographers attending a short course on musculoskeletal trauma to ‘red dot’ and comment on A&E radiographic appearances. Methods: This study adopted a pre-test, post-test approach. One hundred and twenty one radiographers attending a short course on musculoskeletal trauma (Bradford Red Dot Course) were invited to undertake an assessment of their ability to recognise (‘red dot’) and describe (comment upon) radiographic abnormalities at the start and end of the short course. Results: One hundred and fifteen radiographers (n = 115/121; 95.0%) completed both the pre- and post-training assessments. Post-training mean scores per case improved on average by 9.8% [p = 0.012; 95% CI: 2.4, 17.1] for ‘red dots’ and 12.7% [p = 0.007; 95% CI: 3.8, 21.5] for commenting. However, the difference between mean ‘red dot’ and commenting scores remained similar with mean radiographer comment scores being 13.7% less than mean ‘red dot’ scores pre-training and 10.8% less post-training. Conclusions: The results of this study indicate that the accuracy of radiographer comments was significantly reduced when compared to the accuracy of ‘red dots’ for the same radiographic images. The clinical significance of these findings for departments wanting to move from a ‘red dot’ system to a radiographer commenting scheme is that without appropriate training and audit, the quality of service and assistance to the A&E department could be significantly reduced.

No / To determine the accuracy of radiographers red dot or triage of accident and emergency (A&E) radiographs in clinical practice. MATERIALS AND METHODS Eligible studies assessed radiographers red dot or triage of A&E radiographs in clinical practice compared with a reference standard and provided accuracy data to construct 2×2 tables. Data were extracted on study eligibility and characteristics, quality, and accuracy. Pooled sensitivities and specificities and chi-square tests of heterogeneity were calculated. RESULT Three red dot and five triage studies were eligible for inclusion. Radiographers' red dot of A&E radiographs in clinical practice compared with a reference standard is 0.87 [95% confidence interval (CI) 0.85¿0.89] and 0.92 (0.91¿0.93) sensitivity and specificity, respectively. Radiographers' triage of A&E radiographs of the skeleton is 0.90 (0.89¿0.92) and 0.94 (0.93¿0.94) sensitivity and specificity, respectively; and for chest and abdomen is 0.78 (0.74¿0.82) and 0.91 (0.88¿0.93). Radiographers' red dot of skeletal A&E radiographs without training is 0.71 (0.62¿0.79) and 0.96 (0.93¿0.97) sensitivity and specificity, respectively; and with training is 0.81 (0.72¿0.87) and 0.95 (0.93¿0.97). Pooled sensitivity and specificity for radiographers without training for the triage of skeletal A&E radiographs is 0.89 (0.88¿0.91) and 0.93 (0.92¿0.94); and with training is 0.91 (0.88¿0.94) and 0.95 (0.93¿0.96). CONCLUSION Radiographers red dot or triage of A&E radiographs in clinical practice is affected by body area, but not by training.

No / Radiographer abnormality detection schemes (RADS) were first introduced in the United Kingdom (UK) in the mid 1980s with the development of the ‘red dot scheme’. This article establishes the current position of UK RADS practice and provides insight into specific areas for development. Method: A postal questionnaire was distributed to 456 sites, including 270 emergency departments and 186 minor injuries units (MIU). Information was sought relating to: the type of emergency department and radiography service provided; details of RADS operated including any education and audit to support radiographer participation; and the mandatory/voluntary nature of the system adopted. Results: A total of 306 (n = 306/456; 74%) responses were received. The large majority of respondents (n = 284/306; 92.8%) indicated that a RADS was in operation. Of these, 221 sites operated a red dot scheme, 7 sites operated a radiographer comment system, and a further 54 sites operated both a red dot and comment scheme. Two sites indicated that a RADS other than red dot or radiographer commenting was operated. Twenty-one different methods of highlighting abnormal images were identified and eight different commenting methods. The RADS was considered mandatory at 25% of sites. Conclusion: This study confirms the continued widespread contribution of radiographers to the trauma diagnostic process through the use of RADS. The informal nature of the systems, inconsistent approaches to audit and education, and variations in the methods employed are issues which require national guidance.

Thesis (MSc (Radiography))--Cape Peninsula University of Technology, 2019 / Introduction: After-hours diagnostic imaging is essential in the majority of large public hospitals, as it plays a vital role in the treatment and management of patients. Radiologists are not always available after hours to provide reports on radiographic images since, nationally and globally, there is a shortage of these professionals. Radiographic images are frequently interpreted by emergency physicians after hours. Thus, while diagnostic imaging represents an essential component in patient care (including management and treatment), according to the literature, a significant cause of clinical error occurs through the misinterpretation of radiographic images by emergency physicians. The aim of this study was to determine emergency physicians’ views on whether there was a need for an after-hours diagnostic radiology reporting service in emergency departments at some public hospitals, in the Durban Metropole. It is important to note that in addition to the above, this study calculated the number of radiographic examinations performed after-hours, and the number that was reported by the radiologist during office hours, since there was no radiology cover after hours. Methods: A descriptive cross-sectional quantitative survey design was employed using a self-administered questionnaire as a data collection instrument completed by emergency physicians at four public hospitals. In addition, additional data was collected to determine the number of radiographic examinations that had been performed after hours, at the selected four public hospitals over a period of three months, as well as the number of radiographic examinations that was reported on. This enabled the authors to determine the number of radiographic examinations that went unreported during this study period. Results: A total of 39 emergency physicians participated in the survey, with a mean and median age of 39.46 and 38 years, respectively (SD = 9.11 years). The results of this study showed that between 0.1% and 0.6% of radiographic examinations performed after hours were reported on by radiologists during office hours, for this study period. This implies that less than 1% of all examinations produced after hours at the four public hospitals, received a radiology report. Emergency physicians felt that the interpretation of images took up valuable time. The survey found that there was near total consensus amongst respondents on whether they prefer after-hours reporting to be performed by a radiologist as 46.2% (n = 18) of the respondents strongly agreed and 41.0% agreed (n = 16). Furthermore, a total of 35.9% (n=14) of respondents agreed and 43.6% (n=17) strongly agreed, that having a reporting radiographer reporting on radiographic images after-hours, would benefit patient flow. The survey also found that 92% of the sampled emergency physicians agreed (59.0% strongly agreed and 33.3% agreed, respectively) that there was a need for further training in the interpretation of radiographic images. Discussion: From the above results, it is evident that since the majority of radiographic examinations went unreported after hours, the task to interpret the radiographic images is left to the emergency physicians as part of their patient management. Conceivably, this added image interpretation results in a further increase in the workload of emergency physicians. It is therefore not surprising that emergency physicians preferred that after-hours reporting of radiographic images be done by radiologists. According to the literature, reporting radiographers also play a role in alleviating the workload of emergency physicians and improving patient flow, by providing a report for the radiographic images during after-hours. Thus, reporting radiographers afford emergency physicians additional time to concentrate on patient treatment, resulting in faster patient throughput. Reporting on radiographic images is not yet included in the scope of the South African radiographer. The findings of this study, though, suggested that there was a need for emergency physicians to undergo training in the interpretation of radiographic images. Conclusion: The study recommends that an after-hours reporting service be considered for the four public hospitals concerned. It is recommended that the heads of the emergency and radiology departments further consider offering courses on radiographic image interpretation for emergency physicians.

No / Errors in the interpretation of diagnostic images in the emergency department are a persistent problem internationally. To address this issue, a number of risk reduction strategies have been suggested but only radiographer abnormality detection schemes (RADS) have been widely implemented in the UK. This study considers the variation in RADS operation and communication in light of technological advances and changes in service operation. A postal survey of all NHS hospitals operating either an Emergency Department or Minor Injury Unit and a diagnostic imaging (radiology) department (n = 510) was undertaken between July and August 2011. The questionnaire was designed to elicit information on emergency service provision and details of RADS. 325 questionnaires were returned (n = 325/510; 63.7%). The majority of sites (n = 288/325; 88.6%) operated a RADS with the majority (n = 227/288; 78.8%) employing a visual ‘flagging’ system as the only method of communication although symbols used were inconsistent and contradictory across sites. 61 sites communicated radiographer findings through a written proforma (paper or electronic) but this was run in conjunction with a flagging system at 50 sites. The majority of sites did not have guidance on the scope or operation of the ‘flagging’ or written communication system in use. RADS is an established clinical intervention to reduce errors in diagnostic image interpretation within the emergency setting. The lack of standardisation in communication processes and practices alongside the rapid adoption of technology has increased the potential for error and miscommunication.

Aluminium har flera fördelar inom konstruktion och produktframtagning. Aimpoint AB har resonerat för kostnad samt viktreducering i sikteshuset Micro T-2. Syftet med rapporten var att undersöka möjligheterna att implementera polymera material som tillfredsställer framlagd kravspecifikation för Aimpoint AB. Målet med arbetet var att identifiera lämpligt material i form av polymer, med lämplig tillverkningsmetod som kan appliceras för sikteshuset utan att påverka de mekaniska egenskaperna negativt.  Lämpliga material som identifierades under litteraturstudien i arbetet var termoplasterna polyfenylensulfid (PPS) och polyetereterketon (PEEK) med implementerat kolfiber. Valet av polymerbaserade material utgjorde ett mindre omfång av lämpliga tillverkningsmetoder, som med hjälp av leverantörer och kostnadskalkylscenarier i Excel jämfördes.  Med hjälp av tredimensionella verktyg utfördes FEM-analyser i ABAQUS CAE® av det exemplifierade sikteshuset. Baserat på simuleringarna i ABAQUS CAE®, presenterar arbetet en jämförelse mellan befintligt sikteshus av Al6082-T6 och sikteshus av polymera material med implementerad förstärkning för modellen Micro T-2. Simuleringarna konstaterade deformation vid det dynamiska explicita fallet mot en konstruerad laminatskiva enligt standarden MIL-STD-810G.  För att bekräfta material och tillverkningsmetod krävs vidare undersökning. Detta för att med säkerhet besvara arbetets frågeställningar då FEM - analyser är en approximativ lösning. / SvenskaAluminum has several advantages in construction and product development. Aimpoint AB requires to reduce both the costs and the weight of their aluminum reflex sight of model Micro T-2.   The aim with the report was to investigate the possibility to implement polymeric materials as a substitute to aluminum that fulfills the requirements specification set by the manufacturer Aimpoint AB.   In addition to that, the aim was also to find suitable polymeric materials with an alternative production technique that is applicable for the reflex sight without compromising the mechanical integrity.  Suitable materials identified during the literature part of this report were two types of thermoplastic materials, polyphenylene sulfide (PPS) and polyetheretherketone (PEEK), both with addition of carbon fiber. The selection process of the polymeric materials was based on several factors and together with contractors, different cost estimation scenarios were compared in Excel. By help from three dimensional tools, FEM-analysis of the sight were performed in ABAQUS CAE®. Based on the results from the simulations performed in ABAQUS CAE®, the report presents a comparison between the original aluminum sight with the two types of carbon fiber reinforced thermoplastic sights. During the dynamic explicit case the simulation was performed as a drop test against a laminate board according to standard MIL-STD-810G. The results of the simulation presented a deformation of the tested sight. To confirm the material and manufacturing method, further investigation is required. This is necessary to address the questions posed in the current project since the FEM - analysis is an approximate solution. / <p>2023-06-28</p>