Immediate reporting of chest X-rays referred from general practice by reporting radiographers: a single centre feasibility study

Background: Lung cancer is a leading cause of mortality worldwide, and England has poorer outcomes compared to other countries. Early and accurate diagnosis is key to improving outcomes.<br /> <br />Aim: To investigate the feasibility of radiographer-led immediate reporting of chest X-rays (CXRs) referred from general practice. Design and Setting: Design: Four month feasibility study (November 2016 – March 2017). Setting: Single radiology department at a London acute general hospital.<br /><br />Method: Primary outcome was feasibility of immediate reporting. Secondary outcomes were number of lung cancers diagnosed, time to diagnosis of lung cancer, time to computed tomography (CT) chest, and number of urgent referrals to respiratory medicine. Comparison was made between CXRs that received an immediate and routine report.<br /><br />Results: Forty of 186 sessions (22%) were covered by radiographer immediate reporting. Of the 1,687 CXRs referred from general practice, 558 (33.1%) received an immediate report (radiographer or radiologist). Twenty-two (of 36) CT scans performed were following an abnormal CXR with an immediate report (mean 0.8 scans/week). Time from CXR to CT was shorter in the immediate report group (n=22 mean 0.9 days SD 2.3) compared to routine reporting (n=14; mean 6.5 SD 3.2; F=27.883, p<0.0001). Time to MDT discussion was shorter in the immediate reporting group (mean 4.1 SD 2.9) compared to routine reporting (mean 10.6; SD 4.5; F=11.59, p<0.0001). No apparent difference was found for time to discussion at treatment MDT.<br /><br />Conclusion: It is feasible to introduce a radiographer-led immediate CXR reporting service. Patients can be taken off the lung cancer pathway sooner with the introduction of radiographer immediate reporting of CXRs and this may improve outcomes for patients. A definitive study assessing outcomes is required