Chest X-ray interpretation in UK intensive care units: A survey 2014

Abstract

Purpose: This survey investigated current practice in intensive care unit radiology reporting using a survey tool. We ascertained physician attitudes regarding best practice.

Methods: A national survey was sent by email to a sample of intensive care units throughout UK between March and October 2014. The questionnaire determined current practice in reporting chest X-ray in intensive care units. It also identified differences between 'routine' and emergency and out-of-hours service. Further, it investigated how reports were documented and physician preferences for perceived best practice.

Results: Of 146 intensive care units contacted, 55% completed the survey. Of the sample, radiologists were solely responsible for chest X-ray reporting in 43.7%, intensive care unit clinicians in 33.7% and joint reporting in 25% of intensive care units. The reporting clinician on intensive care unit was a consultant in 67% of the centres. Written reports by radiologists were provided in 71.7% of cases. This was only 54.5% when intensive care unit clinicians reported chest X-rays. For all routine and emergency films, written reports by radiologists occurred in 63.1% of responders. Out-of-hours, 54.9% of clinicians described different reporting practice to normal hours. Regarding perceived best practice, 64.8% of clinicians preferred joint daily reporting, whilst 27% preferred a radiologist's formal report. For emergencies, 55.2% of the survey recipients preferred a joint report.

Conclusion: Based on this cohort of UK intensive care units, at present, there appears to be a lack of a standardised system for image reporting. There are discrepancies in who reports chest X-rays, written documentation and the timing of reports, more so out-of-hours. Clinicians suggest that joint reporting should be the standard.

Keywords: Chest radiograph; X-ray in ICU; image-reporting system in ICUs in UK.

Figures

Figure 1.

How are chest radiographs reported in your unit? The radiologist report only 43.7%, ICM clinician reports 33.7% and in 25% of the units, CXRs are reported from both in daily meeting/joint report; 13.7% of the responders elaborated their choice (as explained in the text) in the descriptive text box ‘other’.

Figure 2.

If reported by ICM clinician, is a report of the radiograph recorded in the patient’s notes? 54.5% say ‘yes’ and 45.4% say ‘no’.

Figure 3.

What do you think should be the best practice in reporting routine films? 9.4% choose ICM clinician report only, 27% radiologist report only and 64.8% daily meeting/joint report.