Now showing 1 - 10 of 20
  • Publication
    Paediatric imaging radiation dose awareness and use of referral guidelines amongst radiology practitioners and radiographers
    Objectives: The objectives are to investigate radiology practitioners' and radiographers' radiation dose awareness and use of referral guidelines for paediatric imaging examinations. Methods: A prospective cross-sectional survey was conducted amongst radiology practitioners and radiographers working at a primary paediatric referral centre in Malta. Part of the survey asked participants to indicate the typical effective dose (ED) for several commonly performed paediatric imaging examinations, answer five true-false statements about radiation protection principles, and specify their use of referral guidelines for paediatric imaging. Results: The return of 112 questionnaires provided a response rate of 66.7 %. Overall, imaging practitioners demonstrated poor awareness of radiation doses associated with several paediatric imaging examinations, with only 20 % providing the correct ED estimate for radiation-based examinations. Nearly all participants had undertaken radiation protection training, but the type and duration of training undertaken varied. When asked about the use of referral guidelines for paediatric imaging, 77.3 % claimed that they 'did not' or 'were not sure' if they made use of them. Conclusions: Poor awareness of radiation doses associated with paediatric imaging examinations and the non-use of referral guidelines may impede imaging practitioners' role in the justification and optimisation of paediatric imaging examinations. Education and training activities to address such shortcomings are recommended.
    Scopus© Citations 23  282
  • Publication
    Exploring the translational challenge for medical applications of ionising radiation and corresponding radiation protection research
    (Springer Science and Business Media LLC, 2022-03-18) ; ; ;
    Background: Medical applications of ionising radiation and associated radiation protection research often encounter long delays and inconsistent implementation when translated into clinical practice. A coordinated effort is needed to analyse the research needs for innovation transfer in radiation-based high-quality healthcare across Europe which can inform the development of an innovation transfer framework tailored for equitable implementation of radiation research at scale. Methods: Between March and September 2021 a Delphi methodology was employed to gain consensus on key translational challenges from a range of professional stakeholders. A total of three Delphi rounds were conducted using a series of electronic surveys comprised of open-ended and closed-type questions. The surveys were disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field. Approximately 350 professionals were invited to participate. Participants’ level of agreement with each generated statement was captured using a 6-point Likert scale. Consensus was defined as median ≥ 4 with ≥ 60% of responses in the upper tertile of the scale. Additionally, the stability of responses across rounds was assessed. Results: In the first Delphi round a multidisciplinary panel of 20 generated 127 unique statements. The second and third Delphi rounds recruited a broader sample of 130 individuals to rate the extent to which they agreed with each statement as a key translational challenge. A total of 60 consensus statements resulted from the iterative Delphi process of which 55 demonstrated good stability. Ten statements were identified as high priority challenges with ≥ 80% of statement ratings either ‘Agree’ or ‘Strongly Agree’. Conclusion: A lack of interoperability between systems, insufficient resources, unsatisfactory education and training, and the need for greater public awareness surrounding the benefits, risks, and applications of ionising radiation were identified as principal translational challenges. These findings will help to inform a tailored innovation transfer framework for medical radiation research.
      128Scopus© Citations 1
  • Publication
    Establishment of CT diagnostic reference levels in Ireland
    (British Institute of Radiology, 2012-10) ; ;
    Objective: To propose Irish CT diagnostic reference levels (DRLs) by collecting radiation doses for the most commonly performed CT examinations. Methods: A pilot study investigated the most frequent CT examinations. 40 CT sites were then asked to complete a survey booklet to allow the recording of CT parameters for each of 9 CT examinations during a 12-week period. Dose data [CT volume index (CTDIvol) and dose–length product (DLP)] on a minimum of 10 average-sized patients in each category were recorded to calculate a mean site CTDIvol and DLP value. The rounded 75th percentile was used to calculate a DRL for each site and the country by compiling all results. Results are compared with international DRL data. Results: Data were collected for 3305 patients. 30 sites responded with data for 34 scanners, representing 54% of the national total. All equipment had multislice capability (2–128 slices). DRLs are proposed using CTDIvol (mGy) and DLP (mGy cm) for CT head (66/58 and 940, respectively), sinuses (16 and 210, respectively), cervical spine (19 and 420, respectively), thorax (9/11 and 390, respectively), high resolution CT (7 and 280, respectively), CT pulmonary angiography (13 and 430, respectively), multiphase abdomen (13 and 1120, respectively), routine abdomen/pelvis (12 and 600, respectively) and trunk examinations (10/12 and 850, respectively). These values are lower than current DRLs and comparable to other international studies. Wide variations in mean doses are noted across sites. Conclusions: Baseline figures for Irish CT DRLs are provided on the most frequently performed CT examinations. The variations in dose between CT departments as well as between identical scanners suggest a large potential for optimisation of examinations.
    Scopus© Citations 129  479
  • Publication
    A questionnaire survey reviewing radiologists and clinical specialist radiographers knowledge of CT exposure parameters
    Objective: To review knowledge of computed tomography (CT) parameters and their influence on patient dose and image quality amongst a cohort of clinical specialist radiographers (CSRs) and examining radiologists. Methods:A questionnaire survey was devised and distributed to a cohort of 65 examining radiologists attending the American Board of Radiology exam in Kentucky in November 2011. The questionnaire was later distributed by post to a matching cohort of Irish CT CSRs. Each questionnaire contained 40 questions concerning CT parameters and their influence on both patient dose and image quality. Results: A response rate of 22 % (radiologists) and 32 % (CSRs) was achieved. No difference in mean scores was detected between either group (27.8 ± 4 vs 28.1 ± 4, P = 0.87) although large ranges were noted (18–36). Considerable variations in understanding of CT parameters was identified, especially regarding operation of automatic exposure control and the influence of kilovoltage and tube current on patient dose and image quality. Radiologists were unaware of recommended diagnostic reference levels. Both cohorts were concerned regarding CT doses in their departments. Conclusions: CT parameters were well understood by both groups. However, a number of deficiencies were noted which may have a considerable impact on patient doses and limit the potential for optimisation in clinical practice.
    Scopus© Citations 34  348
  • Publication
    Research ethics systems, processes, and awareness across Europe: Radiography research ethics standards for Europe (RRESFE)
    Introduction: The Radiography Research Ethics Standards for Europe (RRESFE) project aims to provide a cross-sectional snapshot of current research ethics systems, processes, and awareness of such, across Europe together with identifying the associated challenges, education, and training needs. Methods: A cross-sectional online survey targeting radiography researchers in Europe was conducted. Data collection took place between April 26 and July 12, 2021, using a snowball sampling approach. Descriptive and analytical statistics were used to identify trends in research ethics frameworks across Europe. Results: 285 responses were received across 33 European and 23 non-European countries. Most (n = 221; 95%) European respondents stated ethics approval is required before commencing research in their country. Requirements around research ethics approval and awareness of such requirements varied by European region (X2 (2, n = 129) = 7.234, p = 0.013) and were found to differ depending on the type of research participant and study design. Additionally, European respondents reported ethics approval is a national requirement more often than their non-European counterparts (X2 (1, n = 282) = 4.316, p = 0.049). Requirements for ethics approval were also associated with the undergraduate programme duration (2-year vs. 3-year vs. 3.5 year vs. 4-year vs. multiple programme durations; X2 (4, n = 231) = 10.075, p = 0.016) and availability of postgraduate training (postgraduate training available vs. postgraduate training not available; X2 (1, n = 231) = 15.448, p = <0.001) within respondents’ country. Conclusion: Respondents from countries with longer programme durations/availability of multiple programme lengths, availability of postgraduate training, and establishment of European Qualifications Framework Level 6 were generally associated with less uncertainty and more comprehensive research ethics requirements. Implications for practice: Results are informative of the current status of research ethics within evidence-based radiography.
    Scopus© Citations 4  77
  • Publication
    The risk of burnout in academic radiographers during the COVID-19 pandemic
    Introduction: The COVID-19 pandemic created major challenges across society, healthcare provision and also for those delivering healthcare education programmes. Clinical placements were disrupted and, in many incidences cancelled. Higher education institutions were required to move completely to online delivery methods with little notice. This created significant additional workload, stress and the need to learn new skills at a time of great uncertainty. This study explored the risks of burnout in academic radiographers during the first 12 months of the pandemic. Methods: A survey was circulated using SurveyMonkey™ via personal, national and international networks, including the European Federation of Radiographer Societies (EFRS), to reach as many academic radiographers as possible. Disengagement and exhaustion were measured using the Oldenburg burnout inventory. Descriptive statistics and a one-way ANOVA were used to analyse the quantitative data using STATA V16 (Statacorp, TA). Results: 533 academic radiographers responded to the survey from 43 different countries. Mean disengagement was in the medium range and exhaustion was high for the total dataset. In a subset of countries with 10 or more responses, there was significant variation between countries, with the UK having highest mean exhaustion score and the UK, Ireland and France sharing the highest mean disengagement score. In the total dataset, 86% agreed workload had increased during the pandemic and 35% had considered leaving academia in the last year. Conclusion: These data demonstrate the stark reality of the impact of the COVID-19 pandemic on academic radiographers’ workload, wellbeing, and intention to leave their roles. Implications for practice: COVID-19 has had a significant impact on academic radiographers and this study highlights the urgent need for remedial measures to better support academic radiographers in order to ensure a sufficient, and sustainable workforce.
    Scopus© Citations 3  52
  • Publication
    Education and training in radiation protection in Europe: results from the EURAMED Rocc-n-Roll project survey
    Purpose: To analyse the existing radiation protection (RP) education and training (E&T) capabilities in the European Union and identify associated needs, problems and challenges. Method: An online survey was disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field of radiological research. The survey sections analyse the RP E&T during undergraduate, residency/internship and continuous professional development; RP E&T problems and legal implementation. Differences were analysed by European geographic regions, profession, years of professional experience and main area of practice/research. Results: The majority of the 550 respondents indicated that RP topics are part of undergraduate curricula in all courses for their profession and country (55%); however, hands-on practical training is not included according to 30% of the respondents. The lack of E&T, practical aspects in current E&T, and mandatory continuing E&T were considered the major problems. The legal requirement that obtained higher implementation score was the inclusion of the practical aspects of medical radiological procedures on education (86%), and lower score was obtained for the inclusion of RP E&T on medical and dental school curriculums (61%). Conclusions: A heterogeneity in RP E&T during undergraduate, residency/internship and continuous professional development is evident across Europe. Differences were noted per area of practice/research, profession, and European geographic region. A large variation in RP E&T problem rating was also obtained.
    Scopus© Citations 1  40
  • Publication
    The impact of COVID-19 upon student radiographers and clinical training
    Introduction: To investigate student clinical placement concerns and opinions, during the initial COVID-19 pandemic outbreak and to inform educational institution support planning. Methods: Between mid-June to mid-July 2020, educational institutions from 12 countries were invited to participate in an online survey designed to gain student radiographer opinion from a wide geographical spread and countries with varying levels of COVID-19 cases. Results: 1277 respondents participated, of these 592 had completed clinical placements during January to June 2020. Accommodation and cohabiting risks were identified as challenging, as was isolation from family, travel to clinical placements, and to a lesser extent childcare. Students stated they had been affected by the feeling of isolation and concerns about the virus whilst on placement. Overall 35.4% of all respondents were ‘Not at all worried’ about being a radiographer, however, 64.6% expressed varying levels of concern and individual domestic or health situations significantly impacted responses (p ≤ 0.05). Year 4 students and recent graduates were significantly more likely to be ‘Not worried at all’ compared to Year 2 and 3 students (p ≤ 0.05). The need for improved communication regarding clinical placements scheduling was identified as almost 50% of students on clinical placements between January to June 2020 identified the completion of assessments as challenging. Furthermore, only 66% of respondents with COVID-19 imaging experience stated being confident with personal protective equipment (PPE) use. Conclusion: Student radiographers identified key challenges which require consideration to ensure appropriate measures are in place to support their ongoing needs. Importantly PPE training is required before placement regardless of prior COVID-19 imaging experience. Implications for practice: As the next academic year commences, the study findings identify important matters to be considered by education institutions with responsibility for Radiography training and as students commence clinical placements during the on-going global COVID-19 pandemic.
    Scopus© Citations 39  166
  • Publication
    The impact of COVID-19 upon student radiographers and clinical training in Latin America
    Introduction: This study aimed to identify the impact of the COVID-19 pandemic upon radiography education across Latin American countries. Methods: A survey containing 20 questions was circulated to radiography students, across 13 universities in 11 countries of Latin America using Google Forms. The survey contained open and closed questions. Answers were analysed with descriptive statistics and the methodology of interpretative phenomenological analysis for the open answers. Results: Of the 1310 responses only 23.9% (n = 313) of students reported attending clinical placements and from this cohort only 8.9% (n = 28) became infected with COVID-19. In response to how the pandemic had impacted upon the students’ academic progression, the most common topic in the open answers was “Concerns about the lack of clinical training”, mentioned by 629 students. Students in middle and later years of their radiography education expressed the greatest concern about future clinical placements. Almost all radiography students (95.2%/n = 1247) indicated that their main concerns regarding COVID-19 infection while undertaking clinical placements was in relation to the risk of infecting their families as most students stated they cohabited with relatives (86.6%/n = 1134). Conclusion: Compared to European findings co-habitation trends increased anxiety related to infection and impacted their mental health. Students expressed concern about the quality of education they were receiving during the pandemic and access to resources to facilitate on-line learning was inadequate. Socio-economic and internet connectivity factors specific to Latin America were identified and these issues need to be addressed if on-line education is required in the future. Implications for practice: The COVID-19 pandemic has impacted Latin America and this study identifies the implications for radiography students related to their clinical and academic training and highlights factors which require consideration to support radiography students as the pandemic continues.
    Scopus© Citations 6  74
  • Publication
    Variability of Breast Density Classification Between US and UK Radiologists
    Purpose: To assess whether subjective breast density categorization remains the most useful way to categorize mammographic breast density and whether variations exist across geographic regions with differing national legislation. Methods: Breast radiologists from two countries (UK, USA) were voluntarily recruited to review sets of anonymized mammographic images (n = 180) and additional repeated images (n = 70), totaling 250 images, to subjectively rate breast density according to the Breast Imaging Reporting and Data system (BI-RADS) categorization. Images were reviewed using standardized viewing conditions and Ziltron software. Inter-rater reliability was analyzed using the Kappa test. Results: The US radiologists (n = 25) judged fewer images as being “mostly fatty” than UK radiologists (n = 24), leading a greater number of images classified in the higher BI-RADS categories, particularly in BI-RADS 3. Overall agreement for all data sets was k = 0.654 indicating substantial agreement between the two cohorts. When the data were split into BI-RADS categories, the level of agreement varied from fair to substantial. Conclusion: Variations in how radiologists from the USA and UK classify breast density was established, especially when the data were divided into breast density categories. This variation supports the need for a reliable breast density assessment method to enhance the individualized supplemental screening pathways for dense breasts. The use of two-scale categorization method demonstrated improved agreement.
    Scopus© Citations 12  389