Free Health Dissertations - This Statement Is Behind The Reasoning For The Legal Responsibility Of X-ray
This statement is behind the reasoning for the legal responsibility of X-Ray interpretation. It would be clearly inappropriate to ask a radiographer for his opinion on a film and then make him responsible for any subsequent management decisions that were based on that opinion. Some commentators have criticised the red dot system for its clear lack of apportionment of responsibility to the radiographer. We would suggest that this shows a fundamental lack of appreciation of the problems involved. The radiographers are trained to be experts in taking X-Ray films. They are not, and do not pretend to be, trained in the biological sciences and their applications to pathology and the human disease processes. It is quite appropriate to ask their opinion in an area of their expertise (the interpretation of the X-Ray film), but it is quite inappropriate to ask them to make clinical management decisions. For this reason, all questions of liability always rest on the clinician in charge of the patient, and it is only right that this should be the case.
It is fair to say that some of the views reviewed so far have been old school necessarily so, as the intention was to document the evolution of the red dot system. It is equally fair to state that we have only considered the use of the system in the A&E Department. The truth of the matter is that in the recent past, the status of the radiographer has increased in professionalism both within their own speciality and within the NHS as a whole. Many of the comments made in some of the earlier papers quoted will therefore, now seem rather outmoded and not consistent with the modern experience of working in the NHS.
To redress the balance we shall look at an article from Papworth hospital by Sonnex et al; (2001) . The authors describe a system currently in use at an acute cardiothoracic unit. Radiographers were asked to assess all the X-Rays taken over a six month trial period. Those that were assessed as showing acute changes had a red dot placed on them to denote an abnormality and these were then assessed by a radiologist. The success or failure rate was then measured against this standard.
The figures are rather different from the figures quoted in the studies that looked at skeletal X-Ray in A&E Departments. The reason for this is almost certainly that a chest X-Ray is notoriously hard to interpret, even more so when it is a post operative X-Ray. The results were reported as a total sample of 8614, of which 464 (5%) had red dots applied. Over 100 of these were considered inappropriate. 38 X-Rays which were abnormal were not picked up. It would appear that radiographers tend to err on the side of caution when reviewing an abnormal chest X-Ray, even more so when previous comparative films were not available for comparison. This particular study had a high false positive rate.
