Machine verification radiographs: an opportunity for role extension?

Abstract

Purpose: To improve the efficiency of the established system of verification film assessment by transferring the responsibility from clinicians to therapy radiographers.Methods:Radiographers assessed films before clinicians during a blind pilot study. They recorded their verdict on the films’ accuracy and included comments about any remedial action that they would recommend. Eighty-nine percent agreement with the clinicians was achieved. Following these results, a further study was established. Guidelines for assessment were issued to both radiographers and clinicians. Radiographers were responsible for film assessment for up to five radiotherapy treatment fractions before the films were viewed by clinicians. All grades of radiographer participated in the assessment process. The radiographers’ decisions were compared to the clinicians’ and the clinicians’ decisions were regarded as the gold standard.Results: Five hundred and seventeen films were assessed. The results were analysed quantitatively using the predictivity test which is used to compare a sample to the gold standard. Radiographers demonstrated 97% overall accuracy in comparison to the clinicians. A small questionnaire evaluated whether radiographers and clinicians perceived a benefit to the service delivery as a result of the transfer of responsibility.Conclusions: Radiographers demonstrated sufficient parity with the clinicians to warrant a change to the departmental protocol. There was a significant improvement to the efficiency of the process and consequently the service delivery. Radiographers have continued to assess verification films without clinician supervision.