Improving diagnostic quality of X-ray images through a radiographer comment model: An exploratory survey of radiologists' perspectives

Introduction Radiologists' expert perspectives on image quality are influenced by their ability to perceive complete diagnostic information. However, acquisition and submission of images for reporting is subject to radiographers' discretion, which typically prioritises technical features. Evidence suggests image interpretation may shift radiographers' focus from technical to diagnostic image quality. This study therefore investigates radiologists' perspectives on the diagnostic quality of X-ray images following implementation of a Radiographer Comment and Alert (RCA) model. Methods Radiologists employed at hospitals with RCA systems, who worked in these hospitals before and after implementation and knowingly reported X-rays with comments, were invited to participate. The study setting was an online exploratory survey using simple convenience sampling. The survey collected demographic, Likert-scale, and free response answers examining radiologists' perspectives on X-ray image quality before and after RCA implementation. Descriptive analysis was performed for quantitative data, and free responses were coded and categorised. Results Fourteen eligible radiologists were identified, and seven completed the survey. Participants reported increased satisfaction with image quality, increasing from 71.4% prior to RCA, to 100% following implementation. Most participants (71.4%) observed a difference in image quality following RCA, with 57.1% reporting quality improvements. The majority (85.7%) of participants reported receiving more useful supplementary images demonstrating pathology. All participants supported the professional capabilities for radiographers to alert urgent findings and desired expansion of RCA to additional sites. Radiologists attributed quality improvements to increased care, engagement with clinical histories, learning culture, radiologist feedback, and improved technique selection. Conclusion Data provides foundational evidence that radiologists perceive an improvement in diagnostic quality of X-ray images following RCA implementation. Implications for practice Radiographer image interpretation models may enhance ease and efficiency of radiologist reporting through improved image quality.