Defining Adequate Clinical Information in Chest X‐Ray Requests: A Delphi Study

INTRODUCTION: Chest x-rays (CXRs) are the most common radiographic examinations performed. Given their prevalence and the potential for associated stochastic effects, it is vital these examinations are justified through high-quality requests. In the absence of published Australian guidelines defining adequate clinical information in CXR requests, this study aimed to develop a criteria standard reflecting radiologists' specific clinical information requirements to support optimal reporting. METHODS: Following ethical approval (HREC/2025/QMS/122483), a three-round electronic-Delphi study of six consultant radiologists was conducted using Microsoft Forms. Round 1 invited open-ended responses to create a list of what panellists required in CXR requests. Items from this list were rationalised into common categories for subsequent rounds. For Round 2, a dichotomous scale helped narrow the list of items using a 50% agreement threshold. Round 3 had panellists rank the remaining items from most useful to least useful. The final criteria standard consisted of the five most essential items. RESULTS: The panel provided 54 items in Round 1. These were organised into 17 categories to avoid redundancy and support consensus building. In Round 2, six items passed the 50% agreement threshold. Consensus was gained in Round 3, and the five highest ranked items formed the criteria standard for information required in CXR requests. CONCLUSION: This study established a consultant radiologist-derived standard for the clinical information required in CXR requests. Adoption of these criteria may improve request quality and support more informed radiology reporting, with future research evaluating the impact of targeted education on request and report quality.