Evidence map›Paper›PMID 36351688›Full record

Trial reportThorax2023

Impact of radiographer immediate reporting of X-rays of the chest from general practice on the lung cancer pathway (radioX): a randomised controlled trial.

Nick Woznitza, Bhagabati Ghimire, Anand Devaraj, Sam M Janes, Keith Piper, Susan Rowe, Angshu Bhowmik, Natasha Hayes, Daniel Togher, Nikita Arumalla and 10 more

Open access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Thorax, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 14 institutions in 4 countries.

Nick WoznitzaSchool of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK nicholas.woznitza@nhs.net.ORCID 0000-0001-9598-189X
Bhagabati GhimireCollege of Health, Medicine and Life Sciences, Brunel University London, Uxbridge, UK.
Anand DevarajRadiology, Royal Brompton Hospital, London, UK.
Sam M JanesLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID 0000-0002-6634-5939
Keith PiperSchool of Allied and Public Health Professions, Canterbury Christ Church University, Canterbury, UK.
Susan RoweRadiology Department, Homerton University Hospital NHS Foundation Trust, London, UK.
Angshu BhowmikRespiratory Medicine, Homerton University Hospital NHS Foundation Trust, London, UK.ORCID 0000-0003-4227-3085
Natasha HayesRadiology Department, Homerton University Hospital NHS Foundation Trust, London, UK.
Daniel TogherRadiology Department, Homerton University Hospital NHS Foundation Trust, London, UK.
Nikita ArumallaRespiratory Medicine, Homerton University Hospital NHS Foundation Trust, London, UK.
Erik SkyllbergRespiratory Medicine, Barts Health NHS Trust, London, UK.
Iain T H Au-YongRadiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Susan GearyRadiology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-In-Ashfield, UK.
Bindu GeorgeRadiology, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Sarah SheardRadiology, Imperial College Healthcare NHS Trust, London, UK.
Stephen EllisRadiology, Barts Health NHS Trust, London, UK.
Zoheb ShahWolfson Institute of Preventive Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK.
Sue MaughnNHS England and NHS Improvement London, London, UK.
Stephen W DuffyWolfson Institute of Preventive Medicine, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK.
David BaldwinSchool of Medicine, University of Nottingham, Nottingham, UK.ORCID 0000-0001-8410-7160
Homerton University Hospital NHS Foundation Trust · GBBarts Health NHS Trust · GBCanterbury Christ Church University · GBNottingham University Hospitals NHS Trust · GBQueen Mary University of London · GBBrunel University of London · GBEpsom and St Helier University Hospitals NHS Trust · GBGuy's and St Thomas' NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBNHS EnglandRoyal Brompton Hospital · GBSherwood Forest Hospitals NHS Foundation Trust · GBUniversity College London · GBUniversity of Nottingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The National Optimal Lung Cancer Pathway recommends rapid progression from abnormal chest X-rays (CXRs) to CT. The impact of the more rapid reporting on the whole pathway is unknown. The aim of this study was to determine the impact of immediate reporting of CXRs requested by primary care by radiographers on the time to diagnosis of lung cancer.

methodPeople referred for CXR from primary care to a single acute district general hospital in London attended sessions that were prerandomised to either immediate radiographer (IR) reporting or standard radiographer (SR) reporting within 24 hours. CXRs were subsequently reported by radiologists blind to the radiographer reports to test the reliability of the radiographer report. Radiographer and local radiologist discordant cases were reviewed by thoracic radiologists, blinded to reporter.

results8682 CXRs were performed between 21 June 2017 and 4 August 2018, 4096 (47.2%) for IR and 4586 (52.8%) for SR. Lung cancer was diagnosed in 49, with 27 (55.1%) for IR. The median time from CXR to diagnosis of lung cancer for IR was 32 days (IQR 19, 70) compared with 63 days (IQR 29, 78) for SR (p=0.03).8258 CXRs (95.1%) were reported by both radiographers and local radiologists. In the 1361 (16.5%) with discordance, the reviewing thoracic radiologists were equally likely to agree with local radiologist and radiographer reports.

conclusionsImmediate reporting of CXRs from primary care reduces time to diagnosis of lung cancer by half, likely due to rapid progress to CT. Radiographer reports are comparable to local radiologist reports for accuracy.

trial registrationInternational Standard Randomised Controlled Trial Number ISRCTN21818068. Registered on 20 June 2017.

Indexed as

General PracticeLung NeoplasmsHumansRadiographyReproducibility of ResultsX-RaysImaging/CT MRI etcLung Cancer

Identifiers

PMID36351688
PMCPMC10447363
OpenAlexW4308571575

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.