Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study

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dc.contributor.authorCreeden, A.en
dc.contributor.authorMcFadden, S.en
dc.contributor.authorRainey, Clareen
dc.contributor.authorCampbell, S.en
dc.contributor.authorAther, S.en
dc.contributor.authorHajilou, A.en
dc.contributor.authorBond, R.en
dc.contributor.authorMcAllister, P.en
dc.contributor.authorWoznitza, N.en
dc.date.accessioned2025-01-30T12:30:20Z
dc.date.available2025-01-30T12:30:20Z
dc.date.issued2024-11-14en
dc.description.abstractIntroduction: Feeding via a misplaced nasogastric tube (NGT) is a common but preventable cause of patient harm. The aim of this study was to determine the accuracy of diagnostic radiographers’ assessment of NGT position on chest radiographs (CXRs) and safe-to-feed decisions. Methods: A multi-case, multi-reader study was conducted using an online image interpretation platform. A test bank consisting of 15 CXRs with an NGT in-situ was created. Diagnostic radiographers without formal qualifications in CXR interpretation were recruited via two international conferences. Participants placed an electronic marker on each CXR to identify the location of the tip of the NGT and indicated whether or not they believed that the tube was safely positioned. Results: 68 participants were recruited. Each participant reviewed 15 CXRs, providing 1020 unique image assessments. 76 % (n = 778/1020) image assessments were completely correct (both the position of the tip of the NGT was accurately located and an appropriate safe-to-use decision made). In 5 % (n = 56/1020) of cases the NGT was safely positioned and the location of the tip was correctly identified by the participant but the tube was erroneously determined to be unsafe for feeding. In a further 6 % (n = 59/1020) of cases the participant correctly located the tip of an NGT in an unsafe position but indicated that the tube was safe to use. Participants failed to correctly identify the tip of the NGT in the remaining 12 % (n = 127/1020) of cases. Conclusion: Consistent with previous studies involving other staff groups, diagnostic radiographers without formal qualification in CXR interpretation can assess NGT positioning on radiographs with moderate accuracy but require further training, including strategies for the identification of poorly-visualised tube tips, to achieve the 100 % accuracy necessary for this safety-critical task. Implications for practice: A bespoke training programme which includes teaching on image quality, tube tip identification and assessment of tube positioning using the National Patient Safety Agency (NPSA) four criteria, should be delivered prior to implementation of a radiographer-led NGT CXR evaluation service.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationCreeden, A., McFadden, S., Rainey, C., Campbell, S., Ather, S., Hajilou, A., Bond, R., McAllister, P. and Woznitza, N. (2024) 'Accuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader study', Radiography, 31(1), pp.83-88. https://doi.org/10.1016/j.radi.2024.10.022en
dc.identifier.doihttps://doi.org/10.1016/j.radi.2024.10.022en
dc.identifier.endpage88en
dc.identifier.issn1078-8174en
dc.identifier.issued1en
dc.identifier.journaltitleRadiographyen
dc.identifier.startpage83en
dc.identifier.urihttps://hdl.handle.net/10468/16938
dc.identifier.volume31en
dc.language.isoenen
dc.publisherElsevier Ltd.en
dc.relation.ispartofRadiographyen
dc.rights© 2024, the Authors. Published by Elsevier Ltd on behalf of The College of Radiographers. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectNasogastric tubeen
dc.subjectRadiographen
dc.subjectChest x-rayen
dc.subjectRadiographeren
dc.subjectReader performanceen
dc.subjectAccuracyen
dc.titleAccuracy of interpretation of nasogastric tube position on chest radiographs by diagnostic radiographers: A multi-case, multi-reader studyen
dc.typeArticle (peer-reviewed)en
oaire.citation.issue1en
oaire.citation.volume31en
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