OAR@UM Collection:

Radiographers’ opinion and practice in relation to the justification of radiological medical exposures in Malta

Mon, 01 Jan 2024 00:00:00 GMT

Title: Radiographers’ opinion and practice in relation to the justification of radiological medical exposures in Malta Abstract: Purpose: To investigate local radiographers’ opinion and practice relating to any role they have in the justification of radiological procedures within the public health service in Malta. Methodology: A prospective, cross-sectional quantitative research design was adopted. A previously published questionnaire was adapted with permission to the local scenario and was distributed amongst a sample of radiographers working at a general hospital and healthcare centres in Malta. Results: Out of 117 distributed questionnaires, fifty-seven were completed, resulting in a response rate of 48.7%. Radiographers identified five main principles of justification: ensuring benefits outweigh risks, verifying adequate clinical information, assessing the impact on patient management and care, considering alternative modalities, and properly timing examinations to avoid unnecessary or duplicate scans. A significant majority (91.22%) felt they played an important role in the justification process, integrating it into their daily workflow. However, only 61.4% reported using referral criteria or guidelines. Key challenges included insufficient clinical information and the influence of traditional medical dominance. Although 88% had received prior training in justification, most expressed a desire for further education through CPD courses or lectures to improve their skills. Conclusions: Justification is key in radiation protection, with local radiographers generally recognizing their crucial role. Given the challenges faced, most participants desired additional training to enhance confidence and their autonomy to better fulfil this role. Implications for practice: While most radiographers were aware of their important role in justification, there seems to be a lack of consensus about the shared roles and responsibilities of the referrer and practitioner, as well as the use of referral guidelines. Respective stakeholders should therefore aim to provide continuing professional development courses and/or training to further enhance practices and procedures relating to the justification of radiological procedures so as to enhance efficacy of services, patient safety and outcomes. Description: B.Sc. (Hons)(Melit.)

Radiography student’s knowledge and attitudes towards Alzheimer’s disease and related dementias (ADRD)

Mon, 01 Jan 2024 00:00:00 GMT

Title: Radiography student’s knowledge and attitudes towards Alzheimer’s disease and related dementias (ADRD) Abstract: Purpose: The aim of this study was to assess the knowledge that Maltese Radiography students have regarding Alzheimer’s Disease and Related Dementias (ADRD) and investigate potential attitudes that these students may have towards individuals with dementia. Objectives: The study investigated the knowledge of current Radiography students enrolled in their second-, third- and fourth-year of the course regarding ADRD and potential attitudes students may have towards individuals with dementia. The study also explored whether demographics, such as the year of study, previous ADRD training and family member or patient exposure during clinical placements had an impact on the knowledge or attitudes portrayed. Methodology: This study utilised a prospective approach to evaluate the knowledge and attitudes of Radiography students. To achieve this, a non-experimental and cross-sectional design was adopted. The target population for this study consisted of all second-, third- and fourth-year students currently undertaking the Bachelor of Science (Honours) in Radiography at a University in Malta throughout the academic year 2023/24. The questionnaire was distributed by the university’s Academic Registrar’s office through the university’s electronic messaging system with a link to the questionnaire used. Results: From a total of 25 students, 24 questionnaires were returned. Results indicated that Maltese Radiography students have adequate ADRD knowledge, achieving a mean Alzheimer’s Disease Knowledge Scale score of 20.4 (68%). Students also portrayed a positive attitude towards individuals with dementia, scoring a mean Dementia Attitudes Scale score of 83.58. Moreover, course year, training, household exposure and previous clinical exposure to ADRD were found to influence the knowledge and attitudes portrayed by participants. Conclusion: Based on the data obtained and the conclusions drawn, recommendations were suggested for future research and educational institutions. Although adequate, knowledge and attitudes of radiography students may be further improved through additional dementia care training. Description: B.Sc. (Hons)(Melit.)

Accuracy and feasibility of using artificial intelligence software to segment the organs at risk for patients treated with radiotherapy for head and neck cancer

Mon, 01 Jan 2024 00:00:00 GMT

Title: Accuracy and feasibility of using artificial intelligence software to segment the organs at risk for patients treated with radiotherapy for head and neck cancer Abstract: Purpose: This study aimed to evaluate the accuracy of an in-house developed artificial intelligence (AI) based software in contouring organs at risk (OARs) namely the parotids, submandibular glands, mandible, brainstem, optic nerves, and optic chiasm. Methodology: Ten computed tomography images (CT) were identified from an online open-source dataset developed by the University of Ljubljana. The accuracy of the AI software in relation to an expert gold standard contour was assessed by calculating the volume ratio, Clinical Index (CI), and 95% Hausdorff distance (95%HD). A high DSC (closer to 1) and low 95%HD (closer to 0mm) indicate higher accuracy. Two experienced radiographers were asked to rate the AI-generated contours using a Likert scale ranging from 1 (unusable) to 5 (clinically acceptable). In addition, the radiographers were also asked to provide feedback on the use of the system through the use of a questionnaire. Results: The mean DSC score for all structures was 0.56±0.26 and was highest for the brainstem (0.81±0.08) and lowest for the right optic nerve (0.18±0.14). The mean 95%HD was 12.07mm±16.68 and was highest for the mandible (57.24mm ± 3.15) and lowest for the optic chiasm (4.54mm±3.39). Compared to the gold standard segmentations, the mean AI segmented volume was smaller for all OARs except for the left parotid and brainstem. However, the difference was only significant for the left parotid and optic nerves (P<0.05). The mean rating provided by the radiographers was 2.47±0.68. The highest rating was provided for the right parotid (3.10±0.21) and the lowest for the optic chiasm (1.36±0.48). Under-contouring for some OARs, particularly the mandible and unusable optic chiasm contours were key issues highlighted by the radiographers. Conclusion: The AI software has potential for clinical use however further refinement is required for some OARs, particularly the mandible, optic nerves, and optic chiasm. Description: B.Sc. (Hons)(Melit.)

Evaluating referral criteria for local imaging guidelines of the cervical spine in trauma radiography

Mon, 01 Jan 2024 00:00:00 GMT

Title: Evaluating referral criteria for local imaging guidelines of the cervical spine in trauma radiography Abstract: Purpose: A Delphi study was conducted in order to develop a local guideline for cervical spine imaging in trauma cases, for use in the emergency department of a state general hospital in Malta. Objectives: The study compared criteria in established cervical spine imaging guidelines for trauma, with findings in the reviewed literature in order to develop a local guideline. This was reviewed through the use of a Delphi methodology. Methodology: The study utilised self-constructed, anonymous, online Delphi questionnaires to achieve a minimal requirement of an 80% consensus. Nine experts participated in the study, including 3 physicians, 3 radiographers, and 3 radiologists with varying years of experience in the trauma setting. In the first round, a 5-point Likert scale gathered general views. This was later modified to a more focused 3-point Likert scale, in the second round. The participants were also given the option of including their comments for specific questions. Results: In the first round, four criteria reached 100% consensus, and were thus excluded from the second Delphi round. Meanwhile, in the second round, three more criteria achieved 80% consensus. Despite not reaching consensus, the remaining four criteria were still included in the suggested guideline under a separate heading. Conclusion: The Delphi study gave rise to a proposed local guideline for cervical spine trauma cases, incorporating criteria from both NEXUS and CCR guidelines. The suggested guideline is unique to the local clinical scenario, while also taking in consideration the mechanism of trauma of the patients. Description: B.Sc. (Hons)(Melit.)