An evaluation of radiographer performed and interpreted barium swallows and meals

To determine whether radiographers are able to perform and interpret barium swallows and meals (BSM) to an acceptable standard.

A retrospective audit was performed of all radiographer-managed BSMs over a 4-year period in an acute hospital. Descriptive statistics were used to analyse patient demographics, radiation doses, referral sources, and imaging findings. Radiographer reports were compared with radiologist reports assumed to be the reference standard, and correlated with patient outcomes via electronic record searches and case note scrutiny. Reporting accuracy, sensitivity, and specificity were calculated.

Three radiographers performed a total of 962 BSMs in the 4-year audit period, including a varied and complex case-mix. Only 13 (0.01%) cases were abandoned due to technical reasons, with all other examinations of diagnostic quality. Although radiation dose levels were initially variable, following the installation of modern fluoroscopy equipment they remained comfortably within the national and regional diagnostic reference levels. Consultant radiologists verified the majority of the radiographer reports, with the most experienced radiographer independently reporting 230 cases (24%). Follow-up of patient outcome was possible in 935 cases. The overall radiographer accuracy based on the 935 cases was 98.9%, sensitivity 98%, and specificity 98.9%.

Appropriately trained radiographers are able to perform and interpret BSM examinations to a very high standard.