Jennifer van den Heuvel1, Amanda Punch1, Layal Aweidah1, Robert Meertens2, Sarah Lewis3. 1. Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia. 2. Faculty of Medicine, St Luke's Campus, University of Exeter, Exeter, UK. 3. Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia. Electronic address: sarah.lewis@sydney.edu.au.
Abstract
PURPOSE: Obesity is increasing in prevalence globally, with increased demands placed on radiology departments to image obese patients to assist with diagnosis and management. The aim of this study was to determine perceived best practice techniques currently used in clinical practice for projectional radiography of the abdomen for obese patients with the aim to help elucidate areas for future research and education needs in this field. EXPERIMENTAL DESIGN: A two round e-Delphi study was undertaken to establish a consensus within a reference group of expert Australian clinical educator diagnostic radiographers (CEDRs). Initially, a conceptual map of issues regarding imaging obese patients was undertaken by analysing interview transcripts of 12 CEDRs. This informed an online questionnaire design used in Delphi rounds 1 and 2. A consensus threshold was set <75% "agreement/disagreement", with 15 and 14 CEDRs participating in rounds 1 and 2, respectively. RESULTS: Seven of the 11 statements reach consensus after round 2. Consensus on using a combination of higher peak kilovoltage (kVp) and milliampere-seconds (mAs) to increase radiation exposure increased source-to-image distance and tighter collimation was achieved. There was no consensus regarding patient positioning practices or patient communication strategies. The expert group reported the importance of personal confidence and treating patients as individuals when applying techniques. CONCLUSION: Diversity of experts' opinions and current practice may be due to the variations in obese patients' size and presentation. Therefore, there is a need for extensive empirical evidence to underpin practice and education resources for radiographers when imaging obese patients.
PURPOSE: Obesity is increasing in prevalence globally, with increased demands placed on radiology departments to image obesepatients to assist with diagnosis and management. The aim of this study was to determine perceived best practice techniques currently used in clinical practice for projectional radiography of the abdomen for obesepatients with the aim to help elucidate areas for future research and education needs in this field. EXPERIMENTAL DESIGN: A two round e-Delphi study was undertaken to establish a consensus within a reference group of expert Australian clinical educator diagnostic radiographers (CEDRs). Initially, a conceptual map of issues regarding imaging obesepatients was undertaken by analysing interview transcripts of 12 CEDRs. This informed an online questionnaire design used in Delphi rounds 1 and 2. A consensus threshold was set <75% "agreement/disagreement", with 15 and 14 CEDRs participating in rounds 1 and 2, respectively. RESULTS: Seven of the 11 statements reach consensus after round 2. Consensus on using a combination of higher peak kilovoltage (kVp) and milliampere-seconds (mAs) to increase radiation exposure increased source-to-image distance and tighter collimation was achieved. There was no consensus regarding patient positioning practices or patient communication strategies. The expert group reported the importance of personal confidence and treating patients as individuals when applying techniques. CONCLUSION: Diversity of experts' opinions and current practice may be due to the variations in obesepatients' size and presentation. Therefore, there is a need for extensive empirical evidence to underpin practice and education resources for radiographers when imaging obesepatients.