Development of a checklist for interpretation of chest X-rays

The researchers used a three-phased exploratory sequential mixed methodology to develop a quantitative checklist. In phase one, the results from the literature review were jointly displayed with recommendations from another qualitative study to form meta-inferences. The domains were operationalised and jointly displayed to build items for a preliminary qualitative checklist for chest interpretation. The researcher developed a draft survey tool. Phase two comprised a review of the preliminary checklist and survey tool. The checklist was further developed and validated by a panel of nine experts using the Delphi technique. In phase three, the developed quantitative standardisation, communication, image evaluation, and pattern recognition (SCIEPR) checklist, was sent for field testing. A biostatistician validated the survey tool before use. 103 participants (40 radiographers and 63 medical doctors) in district hospitals were recruited to use the SCIEPR checklist in clinical settings. A cross-sectional study design was applied. Purposive sampling was used, and interested participants signed consent. Participants were given four weeks per hospital to use the checklist at least three times before taking part in the three-phase Likert scale survey. The survey validated the checklist's relevance, clarity, and duration to complete. The data from open and closed questions were analysed. Quantitative results were grouped and are presented as percentages in bar graphs. Qualitative data were analysed using content analysis. Codes were grouped into categories, and themes were identified to support the quantitative results.

本研究采用三阶段探索性顺序混合研究方法（three-phased exploratory sequential mixed methodology）开发一款量化检查表。第一阶段，研究人员将文献综述结果与另一项质性研究的建议相结合以形成元推论（meta-inferences）；对研究领域进行操作化处理后，整合形成用于胸部影像判读的初步质性检查表，并起草了调研工具草案。第二阶段为初步检查表与调研工具草案的评审环节，由9名专家组成的评审小组采用德尔菲法（Delphi technique）对检查表进行进一步开发与验证。第三阶段中，已开发完成的量化标准化、沟通、影像评估与模式识别（SCIEPR）检查表被用于现场测试。使用前，一名生物统计学家对调研工具进行了效度验证。研究招募了地区医院的103名参与者（其中放射技师40名、临床医师63名），要求其在临床场景中使用SCIEPR检查表。本研究采用横断面研究设计（cross-sectional study design），通过目的抽样（purposive sampling）招募受试者，所有感兴趣的参与者均签署了知情同意书。每位参与医院的参与者需耗时四周，至少使用该检查表三次后，方可参与三阶段李克特量表调研。该调研用于验证检查表的相关性、清晰度与完成时长。研究对开放式与封闭式问题收集的数据分别进行分析：量化结果经分组后以百分比形式在柱状图中呈现；质性数据则采用内容分析法（content analysis）进行编码、归类并提炼主题，以辅助量化结果的论证。