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Imaging platform gets grant to teach frontline staff how to recognise COVID-19

04/06/2020
This article is more than three years old.
A chest X-ray

A team of radiologists and radiographers at Oxford University Hospitals has secured a grant to customise a teaching platform to educate frontline NHS staff to diagnose COVID-19 using chest X-rays and CT scans.

Dr Sarim Ather, a Specialist Registrar in Clinical Radiology, has been working alongside Professor Fergus Gleeson, Dr Rachel Benamore, Dr Andrew Murchinson and Julie-Ann Moreland to develop the Report and Image Quality Control (RAIQC) training platform. This interactive web-based platform hosts a large database of diagnostic quality images and other educational materials that allow clinical staff to assess in real time their medical image reporting skills.

Now they have won funding from the pharmaceutical company Pfizer to develop additional material for the platform, to help frontline clinicians to recognise COVID-19 on patients' chest X-rays and CT scans, as well as other life-threatening conditions with which the COVID-19 images can be confused.

The Oxford-based Interactive Pharma Solutions, who have been carrying out the technical development of the RAIQC platform, provided pro-bono support to help create the COVID-19 module.

The materials on the platform will include an image database consisting of a large number of anonymised images alongside associated clinical data, all complying with strict data protection rules, as well as a range of teaching materials such as slideshows, notes and videos.

Many of the currently published images of COVID-19 are of low quality, which limits their educational value. In addition, the number of reference cases in any one location is limited to a few still images and does not capture the spectrum of findings seen in COVID-19.

"A shortage of radiologists across the NHS means that the acute interpretation of medical imaging is often done by frontline clinicians such as junior doctors and emergency department staff. This platform will go a long way to ensuring that the image interpretation meets a suitable standard, through high-quality training and quality assurance," Sarim said.

The platform has a modular format that allows cases to be grouped according to subject and difficulty. Modules can be individually tailored for different professional groups, training grades and sub-specialties including junior doctors, registrars and consultants as well as nurses and radiographers.

"There's a growing awareness among healthcare professionals of the importance of medical imaging - chest X-rays, ultrasound or CT scans - in diagnosing COVID-19, assessing how severe the disease is in individual patients and identifying other underlying conditions," Sarim explained.

"Imaging also plays a key role in diagnosing alternative causes for a patient's symptoms, such as pneumonia, heart failure or pulmonary embolism, all of which are potentially life-threatening conditions that require a different treatment.

"To get the most from the images and to diagnose as many cases correctly as possible, it's important that as many medical staff as possible are trained in recognising COVID-19 related imaging findings," he said.

As it is a web-based tool, RAIQC is accessible from anywhere in the world. As well as being an aid to training, it also acts as a reference library against which individuals can compare live clinical cases.

"We are able to provide users with feedback on their diagnostic accuracy on real-life cases. This should give them confidence in their abilities, as well as highlighting areas of image interpretation that may be further improved," Sarim explained.

The prototype platform was initially developed with funding from Health Education England to train Oxford Medical School students and trainee radiologists in the Thames Valley and London regions. The OUH Radiology team is also working with Public Health England to train their medical officers how to recognise tuberculosis on chest X-rays, and with Prostate Cancer UK to develop a training platform for prostate cancer MRI imaging.

Beyond the current pandemic, the platform will have the ability to host educational material related to other diagnoses such as cancer, stroke and trauma. It will be able to act as a standardised quality assessment tool, reducing variation in practice and improving patient care, as well as providing benchmarking at a national level to help address quality control and standards.

The tool will also allow a wider workforce to be trained, enabling upskilling of the NHS workforce and improving the diagnosis of time critical diseases such as lung cancer.