Radiographer-led vetting and protocolling of medical imaging referrals: A systematic literature review of contributions to value-based imaging care
Authors: Clarke, J.A., Docherty, S., Akudjedu, T.N.
Journal: Journal of Medical Imaging and Radiation Sciences
Publication Date: 01/12/2026
Volume: 57
Issue: 6
eISSN: 1876-7982
ISSN: 1939-8654
DOI: 10.1016/j.jmir.2026.102608
Abstract:Introduction Radiographer-led vetting and protocolling of diagnostic imaging referrals are increasingly used to support service capacity, patient safety and value-based imaging amid rising demand and radiologist workforce pressures. This review evaluated their contribution to value-based imaging relative to other vetting models. Methods A mixed-methods systematic review was conducted in accordance with Joanna Briggs' Institute guidance and PRISMA 2020. MEDLINE Complete, CINAHL, APA PsycINFO and Academic Search Ultimate were searched via EBSCOhost, supplemented by reference and manual searching. Eligible studies examined radiographer-led vetting and/or protocolling. Two reviewers independently undertook data extraction and quality appraisal using QATSDD. Findings were integrated using convergent segregated synthesis. Results Following duplicate removal, 1189 records were identified and 15 met the inclusion criteria. Studies evaluated radiographer-led, radiologist-led and AI-supported models. Evidence for radiographer-led vetting accuracy was inconsistent and context-dependent, with reported equivalence to radiologists frequently based on guideline concordance rather than validated clinical outcomes. Definitions and reference standards for appropriateness varied substantially. Radiographer-led protocolling demonstrated consistent involvement in patient-specific safety and examination optimisation, although outcomes were predominantly process-based. Poor referral quality, inconsistent guideline adherence and organisational pressures limited effectiveness across models. Evidence of reductions in low-value imaging, waiting times or downstream clinical delays was limited. Discussion Radiographer-led vetting and protocolling may improve imaging appropriateness and safety, but effectiveness appears dependent on governance, referral quality, education and organisational infrastructure. Conclusion Radiographer-led vetting is a promising component of value-based imaging when supported by structured education, clear delegation, multidisciplinary collaboration and robust governance. Plain language summary Medical imaging referrals need to be checked to make sure patients receive the most suitable scan. This study reviewed research on radiographers who help assess referrals and plan imaging examinations. This study found that radiographers can support safe and appropriate imaging, although success depends on training, teamwork, and clear processes. This matters because good referral review can improve patient safety and help imaging services use resources more effectively.
Source: Scopus
Radiographer-led vetting and protocolling of medical imaging referrals: A systematic literature review of contributions to value-based imaging care.
Authors: Clarke, J.A., Docherty, S., Akudjedu, T.N.
Journal: J Med Imaging Radiat Sci
Publication Date: 22/09/2026
Volume: 57
Issue: 6
Pages: 102608
eISSN: 1876-7982
DOI: 10.1016/j.jmir.2026.102608
Abstract:INTRODUCTION: Radiographer-led vetting and protocolling of diagnostic imaging referrals are increasingly used to support service capacity, patient safety and value-based imaging amid rising demand and radiologist workforce pressures. This review evaluated their contribution to value-based imaging relative to other vetting models. METHODS: A mixed-methods systematic review was conducted in accordance with Joanna Briggs' Institute guidance and PRISMA 2020. MEDLINE Complete, CINAHL, APA PsycINFO and Academic Search Ultimate were searched via EBSCOhost, supplemented by reference and manual searching. Eligible studies examined radiographer-led vetting and/or protocolling. Two reviewers independently undertook data extraction and quality appraisal using QATSDD. Findings were integrated using convergent segregated synthesis. RESULTS: Following duplicate removal, 1189 records were identified and 15 met the inclusion criteria. Studies evaluated radiographer-led, radiologist-led and AI-supported models. Evidence for radiographer-led vetting accuracy was inconsistent and context-dependent, with reported equivalence to radiologists frequently based on guideline concordance rather than validated clinical outcomes. Definitions and reference standards for appropriateness varied substantially. Radiographer-led protocolling demonstrated consistent involvement in patient-specific safety and examination optimisation, although outcomes were predominantly process-based. Poor referral quality, inconsistent guideline adherence and organisational pressures limited effectiveness across models. Evidence of reductions in low-value imaging, waiting times or downstream clinical delays was limited. DISCUSSION: Radiographer-led vetting and protocolling may improve imaging appropriateness and safety, but effectiveness appears dependent on governance, referral quality, education and organisational infrastructure. CONCLUSION: Radiographer-led vetting is a promising component of value-based imaging when supported by structured education, clear delegation, multidisciplinary collaboration and robust governance. PLAIN LANGUAGE SUMMARY: Medical imaging referrals need to be checked to make sure patients receive the most suitable scan. This study reviewed research on radiographers who help assess referrals and plan imaging examinations. This study found that radiographers can support safe and appropriate imaging, although success depends on training, teamwork, and clear processes. This matters because good referral review can improve patient safety and help imaging services use resources more effectively.
Source: PubMed