Abstract
This thesis describes the design and trial of a study tool to investigate the performance of sonographer reporting in New Zealand, and explores its potential to optimise healthcare delivery by reducing report turnaround times and alleviating radiologist workload. The significance and context for this work derives from variation in reporting models around the world and the implication to the New Zealand health system. Evidence from the United Kingdom and other countries suggests that autonomous sonographer reporting is both accurate and efficient. However, in New Zealand, the sonographer–radiologist working model dominates, where sonographers perform ultrasound examinations while radiologists are responsible for final reports. It is not clear whether New Zealand should continue with its current model, or transition towards the United Kingdom model. Concordance between sonographer preliminary reports and radiologist final reports was evaluated, with the radiologist report serving as the reference standard. A pilot study involving Emergency Department patients at Christchurch Hospital showed that 80.2% of the reports were concordant based on a primary review by imaging experts. Of the discordant cases, only 3.12% were considered clinically significant after secondary review. Challenges arose in comparing complex reports, which differed in structure, terminology, and intent. Multicentre studies evaluating reports for different patient cohorts will be required to further validate and refine these findings, as well as explore their applicability in diverse clinical environments. This thesis contributes to the growing body of evidence supporting the extension of sonographer roles and emphasises the need for standardised reporting practices, ongoing education, and regular audits to ensure ultrasound report accuracy and consistency across healthcare settings in New Zealand.