Table 2.

Data extraction.

Source	Diagnostic test/indication	Studies/readers	Method	Info – first review	Additional info – subsequent review	Relevant findings	JBI (n/9)
Maizlin & Somers, 2019 14	XR and US/ ++	250/Multiple	Radiologists characterised the effect of additional info on imaging interp.	Original imaging request	Clinical info from imaging techs	Added info deemed important in 173 cases (69.2%), not critically important in 77 cases (30.8%). Significantly more useful for radiographic examinations compared to ultrasound.	3
Lacson et al, 2018 15	MRI L‐spine and CT AP/ ++	315/4	Same studies reviewed twice by the same readers	Original imaging request	Provider notes (medical Hx, physical examination, progress, phone notes)	Potential impact of incomplete or inaccurate order indications on examination interpretation in 135/315 cases (43%). IOA = moderate to strong agreement ‐ discordance (K = 0.89), incompleteness (K = 0.72).	6
Doshi et al, 2017 30	CT Abdo + Pelvis/ Abdo pain	100/2	Same studies reviewed twice (6 weeks apart) by the same readers	Original imaging request	Patient questionnaire – current Sx, previous surgery, localisation of pain	R1: Cause of pain identified in 7 cases post‐questionnaire (37% increase). Confidence 4.8 ± 0.6. R2: Cause of pain identified in 4 cases post‐questionnaire (16% increase). Confidence 4.9 ± 0.3	4
Qureishi et al, 2014 31	CT Temporal Bones/ Various	100/2	2 samples evaluated by 2 assessors, pre‐ and post‐intervention against departmental guideline	Request and report (pre‐intervention)	Request and report (post‐intervention)	Post‐intervention ‐ percentage of reports indicating a Dx or excluding an important complication increased (52 to 94%).	7
Sarwar et al, 2014 16	XR Foot/ Subtle foot Fx	226/7	Same studies reviewed twice (6 months apart) by the same readers	Text Hx	Graphic indicating site of pain	Accuracy (79 to 82%). Sensitivity ‐ Fx detection (67 to 73%). Degree of confidence (8.1 to 8.4). Interp time (53 to 50 sec). Specificity (93% to 94%).	6
Cohen & Ellett, 2012 32	XR Paed Abdo/ NGT position	188/1	Reports reviewed for quality – with and without addition of clinical question	Original imaging request	CQ: ‘newly placed NGT for evaluation of tube tip position’	CQ answered in 95% of cases when specifically asked (134/141 studies). When the request failed to pose clinical question, pertinent info (tube location) was mentioned in 31% (n = 4) of cases.	3
Aubin et al, 2010 33	MRI C‐Spine/ VA path	79/6	Same studies reviewed twice by the same readers	Patient Sx	CQ	Pathology described (0%) in any cases where CQ was not posed. Pathology described in 100% of cases where CQ was posed.	6
Mullins et al, 2002 17	CT Head and MRI Brain/ Stroke	561 CT, 409 MRI/ ++	CT and MRI report results compared with the final discharge Dx	Original imaging request	Radiology report and discharge Dx	Accuracy of stroke detection on CT higher when pertinent clinical info in the request (59% vs 47%). No statistically different outcomes in accuracy of stroke detection on MRI vs CT(94% vs 95%).	4
Leslie, Jones & Goddard, 2000 18	CT/ ++	50 cases, 100 reports/3	Same studies reviewed twice by 2 of 3 same readers. Each CT examination double reported	Name, age, sex of patient	Original imaging request	19/100 reports changed after clinical info known. More accurate reports in 67% (n = 10) of cases. Less accurate reports in 3 of 5 cases where the clinical info in the request was incorrect. IOA = 60% agreement. Weak agreement between readers’ change in opinion and added clinical info (K = 0.42)	4
Berbaum et al, 1994 20	Paed XR Chest and Abdo/ ++	64/9	Same studies reviewed twice by the same readers (4 months apart), 3 reads per study	Patient age and sex	i) Clinical Hx provided before study viewed, ii) clinical Hx provided after study viewed	Appropriate Hx given before viewing study, accuracy was greater than with the same Hx provided after viewing study (.745 vs .693, P < 0.01) or without history (.745 vs 0675, P < 0.01). No increase in detection accuracy with hx provided after inspection than without Hx (.693 vs .675, P > 0.05).	5
Babcook, Norman & Coblentz, 1993 21	Paed XR Chest/ Bronchiolitis	50/4	Equivocal studies only read twice by the same readers	Consistent clinical Hx (+ve XR/+ve Hx and ‐ve XR/‐ve Hx)	Inconsistent clinical Hx (+ve XR/‐ve Hx and ‐ve XR/ +ve Hx)	Significantly more features identified on the equivocal normal XRs when assigned a + ve clinical Hx. No significant difference in the number of features identified on the equivocal bronchiolitis XRs, regardless of the clinical Hx	3
Rickett, Finlay & Jagger, 1992 22	XR Extremity (Trauma)/ Subtle Fx or dislocation	50/7	Same studies reviewed twice by the same readers	Simple description of ROI (e.g. injured hand)	Complete anatomical localisation of symptoms	Diagnostic accuracy was improved from 253 (72.3%) to 281 (80.3%) when localisation clues provided (highly significant). Fx Dx improved by 60%. The accuracy of all but one reader improved with localisation clues. All readers had fewer false negatives.	6
Song et al, 1992 23	XR/ Various	109/8	Same studies reviewed twice (1 month apart) by the same readers	Without clinical Hx	Original imaging request and patient chart	The mean areas under the ROC curves without and with clinical history were 0.75+/‐0.12 and 0.84+/‐0.08, respectively (stat sig). Knowledge of clinical history improved diagnostic accuracy for readers of various experience levels	4
Cooperstein et al, 1990 24	XR Chest/ Various	247/5	Same studies reviewed twice by the same readers. Reference standard created by group of 20 radiologists	Without clinical Hx	With clinical history (as detailed by request requirements)	No significant differences in readers’ performance between interpretations made with or without history. Average additional time of 6.5sec needed when interpreting with clinical history.	5
Berbaum et al, 1988 25	XR Extremity/ Subtle Fx	40/7	Same studies reviewed twice (4 months apart) by the same readers.	No location‐specific clinical hx	Location‐specific clinical hx	Interpretations with location‐specific hx were significantly more accurate than without.	6
Berbaum et al, 1988 26	XR Chest/ Nodules/lesions	44/6	Same studies reviewed twice (++ months apart) by the same readers.	Patient age and sex	Tentative diagnosis	Tentative diagnosis improves detection of more complex lesions, but not of simple nodules.	4
Berbaum et al, 1986 8	XR Chest/ ++	43/6	Same studies reviewed 3 times (++ months apart) by the same readers.	Patient age and sex	Tentative diagnosis	Provision of tentative Dx resulted in significantly greater accuracy than without.	2
McNeil et al, 1983 27	CT Head/ ++	89/4	Same studies reviewed twice (2 weeks apart) by the same readers	Patient age and sex	All clinical info available at the time the study was requested	The inclusion of clinical hx resulted in 3.3% increase in accuracy of interpretation.	6
Doubilet & Herman, 1981 28	XR Chest/ Various	7 cases, 8 abnorm/ ++	Same studies reviewed twice by ++ readers.	Unrelated clinical Hx	Clinical hx suggestive of abnormality	True‐positive rate increased from 38% (non‐suggestive hx) to 84% (suggestive hx), a statistically significant increase. All false positives (n = 9) were suggested by the clinical hx.	4
von Kummer et al, 1996 19	CT Head/ Cerebral ischaemic infarction	45/6	Same studies reviewed twice (30mins apart) by the same readers	Knowledge studies were from stroke pop'n, blinded to side of Sx	Knowledge of side of hemiparesis based on clinical signs and symptoms	No significant difference in blinded and unblinded results. The blinded observer may misinterpret signs of infarction in up to 31% of scans. IO A = varied: Overall – (49% to 71%). Between radiologists and reference radiologist – (69% to 93%)	5
Schreiber, 1963 29	XR Chest/ ++	100/11	Same studies read twice (4 months apart) by the same readers	Without clinical Hx	Clinical hx	Interpretations done with clinical hx showed significantly more correct readings.	4

Abbreviations: Abdo = abdomen; abnorm = abnormalities; CQ = clinical question; CT = computed tomography; CT AP = computed tomography of abdomen and pelvis; Dx = diagnosis; exam/s = examination/s; Fx = fracture/s; Hx = history; info = information; interp = interpretation; IOA = interobserver agreement; JBI/9 = score (out of 9) from Joanna Briggs’ Institute study appraisal tool; MRI = magnetic resonance imaging; NGT = nasogastric tube; paed = paediatric; path = pathology; pop'n = population R = reader; ref standard = reference standard; ROI = region of interest; sec = seconds; stat sig = statistically significant; Sx = symptoms; tech/s = technologist/s; US = ultrasound; VA = vertebral artery; XR/s = radiograph/s; ‐ve = negative; +ve = positive; ++ = multiple