Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana

Ajediran I Bello,Oluwasegun J Alabi,David N Adjei,Eric K Ofori

doi:10.1186/1471-2342-14-13

Ajediran I Bello, Oluwasegun J Alabi + Show 2 more

Open Access

https://doi.org/10.1186/1471-2342-14-13

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Abstract

BackgroundObjective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists’ PFR interpretation with radiologists are not common in Ghana.MethodForty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0–24, interpreted as follow: 0–8 points (low), 9–16 points (moderate) and 17–24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher’s exact test at α = 0.05.ResultsThe mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist’s interpretation of 24 points (assessment guide). The physiotherapists’ levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069).ConclusionsThe physiotherapists’ skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist’s interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing techniques should be made a priority in physiotherapists’ continuing professional education.

Highlights

Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists
Plain film radiograph (PFR) is one of the common imaging techniques used to confirm the diagnosis of lumbar spondylosis by the radiologists in most clinical settings in Ghana and it remains the mainstay in most developing African countries given its availability and cost effectiveness
The outcome of meta-analysis on the degree of agreement between radiographers and radiologists to determine the radiographers’ accuracy in radiographic reports revealed accuracy level of the radiographers at 92.6% and 97.7% sensitivity and specificity respectively while nurses working at remote units showed their respective accuracy levels at 96% for sensitivity and 87% for specificity [5,6]

Summary

Introduction

Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Plain film radiograph (PFR) is one of the common imaging techniques used to confirm the diagnosis of lumbar spondylosis by the radiologists in most clinical settings in Ghana and it remains the mainstay in most developing African countries given its availability and cost effectiveness. Studies assessing the level of agreement of interpretation of imaging techniques among allied health professionals have been documented in literature. Eventhough the interpretation of PFR remains within the purview of the radiologists, physiotherapists often perform this task either as extended scope of practice or as routine procedure during objective assessment. Correct interpretation of PFR among physiotherapists becomes necessary in order to identify possible contra-indications to some physiotherapy techniques and/or modification of treatment plans to change the natural course of the presented conditions [8]

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