Radiographers and trainee radiologists reporting accident radiographs: A comparative plain film-reading performance study

Abstract

To compare the diagnostic accuracy and clinical validity of reporting radiographers with that of trainee radiologists whom they have recently joined in reporting emergency room radiographs at Bispebjerg University Hospital. Plain radiographs of the appendicular skeleton from 1000 consecutive emergency room patients were included in the study: 500 primarily reported by radiographers and 500 by trainee radiologists. The final reporting was subsequently undertaken by a consultant radiologist in consensus with an orthopaedic surgeon. Two observers classified reports as either true positive/negative or false positive/negative based on the final report, which was considered the reference standard. To evaluate the severity of incorrect primary reports, errors were graded into three categories concerning clinical impact and erroneous reports graded as the most severe category were subsequently analysed. Mann-Whitney and Chi-squared tests were used to compare differences and associations between radiographers versus trainee radiologists regarding film reporting. The sensitivity for correct diagnosis was 99% for reporting radiographers and 94% for trainee radiologists. The specificity was found to be 97% for reporting radiographers and 99% for trainee radiologists. Radiographers missed significantly fewer fractures (n = 2) than trainee radiologists (n = 14; p = 0.006) but had a higher, but not significant, degree of over-calling. No significant difference was found between groups regarding clinical impact of incorrect reporting. Trained radiographers report accident radiographs of the extremities with high accuracy and constitute a qualified resource to help meet increasing workload and demands in quality standards.