The Accuracy of Radiographers Preliminary Image Evaluations of Axial Radiographs: a Prospective Longitudinal Study at Al-Hussein Hospital, Iraq

Introduction: Modern emergency departments are under increasing pressure that can only be alleviated by new approaches to meeting demand. One strategy could be the adoption of radiographer preliminary image evaluations (PIEs), which would significantly reduce the time it takes emergency teams to receive critical imagery results. The aim of this study was to examine the accuracy of radiographers’ interpretations of axial radiographs and the impact a short training program had on their image interpretation skills. Methods: Forty-one radiographers volunteered to participate in the study. From 15 January to 15 April 2023 radiographers produced PIEs for 24 axial radiographs which were compared to the radiology reports for the same images. The accuracy each of the radiographers’ PIEs were categorized as true positive, true negative, false positive and false negative, with numerical scores to enable mean accuracies to be calculated. The radiographers’ accuracy was then reassessed on the same images after they had completed a two-week training program on axial skeletal radiograph interpretation. Results: The study reported that demonstrated that most (TP) radiographer PIEs (M 66, SD = 1.24) were about facial bone fracture. Moreover, this study demonstrated that most (FN/TP) radiographer PIEs (M = 3.83, SD = 1.69) were that cases about inflammatory disease of the axial spine, such as ankylosing spondylitis. In contrast, the most common cases misinterpreted were about cervical spine disorders such as diffuse idiopathic skeletal hyperostosis (DISH) (M = 2.49, SD = 1.36). Years of experience in radiography showed a positive but not statistically significant influence on accuracy. Additionally, post training mean accuracy significantly improved. Conclusion: This study found radiographers provided quite accurate PIEs for facial bone fractures when compared to the full radiology reports of the same images. The findings also highlighted specific pathologies that were frequently misinterpreted. A two-week training program was found to be effective at improving radiographers’ ability to correctly identify and describe abnormalities present in axial radiographs.