Skeletal reporting by radiographers: a review of 27800 cases

Aim: To analyse the objective structured examination (OSE) results of 11 cohorts of radiographers (n=278) who completed an accredited postgraduate programme in reporting of appendicular and/or axial skeletal examinations. Content: 100 skeletal examinations were used in each appendicular and/or axial OSE, which included the following appearances: trauma/arthritides/tumour/ infection/metabolic/congenital/miscellaneous conditions/incidental findings and/or normal variants. The prevalence of abnormal examinations approximated 50%. Radiographers (a) noted if an examination was normal or abnormal (b) described the abnormal appearance/s and (c)indicated the most likely pathology/pathologies present. Sensitivity, specificity and total % agreement rates (and 95% confidence intervals) were calculated using all reports (n=27800) for the first 11 cohorts, recruited nationally between 1998 and 2010. Relevance: To review the standards achieved and compare appendicular/axial OSE performance rates. Outcomes: The mean sensitivity, specificity and agreement rates; and 95% confidence intervals, for the 278 radiographers were: appendicular; 95.9% (95.4% – 96.3%); 96.5% (96.0% - 96.9%); and 95.1% (94.7% - 95.4%); axial; 95.6% (95.1% – 96.1%); 94.4% (93.8% - 94.5%); and 94.1% (93.8% - 94.5%) respectively. Although, no significant difference was demon(p=0.41) between the sensitivity rates, the appendicular specificity and agreement rates were both significantly higher (p<0.001). The appendicular rates all improved (1.5% – 4.0%) and this trend increase was significant (r=0.75, 0.63, 0.59; p<0.05). The trend improvement for axial rates was significant for specificity (r=0.82, p