The influence of image interpretation training on the accuracy of abnormality detection and written comments on musculoskeletal radiographs by South African radiographers

Abstract: Purpose: The study was conducted in two government hospitals in Johannesburg, South Africa. The current study investigated the extent to which image interpretation and relevant terminology training would improve the accuracy and descriptive comments provided on musculoskeletal images by South African radiographers. Methods: Nine radiographers interpreted an image bank comprised of 100 skeletal radiographs (50% abnormal) both prior and on completion of a tailored education programme in image interpretation. Radiographer comments were compared to the reference standard diagnosis (single experienced radiologist) and deemed to be correct, partially correct or incorrect. The radiographers were assessed for sensitivity, specificity and accuracy on the image bank pre and post intervention. After testing for normality of the data a Wilcoxon sign rank test was used for non-parametric paired data. Results: Radiographer accuracy (71.04% to 78%), sensitivity (83.73% to 87.28%) and specificity (59.62% to 70.34%) all improved post education programme. The accuracy of radiographer comments demonstrated a statistically significant improvement from to (Wilcoxon value, z=-2.66 p= 0.008). Incorrect radiographer comments also decreased (24.1% to 17.78%, Wilcoxon value, z=-1.96, p= 0.05). Radiographer vocabulary used when describing abnormalities was more in line with the reference standard diagnosis following training. Conclusion: This cohort of radiographers demonstrated increased accuracy when commenting on skeletal radiographs with a significant reduction in incorrect comments. Future work should include