Assessing and comparing chest radiograph interpretation in the Department of Internal Medicine at the University of the Witwatersrand medical school, according to seniority

R G Dreyer; C M van der Merwe; M A Nicolaou; G A Richards

doi:10.7196/AJTCCM.2023.v29i1.265

Assessing and comparing chest radiograph interpretation in the Department of Internal Medicine at the University of the Witwatersrand medical school, according to seniority

Afr J Thorac Crit Care Med. 2023 Apr 11;29(1):10.7196/AJTCCM.2023.v29i1.265. doi: 10.7196/AJTCCM.2023.v29i1.265. eCollection 2023.

Authors

R G Dreyer¹, C M van der Merwe², M A Nicolaou³, G A Richards⁴

Affiliations

¹ Department of Radiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
² WESP Radiology, George, South Africa.
³ Van Rensburg and Partners and Honorary Lecturer, Department of Radiology, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
⁴ Emeritus Professor of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Abstract

Background: Chest radiographs are a common diagnostic tool in the internal medicine department, and correct interpretation is imperative for adequate patient management.

Objectives: To determine the diagnostic accuracy of common pathologies in South Africa that are evident on chest radiographs, and to determine whether there are discrepancies according to different levels of qualification of doctors rotating through the internal medicine department, and which factors contribute to an accurate diagnosis.

Methods: Fifteen chest radiographs with common pathologies were given to all doctors rotating through the Department of Internal Medicine at Chris Hani Baragwanath Academic Hospital, and they were asked to interpret them. Information pertaining to their experience, designation and confidence in chest radiograph interpretation was also obtained.

Results: Diagnostic accuracy according to years of experience was as follows: 0 - 5 years 27.0%, 6 - 10 years 43.0%, and >10 years 47.9%. For different designations, accuracy was as follows: consultants 50.5%, registrars 40.9%, medical officers 36.4%, and interns 19.5%. Participants who were confident obtained a mean score of 39.4% and those who were not, a mean score of 31.6%.

Conclusion: Chest radiographs are readily accessible and used daily in clinical practice in numerous facilities. An accurate diagnosis is important to provide quality healthcare. Improved training in interpretation for all, but especially for junior doctors, should be a priority in our training facilities.

Study synopsis: What the study adds. This study tested the diagnostic accuracy with regard to common pathologies present on chest X ray by doctors rotating through, or stationed at the internal medicine department at an academic hospital. Implications of the findings. Interpretation of chest X-rays was generally poor but the study did find that this improves with experience and confidence in diagnostic ability. These findings are significant in that they indicate a need to implement improved teaching programs in radiological interpretation, especially at an undergraduate level.

Keywords: Chest X-ray; competency; diagnosis; education; medical; radiography; radiology; training.

Copyright © 2023, Dreyer et al. Copyright of published material remains in the Authors’ name. This allows authors to use their work for their own non-commercial purposes without seeking permission from the Publisher, subject to properly acknowledging the Journal as the original place of publication.