Skip to main content
SpringerLink
Log in

Accuracy of chest radiograph interpretation by emergency physicians

  • Original Article
  • Published:
Emergency Radiology Aims and scope Submit manuscript

Abstract

Chest radiographs are one of the most complex imaging modalities to interpret. The objective of this study was to assess how accurately emergency physicians interpreted chest radiographs in relation to radiologist reports. Radiological descriptions of chest radiographs from 667 emergency department (ED) patients, aged 14 to 84 years, were retrospectively reviewed. The overall level of agreement and agreement for different categories (congestive heart failure, pneumonia, and other) were assessed in 312 cases for which reports were available. Statistical analysis was done using the chi-square test, and interobserver agreement was calculated. The proportion of agreement between emergency physician and radiologist reports for normal, congestive heart failure, and pneumonia cases was 84.3%, 41.4%, and 41.4%, respectively. Emergency department physicians frequently missed specific radiographic abnormalities, and there was considerable discrepancy between their interpretations and those of trained radiologists. The agreement for some diagnostic categories such as pneumonia and congestive heart failure was low. This study’s findings emphasize the need for improving interpretive skills among ED physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. IAEA/WHO Expert Committee (1972) The medical uses of ionizing radiation and radioisotopes. WHO Technical Report Series 492. WHO, Geneva

    Google Scholar 

  2. Evans KT (1977) The radiologist’s dilemma. Br J Radiol 50:299–301

    PubMed  CAS  Google Scholar 

  3. Clinical audit in diagnostic radiology (Editorial). BMJ 2(6085):479–480

  4. Hall FM (1976) Over utilization of radiological examinations. Radiology 120:443–448

    PubMed  CAS  Google Scholar 

  5. Brunswick JE, IIkhanipour K, Seaberg D et al (1996) Radiographic interpretation in the emergency room. Am J Emerg Med 14:346–348. doi:10.1016/S0735-6757(96)90045-5

    Article  PubMed  CAS  Google Scholar 

  6. Mayhue FE, Rust DD, Aldag JC et al (1989) Accuracy of interpretation of emergency department radiographs: effect of confidence levels. Ann Emerg Med 18:826–830. doi:10.1016/S0196-0644(89)80205-7

    Article  PubMed  CAS  Google Scholar 

  7. Preston CA, Marr JJ, Amaraneni KK et al (1998) Reduction of “callbacks” to the ED due to discrepancies in plain radiograph interpretation. Am J Emerg Med 16:160–162. doi:10.1016/S0735-6757(98)90036-5

    Article  PubMed  CAS  Google Scholar 

  8. Espinosa JA, Nalan TW (2000) Reducing errors made by emergency physicians in interpreting radiographs: longitudinal study. BMJ 320:737–740. doi:10.1136/bmj.320.7237.737

    Article  PubMed  CAS  Google Scholar 

  9. de Lacey GJ (1976) Clinical and economic aspects of the use of X-rays in the accident and emergency department. Proc R Soc Med 69(10):758–759

    PubMed  Google Scholar 

  10. de Lacey GJ, Barker A, Wignall BK, Reddy JR, Harper J (1979) Reasons for requesting radiographs in an accident department. BMJ 1:1595–1597

    Article  PubMed  Google Scholar 

  11. de Lacey GJ, Brabdbrook S (1979) Rationalizing requests for X-ray examinations of acute ankle injuries. BMJ 1:1597–1598

    PubMed  Google Scholar 

  12. Brand DA, Frazier WH, Kohlhepp WC et al (1982) A protocol for selecting patients with injured extremities who need X-rays. N Engl J Med 306:333–339

    PubMed  CAS  Google Scholar 

  13. Raison JCA (1976) Medical and legal aspects of the increasing demand for diagnostic radiology. Proc R Soc Med 69:755–756

    PubMed  CAS  Google Scholar 

  14. Lufkin KC, Smith SW, Matticks CA et al (1998) Radiologist’s review of radiographs interpreted confidently by emergency physicians infrequently leads to changes in patient management. Ann Emerg Med 31:202–207. doi:10.1016/S0196-0644(98)70307-5

    Article  PubMed  CAS  Google Scholar 

  15. Campbell SG, Murray DD, Hawass A et al (2005) Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia. Emerg Radiol 11:242–246. doi:10.1007/s10140-005-0413-4

    Article  PubMed  Google Scholar 

  16. Basulaiman MO, Elzubier AG (1996) X-ray film interpretation by hospital outpatient departments and primary health care center physicians in Dammam, Saudi Arabia. Ann Saudi Med 16:629–632

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia

    Zohair Al aseri

Authors
  1. Zohair Al aseri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zohair Al aseri.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Al aseri, Z. Accuracy of chest radiograph interpretation by emergency physicians. Emerg Radiol 16, 111–114 (2009). https://doi.org/10.1007/s10140-008-0763-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10140-008-0763-9

Keywords

Search

Navigation