Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations

Woznitza, N., Piper, K., Bothamley, G. and Burke, S. (2014) Do you see what I see? Clinical review of discordant chest x-ray consultant radiologist and radiographer interpretations. In: UK Radiology Congress, 9 - 11 June 2014, Manchester, UK.

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20% observer variation is reported in the literature for chest x-ray (CXR) interpretation. However, not all errors are clinically significant. We examined the clinical significance of discordant radiographer chest x-ray reports.

100 CXRs were randomly selected from a consecutive series of 1,000 interpreted by a trained reporting radiographer in clinical practice. Three consultant radiologists independently assessed 50 CXRs for agreement with the radiographer report, with 50% overlap to assess inter-radiologist variation. Abnormal cases were categorised as clinically significant/insignificant. Clinical review of discordant cases provided the definitive diagnosis.

99 cases were available for review (40 abnormal cases, 30 significant). Seven CXRs were discordant.

The reporting radiographer over-reported and under-reported two x-rays; one of each was also an error from a radiologist. Mediastinal lymphadenopathy was missed by both the radiographer and one radiologist; granulomas were see on lymph node biopsy. In one case, the radiographer correctly diagnosed heart failure rather than COPD.

Chest x-ray reports occasionally disagree; interpretation of the mediastinum is known to be problematic.. Disagreement between a reporting radiographer and consultant radiologists is similar to inter-radiologist disagreement.

Item Type: Conference or Workshop Item (Poster)
Divisions: pre Nov-2014 > Faculty of Health and Social Care > Allied Health Professions
Depositing User: Nick Woznitza
Date Deposited: 16 Sep 2014 13:44
Last Modified: 11 Dec 2014 14:12

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Last edited: 29/06/2016 12:23:00