A Cross-sectional Study on Chest Radiograph Interpretation by Medical Interns and First Year Residents
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Date
2020-12
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Addis Abeba University
Abstract
ABSTRACT
Background: Accurate interpretation of chest radiographs (CXR) is essential as clinical decisions
depend on readings.
AIM: To assess the ability of medical interns and first year residents of internal medicine,
emergency medicine and surgery to interpret conventional chest radiographs.
MATERIALS AND METHODS: Ten conventional chest radiographs were selected that were good
radiological examples of emergency and common medical conditions.
Most were conditions that a first line medical professional should be expected to recognize by the
end of their training. One normal radiograph was included. The radiographs were shown to 49
medical interns and 31 first year residents of emergency medicine, surgery and internal medicine
who were asked to describe their findings and write their most likely diagnosis, certainty about
their diagnosis.
The response for each radiograph was scored on a scale of 0 to 2.
RESULTS: The median score achieved was 8 of 20 (range 1-14). An increased level of training
was not associated with overall score (Interns 8.1, EM 1
st
year residents 8.1, IM 1
year residents
8.2 surgery 1
st
year residents p=0.279). The overall degree of certainty was low. On no
radiograph were more than 35% of participants definite about their answer. The overall certainty
of the participants was significantly correlated with the overall score (r=.283 p<0.011). Seventy
percent of the participants thought they were good at interpreting chest radiographs. The
department of the residents has significant correlation with diagnosis of the pneumothorax with p
< 0.01. Left lower 1lobe collapse, lung metastasis, right upper lobe TB, left pneumothorax were
correctly diagnosed 2.4%, 8.5%, 22% and 52.4% of the time, respectively.
CONCLUSION: First line physicians do not perform well at interpreting simple chest radiographs.
We identified only the level of certainty has significant association with successful chest
radiograph interpretation. Interestingly, significant number of the interns and even many residents
training in different department showed good interest in radiology as a career, which may help
provide training for them and improve their chest radiograph reading skill.
st
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Keywords
Chest Radiograph