Radiographers' performance in chest X-ray interpretation: The Nigerian experience

Objective: To assess the performance of Nigerian radiographers in interpretation of plain chest radiographs and to assess whether age, years since qualification and sector of practice are associated with performance. Methods: A test set of 50 radiographs containing 23 cases with no pathology (normal) and 27 abnormal cases (cardiopulmonary conditions) independently confirmed by 3 radiologists were presented to 51 radiographers in a random order. Readers independently evaluated radiographs for absence or presence of disease and stated the location, radiographic features and diagnosis. Readers self-reported their age, years since qualification and sector of practice. Receiver operating characteristic was used to assess the performance. Mann-Whitney U test was used to assess whether age, years since qualification and sector of practice were associated with performance. Results: Mean location sensitivity was 88.9 [95% confidence interval (CI), 0.787-0.980]. Mean sensitivity and specificity were 76.9 (95% CI, 0.658-0.864) and 79.8 (95% CI, 0.658-0.864), respectively. Age was not associated with performance (p=0.07). Number of years qualified as radiographer (p=0.005) and private practice (p=0.004) were positively associated with performance. Conclusion: Nigerian radiographers can correctly report chest radiographs to a reasonable standard, and performance is associated with number of years since qualification and the sector of practice. Advances in knowledge: There are less than 300 radiologists serving a Nigerian population of about 170 million; therefore, X-ray interpretation by radiographers deserves consideration. Nigerian radiographers have potential to interpret chest X-ray in the clinical setting, and this may significantly improve radiology service delivery in this region.