Digital platform for improving non-radiologists' and radiologists' interpretation of chest radiographs for suspected tuberculosis - a method for supporting task-shifting in developing countries

Namakula S Semakula-Katende, Savvas Andronikou, Susan Lucas

Research output: Contribution to journalArticle (Academic Journal)peer-review

11 Citations (Scopus)

Abstract

BACKGROUND: Shifting X-ray interpretation to non-radiologists can help to address radiologist shortages in developing countries.

OBJECTIVE: To determine the change in accuracy of non-radiologists and radiologists for the radiographic diagnosis of paediatric tuberculosis after a short skill-development course.

MATERIALS AND METHODS: Participants interpreted 15 paediatric chest radiographs before and after a 30-minute course using three possible responses: (1) diagnostic for tuberculosis, (2) abnormal but inconclusive for diagnosis of tuberculosis and (3) normal. We compared proportions of correct diagnoses, sensitivity, and specificity, before and after the course.

RESULTS: We included 256 participants comprising 229 non-radiologists (134 radiographers, 32 paediatricians, 39 Médecins Sans Frontières clinicians and 24 physicians including paediatricians) and 27 radiologists. Mean change proportions of correct diagnosis ranged from -27% to 53% for individuals and 9% to 20% for groups. All groups showed a statistically significant improvement. Mean change in diagnostic sensitivity ranged from -38% to 100% for individuals and from 16% to 41% for groups. All groups showed a statistically significant improvement. Mean change in specificity ranged from -57% to 57% for individuals and from -15% to -4% for groups. The decrease was statistically significant for physicians, paediatricians and radiographers.

CONCLUSION: The course resulted in increased correct diagnoses and improved sensitivity at the expense of specificity.

Original languageEnglish
Pages (from-to)1384-91
Number of pages8
JournalPediatric Radiology
Volume46
Issue number10
DOIs
Publication statusPublished - 30 Sep 2016

Keywords

  • Child
  • Developing Countries
  • Female
  • Humans
  • Male
  • Radiography, Thoracic
  • Sensitivity and Specificity
  • South Africa
  • Tuberculosis, Pulmonary
  • Journal Article

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