Interpretative differences in chest X-ray reading between doctors of Hospital General de Occidente

Abstract

Introduction. The interpretation of a chest X-ray is an essential skill in clinical practice as a tool to evaluate and manage a broad spectrum of diseases. Despite the widespread use of chest X-rays, the clinician's ability to interpret and diagnose findings may not be reliable. The study aim was to determine the inter-observer agreement of cardiopulmonary findings in chest X-rays among doctors working at Hospital de General de Occidente, Santa Rosa, Copán, Honduras. Methods. A total of 123 participants, including last-year students in internship, physicians in social service, and general physicians, were asked to read, independently, a standardized series of 15 chest X-rays coded, with posteroanterior projection. Data of each participant was correlated with the expert evaluation of the radiologist and were analyzed using the Kappa coefficient. Results. Only 89 (72.3%) recognized a normal cardiac silhouette, 117 (95.1%) agreed with the radiologist on the X-ray abnormality. Pleural effusion and infiltrates were the most frequently detected radiological findings. Doctors in Social Service obtained the highest values ​​of agreement with the radiologist. Conclusion. With regard to abnormal findings, moderate concordance was obtained, with a kappa index of 0.45, which is similar to the concordance achieved between clinicians and radiologists in other international studies. In medical schools, the curriculum in radiology should be strengthened, with an emphasis on chest radiography.