Accepted for/Published in: JMIR Formative Research
Date Submitted: Jan 18, 2023
Date Accepted: Aug 9, 2023
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Diagnostic accuracy and confidence of junior doctors interpreting common fractures on plain radiographs
ABSTRACT
Background:
Interpretation of plain radiographs presents a challenging aspect of the management of basic trauma for junior doctors and is one of the main causes of diagnostic error.
Objective:
This study aimed to evaluate the accuracy and confidence in foundation doctors (n=42) interpreting fractures on plain radiographs.
Methods:
Foundation Year 2 doctors at the start of their A&E rotation were sent an online questionnaire three case studies with a clinically vignette and plain films of radiographs of the hand and wrist. Respondents were asked to state whether there was a fracture present, the location of the fracture, the management of the fracture and how confident out of 10 in their diagnoses.
Results:
Across all three case studies 62% of respondents were able to correctly identify whether there was a fracture present though could only correctly identify the location of the fracture in 48%. A fracture was missed in 12% of cases and the correct management option was selected in 65% of cases. Median and mean diagnostic certainty was low overall. Respondents were less confident in case study 3 where there was no fracture present than identifying one in Case Studies 1 and 2.
Conclusions:
This cohort of Foundation Doctors starting A&E rotations have diagnostic uncertainty in interpreting plain radiographs and there is a tendency towards overdiagnoses of fractures. Close supervision and senior support are required to limit diagnostic errors. Clinical Trial: N/A
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