A FROC analysis of radiographers performance in identification of distal radial fractures

The aims of the study are to measure the performance of radiographers in detecting the presence of a distal wrist fracture; to determine whether the number of years clinical service impacts on radiographers' performance and progresses further to compare the performance of the radiographer, untrained in reporting, to that of published data on the performance of consultant radiologists. Method: A Free-response Receiver Operating Characteristic (FROC) study was carried out on radiographers to assess their performance. 19 experienced radiographers untrained in image interpretation were shown 30 wrist radiographs, 15 of which had distal radial fractures, 15 did not. The results of the FROC, false positive and false negative data were assessed. Results: The study showed that for AUC values radiographers scored 0.877 (0.087) on average. A trend of increased performance with increased experience was seen amongst the radiographers. Conclusions: Radiographers AUC scores of 0.87 demonstrates that there is potential for radiographers to recognise fractures with some accuracy. There is a trend of increasing performance with increasing experience. When this was compared to published data it is seen that radiologists outscored radiographers and a difference in performance exists between the groups. The radiologists as a whole and the MSK specialists scored a significantly higher than the radiographers with and AUC value of 0.92 (p ≤ 0.05) and 0.96 (p ≤ 0.001) respectively. Radiologists had fewer false positives than radiographers (P ≤ 0.007), however there was no difference was found in the false negatives (p ≤ 0.11). Further image interpretation training of radiographers should now be carried out and this experiment should be repeated.