[Do we agree on the technical quality of our chest X-rays? A radiologist, an expert in X-ray diagnosis, and a family doctor try to find out]. / 'Estamos de acuerdo con la calidad técnica de nuestras radiografías de tórax? Un radiólogo, un técnico especialista en radiodiagnóstico y un médico de familia intentan corroborarlo.

OBJECTIVE: To appraise the degree of concordance in the interpretation of the technical quality of chest x-rays at a health centre between an expert in x-ray diagnosis, a family doctor, and a radiologist. DESIGN: Transversal study. Setting. Primary care. Cartuja Health Centre, Granada, Spain. PARTICIPANTS: Patients at the Cartuja Health Centre who had a simple chest x-ray in 2002. 150 studies were chosen by simple randomised sampling. Two were rejected because they dealt with a repeat examination of the same patient and seven because they did not reach minimum quality. The final sample was 141 x-rays. MAIN MEASUREMENTS: The observers filled in independently, for each examination, an 11-item protocol on the technical quality of the images. The kappa index between pairs of observers was calculated for each item, as was the overall kappa index. RESULTS: 96% of the examinations were conducted with large x-ray plates (3543). There was only acceptable or good concordance between the 3 observers in 2 questions (kappa, 0.559-0.858). In 5 questions concordance was homogeneously low (kappa, 0.034-0.375). In some questions there was a strong discrepancy between the appraisal of the expert and that of the 2 other observers. CONCLUSIONS: General concordance can be considered low, although it is somewhat greater between the radiologist and the family doctor than between either of these and the expert. This poses the need to improve professional training in evaluation of the technical quality of images. In addition, there was unnecessary expense in large-size x-ray plates.

¿Estamos de acuerdo con la calidad técnica de nuestras radiografías de tórax? Un radiólogo, un técnico especialista en radiodiagnóstico y un médico de familia intentan corroborarlo / Do we agree on the technical quality of our chest X-ray? A radiologist, an expert in X-ray diagnosis, and a family doctor try to find out

Objetivo. Valorar el grado de concordancia en la interpretación de la calidad técnica de las radiografías de tórax de un centro de salud entre el técnico especialista en radiodiagnóstico (TER), el médico de familia y el radiólogo. Diseño. Estudio transversal. Emplazamiento. Atención primaria. Centro de Salud de Cartuja en Granada. Participantes. Pacientes del Centro de Salud de Cartuja con estudio radiológico simple de tórax durante 2002. Mediante muestreo aleatorio simple se seleccionaron 150 estudios. Se rechazaron 2 por tratarse de exploraciones repetidas del mismo paciente y 7 porque no presentaban una calidad mínima. La muestra final fue de 141 exploraciones. Mediciones principales. Los observadores cumplimentaron independientemente, para cada exploración, un protocolo de 11 ítems sobre calidad técnica de la imagen. Para cada ítem se calculó el índice kappa entre parejas de observadores, así como el índice kappa global. Resultados. El 96% de las exploraciones fue realizado con placas radiográficas de gran tamaño (35 x 43). Sólo en 2 preguntas hubo una concordancia aceptable o buena entre los 3 observadores (kappa = 0,559-0,858). En 5 preguntas, la concordancia fue homogéneamente baja (kappa = 0,034-0,375). En algunas preguntas se apreció una fuerte discrepancia entre la valoración del TER y la realizada por los otros 2 observadores. Conclusiones. La concordancia general puede considerarse baja, aunque algo mayor entre el radiólogo y el médico de familia que entre cada uno de éstos y el TER. Esto plantea la necesidad de mejorar la formación de los profesionales en cuanto a la valoración de la calidad técnica de las imágenes. Además, se detecta un gasto innecesario de placas radiográficas de gran tamaño

Objective. To appraise the degree of concordance in the interpretation of the technical quality of chest x-rays at a health centre between an expert in x-ray diagnosis, a family doctor, and a radiologist. Design. Transversal study. Setting. Primary care. Cartuja Health Centre, Granada, Spain. Participants. Patients at the Cartuja Health Centre who had a simple chest x-ray in 2002. 150 studies were chosen by simple randomised sampling. Two were rejected because they dealt with a repeat examination of the same patient and seven because they did not reach minimum quality. The final sample was 141 x-rays. Main measurements. The observers filled in independently, for each examination, an 11-item protocol on the technical quality of the images. The kappa index between pairs of observers was calculated for each item, as was the overall kappa index. Results. 96% of the examinations were conducted with large x-ray plates (35 x 43). There was only acceptable or good concordance between the 3 observers in 2 questions (kappa, 0.559-0.858). In 5 questions concordance was homogeneously low (kappa, 0.034-0.375). In some questions there was a strong discrepancy between the appraisal of the expert and that of the 2 other observers. Conclusions. General concordance can be considered low, although it is somewhat greater between the radiologist and the family doctor than between either of these and the expert. This poses the need to improve professional training in evaluation of the technical quality of images. In addition, there was unnecessary expense in large-size x-ray plates