Presence of bias in radiographer plain film reading performance studies

Abstract

Purpose To raise awareness of the frequency of bias that can affect the quality of radiographer plain film reading performance studies.

Methods Studies that assessed radiographer(s) plain film reading performance were located by searching electronic databases and grey literature, hand-searching journals, personal communication and scanning reference lists. Thirty studies were judged eligible from all data sources.

Results A one-way analysis of variance (ANOVA) demonstrates no statistically significant difference (P=0.25) in the mean proportion of biases present from diagnostic accuracy (0.37), performance (0.42) and outcome (0.44) study designs. Pearson¿s correlation coefficient showed no statistically significant linear association between the proportion of biases present for the three different study designs and the year that the study was performed. The frequency of biases in film and observer selection and application of the reference standard was quite low. In contrast, many biases were present concerning independence of film reporting and comparison of reports for concordance. Conclusions The findings indicate variation in the presence of bias in radiographer plain film reading performance studies. The careful consideration of bias is an essential component of study quality and hence the validity of the evidence-base used to underpin radiographic reporting policy.