title: Impact of specific training in detecting osteoporotic vertebral fractures on routine chest radiographs.
abstract: OBJECTIVE
  Vertebral fractures are the most common complication of osteoporosis. Routine chest radiographs are a potential screening method, but a significant under-reporting has been described previously. The purpose of this study was to evaluate the effect of a specific training on the detection rate of vertebral fractures of a radiology resident.
  
  
  METHODS
  936 routine lateral chest radiographs of postmenopausal women were evaluated by a radiology resident (R1) during clinical routine. After the evaluation of 470 radiographs (pre-training group), R1 underwent a specific training based on the teaching initiative of the IOF/ESSR. Afterwards the remaining 466 radiographs were evaluated (post-training group). As a standard of reference, all radiographs were reviewed by two radiologists in consensus (R2 + 3). A semi-quantitative method (spinal fracture index, SFI) was used to assess vertebral fractures.
  
  
  RESULTS
  Kappa-values as statistical measure of agreement between R1 and R2 + 3 for the detection of vertebral fractures (Genant Severity > 0) increased from κ = 0.311 (95 % CI: 0.217 - 0.405; "fair agreement") in the pre-training group to κ = 0,882 (95 % CI: 0,835 - 0,929; "almost perfect agreement") in the post-training group. Similar results were observed for severe fractures (Genant Severity > 1). Especially fractures with Genant Severity 1 were not detected by R1 before training.
  
  
  CONCLUSIONS
  A brief training is essential to increase the awareness of radiologists to correctly report osteoporotic vertebral fractures and may help to initiate appropriate therapy in patients with vertebral fractures.
authors.affiliation: Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna.
authors.forename: M
authors.initials: M
authors.lastname: Gruber
authors.forename: J
authors.initials: J
authors.lastname: Dinges
authors.forename: D
authors.initials: D
authors.lastname: Müller
authors.forename: T
authors.initials: T
authors.lastname: Baum
authors.forename: E J
authors.initials: EJ
authors.lastname: Rummeny
authors.forename: J
authors.initials: J
authors.lastname: Bauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007396:Internship and Residency / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011361:Professional Competence / Q000706:statistics & numerical data*; D013902:Radiography, Thoracic / Q000706:statistics & numerical data*; D011871:Radiology / Q000193:education* / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology*