title: Development of a valid and reliable test to assess trauma radiograph interpretation performance.
abstract: The purpose of this investigation was to develop and examine the preliminary validity and reliability among radiographers of a test to assess trauma radiograph interpretation performance suitable for use among health professionals.
  
  
  
  Stage 1 examined 14,159 consecutive appendicular and axial examinations from a hospital emergency department over a 12 month period to quantify a typical anatomical region case-mix of trauma radiographs. A sample of radiographic cases representative of affected anatomical regions was then developed into the Image Interpretation Test (IIT). Stage 2 involved prospective investigations of the IIT's reliability (inter-rater, intra-rater, internal consistency) and validity (concurrent) among 41 radiographers.
  
  
  
  The IIT included 60 cases. The median (interquartile range) clinical experience of participants was 5 (2-10) years. Case scores were internally consistent (Cronbach's alpha = 0.90). Favourable inter-rater reliability (kappa > 0.70 for 58/60 cases, Intra-class correlation coefficient (ICC) > 0.99 for total score) and intra-rater reliability (kappa > 0.90 for 60/60 cases, ICC > 0.99 for total score) was observed. There was a positive association between radiographers' confidence in image interpretation and IIT score (coefficient = 1.52, r-squared = 0.60, p < 0.001).
  
  
  
  The IIT developed during this investigation included a selection of radiographic cases consistent with anatomical regions represented in an adult trauma case-mix. This study has also provided foundational preliminary evidence to support the reliability and validity of the IIT among radiographers. The findings suggest that it is possible to assess image interpretation performance of adult trauma radiographs with this test.
authors.affiliation: Department of Medical Imaging, Logan Hospital, Corner of Armstrong Road and Loganlea Road, Meadowbrook, Queensland, Australia; Centre for Functioning and Health Research, Metro South Health, Buranda Plaza, Corner Ipswich Road and Cornwall Street Buranda, Brisbane, Australia; School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Australia. Electronic address: Michael.neep@health.qld.gov.au.
authors.forename: M J
authors.initials: MJ
authors.lastname: Neep
authors.affiliation: Department of Medical Imaging, Princess Alexandra Hospital, Ipswich Road, Brisbane, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Steffens
authors.affiliation: Worcestershire Royal Hospital, Charles Hastings Way, Worcester, United Kingdom.
authors.forename: V
authors.initials: V
authors.lastname: Riley
authors.affiliation: School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; Department of Medical Imaging, Royal Brisbane and Women's Hospital, Bowen Bridge Road, Brisbane, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Eastgate
authors.affiliation: Centre for Functioning and Health Research, Metro South Health, Buranda Plaza, Corner Ipswich Road and Cornwall Street Buranda, Brisbane, Australia; School of Public Health & Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia; Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Brisbane, Australia.
authors.forename: S M
authors.initials: SM
authors.lastname: McPhail
mesh_terms: D000328:Adult; D002983:Clinical Competence; D003953:Diagnosis-Related Groups; D003951:Diagnostic Errors; D004496:Education, Continuing; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015588:Observer Variation; D011871:Radiology / Q000193:education*; D015203:Reproducibility of Results; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*
keywords: Image interpretation; Performance; Reliability; Trauma; Validity