# Assessing Fracture Detection: A Comparison of Minimal-Resource and Standard-Resource Plain Radiographic Interpretations

## TL;DR

This study compares how well doctors can detect fractures in X-rays taken in high-quality and low-quality settings, finding that better imaging and more experienced doctors lead to more accurate diagnoses.

## Contribution

The study provides empirical evidence on the impact of resource availability and interpreter experience on fracture detection accuracy in radiography.

## Key findings

- Standard-resource radiographs showed significantly higher diagnostic accuracy than minimal-resource ones.
- Radiologists had higher diagnostic accuracy than general practitioners and radiology residents.

## Abstract

Background: The accuracy of fracture diagnosis through radiographic imaging largely depends on image quality and the interpreter’s experience. In resource-limited settings (minimal-resource settings), imaging quality is often lower than in standard-resource facilities, potentially affecting diagnostic accuracy. Objective: This study aims to compare the diagnostic accuracy of plain radiograph interpretations between minimal-resource and standard-resource methods and assess the influence of interpreter experience on diagnostic precision. Methods: This cross-sectional study is based on secondary data from patients’ medical records at the Dr. Zainoel Abidin General Hospital (RSUDZA) Banda Aceh, Indonesia. Comparisons between minimal-resource and standard-resource interpretations were made and validated using a reference standard (gold standard). Statistical analyses included diagnostic testing, Chi-square tests, and ROC curve analysis to evaluate sensitivity, specificity, and accuracy. Results: The findings indicate that standard-resource radiographs have significantly higher accuracy than minimal-resource radiographs (p < 0.05). Radiologists demonstrated the highest diagnostic accuracy compared to general practitioners and radiology residents. Conclusions: The standard-resource method is superior in detecting fractures compared to the minimal-resource method. Enhancing imaging quality and providing additional training for medical personnel are essential to improve diagnostic accuracy in resource-limited settings.