ArticleJMIR formative research2023
Diagnostic Accuracy and Confidence in Management of Forearm and Hand Fractures Among Foundation Doctors in the Accident and Emergency Department: Survey Study.
Article in JMIR formative research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Accuracy of junior doctor plain trauma X-ray interpretation: a systematic review and meta-analysis.BMC medical imaging · 2025Pooled it
- Transforming musculoskeletal injury management using Virtual Bones: a novel digital solution.BMJ open quality · 2026Article
- Effectiveness of a Teaching Session on Interpreting Common Orthopaedic Radiographs at a Major Trauma Centre.Cureus · 2026Article
- Adequacy of Emergency Physicians in the Assessment of Hand Injury: A Cross-sectional Study.Plastic and reconstructive surgery. Global open · 2026Article
- Digital Eye: Deep Learning for Detecting Physeal Fractures of the Pediatric Distal Radius.Journal of the Pediatric Orthopaedic Society of North America · 2026Article
- Changing trends in the management of pediatric distal forearm fractures: a descriptive Danish 20-year nationwide registry study of 175,083 cases.Acta orthopaedica · 2026Article
- Factors associated with junior doctor plain trauma X-ray interpretation accuracy and strategies for improvement: a scoping review.BMC medical imaging · 2025Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAccurate interpretation of radiographs is crucial for junior doctors in the accident and emergency (A&E) department (the emergency medicine department). However, it remains a significant challenge and a leading cause of diagnostic errors.
objectiveThis study aimed to evaluate the accuracy and confidence of foundation doctors (doctors within their first 2 years of qualifying) in correctly interpreting and managing forearm and hand fractures on plain radiographs.
methodsA total of 42 foundation doctors with less than 2 years of experience and no prior emergency medicine training who worked in a large district general hospital participated in a web-based questionnaire. The questionnaire consisted of 3 case studies: distal radius fracture, scaphoid fracture, and a normal radiograph. Respondents were required to identify the presence or absence of a fracture, determine the fracture location, suggest appropriate management, and rate their confidence on a Likert scale.
resultsOverall, 48% (61/126) of respondents accurately identified the presence and location of fractures. The correct management option was chosen by 64% (81/126) of respondents. The median diagnostic confidence score was 4 of 10, with a mean diagnostic certainty of 4.4 of 10. Notably, respondents exhibited a significantly lower confidence score for the normal radiograph compared to the distal radius fracture radiograph (P=.01).
conclusionsThis study reveals diagnostic uncertainty among foundation doctors in interpreting plain radiographs, with a notable inclination toward overdiagnosing fractures. The findings emphasize the need for close supervision and senior support to mitigate diagnostic errors. Further training and educational interventions are warranted to improve the accuracy and confidence of junior doctors in radiographic interpretation. This study has several limitations, including a small sample size and reliance on self-reported data. The findings may not be generalizable to other health care settings or specialties. Future research should aim for larger, more diverse samples and explore the impact of specific educational interventions on diagnostic accuracy and confidence.
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