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

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), 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 General Hospital of Dr. Zainal Abidin (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. Conclusion: 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 improving diagnostic accuracy in resource-limited settings.