Inaccurate annotation of radiographic images by radiographers increases the likelihood

that patients will receive an inaccurate diagnosis from radiologists and have surgery on the

wrong side by surgeons. Significant legal and medical repercussions can result from this form of

medical malfeasance, which can have severe implications. Recent image annotation

technologies, such as computed radiography (CR) and direct digital radiography (DDR), were

anticipated to pave the way for a change in clinical practice that would result in fewer annotation

errors. The research institution has just introduced computed radiography as a modality.

According to an unpublished 2013 pilot survey completed by the unit leader, 2% of

radiographs in their research facility contained inaccurate markers. Each radiographer was

provided with their own ASM instead of using one from the department's stock to address this

issue. In addition, the chief of the unit designated three radiographers as picture quality monitors.

The next year, in 2014, computed radiography (CR) replaced film-screen radiography for all

diagnostic imaging purposes (FSR). It was hypothesized that digitally tagging images may be

effective in reducing ASM errors. The objective of this project was to perform an audit of

radiographers' image annotation procedures following the implementation of CR and other steps

to eliminate marker errors. For ASM audits, the presence or absence of markers on images and

the presence of markers in the primary or secondary radiation beam are two of the most crucial

criteria. In this investigation, the presence or absence of a marker, regardless of whether it is

placed in the primary or secondary radiation field, was considered the usual. Marker placement

within the radiation beam and detected error sources were documented but not adopted

explicitly.

After photographs have been captured, this method adds digital annotations to them.

After switching from film-screen radiography (FSR) to computed radiography (CR), the error
rate at the research facility decreased significantly (CR). Nonetheless, the presence of a team of

quality control radiographers stationed at the CR workstation had a greater impact on this shift

than the actual operation of an x-ray imaging suite. When utilized in university teaching

laboratories for demonstrations, the presence of an anthropomorphic phantom is likely to

significantly instill the knowledge necessary to prevent anatomical side marker (ASM) errors in

practice.

This study has several strength and weaknesses. It could point that the flow of the thought

is well planned, it is sectioned, and all the results are documented and well-presented. However,

The 0.6% mistake rate in computed radiography could not be definitely classified as either

exemplary pre-exposure ASM placement or exemplary post-exposure annotation at the

workstation due to the retrospective nature of the data collection. This was due to the

retrospective nature of the data collecting. There is a strong likelihood that future studies will

conclusively demonstrate this claim. In order to establish whether or not a study's conclusions

can be relied upon, it is vital to maintain reliable records of the error rate; hence, this study

should have been strict with their data error rate.

Next, the obtained information was tallied by hand, analyzed with descriptive statistics,

and shown with numbers and percentages. A basic calculator was used to determine the

percentage difference. Data gathering methods and how they would be unbiased have not been

disclosed. In addition, the study doesn't go into detail about the constraints they faced when

gathering their sample sizes and the analysis of their data is murky at best. Lastly, No

recommendations are made regarding how the hospital or other organizations could improve

their future research initiatives.

 With these in mind, it could be said that every article and study has room for

improvement; the research center had a considerable reduction in the amount of errors that were

made as a result of transitioning from film-screen radiography (FSR) to computed radiography

(CR). This change, on the other hand, was driven not so much by actual procedures in the x-ray

imaging room as it was by a crew of quality control radiographers who were stationed at the CR

workstation. The use of an anthropomorphic phantom in the teaching laboratories of universities

for the purpose of conducting demonstrations will significantly contribute to the instillation of

the competence required to eliminate anatomical side marker (ASM) inaccuracy in practice.

However, next researches should be strict with following the error rate, and state their data

procedure, and analyzing method specifically. They should also provide comprehensive

recommendation for the future researches that also aims to study the same topic, or inline on

their research.

REFERENCES

Adejoh, T., Elugwu, C. H., Sidi, M., Ezugwu, E. E., Asogwa, C. O., & Okeji, M. C. (2020,

December 8). An audit of Radiographers' practice of left-right image annotation in film-

screen radiography and after installation of computed radiography in a tertiary hospital in

Africa - egyptian Journal of Radiology and Nuclear Medicine. SpringerOpen. Retrieved

October 26, 2022, from https://ejrnm.springeropen.com/articles/10.1186/s43055-020-

00371-3#Abs1