Evaluation of Chest X-Ray Reporting Accuracy by Radiographers Versus Radiologists at Federal Medical Centre Owerri, Imo State

The accurate interpretation and reporting of chest radiographs is a critical clinical function, and in many Nigerian district and federal medical centres where radiologist-to-patient ratios are inadequate, radiographers are increasingly required to provide preliminary image assessments. The accuracy and reliability of radiographer-generated chest X-ray reports relative to radiologist gold-standard interpretations has important patient safety and healthcare delivery implications. This study evaluates the concordance between chest X-ray reports produced by radiographers and those generated by consultant radiologists at Federal Medical Centre Owerri, Imo State. A retrospective comparative design is employed, reviewing 200 consecutively archived chest radiograph cases where both radiographer and radiologist reports are available from 2021 to 2023. A structured report comparison instrument assesses agreement on pathology identification, laterality, severity grading, and clinical management recommendations. Cohen's kappa coefficient and percentage agreement statistics are calculated in SPSS. Literature from South East Nigerian radiology settings identifies pneumonia and pulmonary tuberculosis as the most frequently misclassified conditions in radiographer chest X-ray assessments. The Radiographer Reporting Competency Framework and the World Health Organization chest X-ray training standards provide the analytical reference. Findings are expected to demonstrate moderate to good agreement for common presentations but lower concordance for complex or uncommon pathologies. Recommendations address structured chest X-ray reporting training programmes and a formal radiographer reporting credentialing pathway for Federal Medical Centre Owerri. Keywords: chest X-ray reporting, radiographers, radiologists, concordance, Imo State.