Assessing the Impact of Digital Radiography on Diagnostic Accuracy in Emergency Departments

Thesis Abstract

In contemporary emergency departments, timely and accurate diagnosis is critical to effective patient management and improved clinical outcomes, prompting ongoing evaluation of diagnostic imaging modalities. Digital radiography (DR) has increasingly replaced conventional film-based systems, promising enhanced image quality, faster processing times, and integrated digital workflows. However, empirical evidence concerning the specific impact of digital radiography adoption on diagnostic accuracy within high-pressure emergency settings remains limited, necessitating a systematic investigation to inform clinical practice, policy decisions, and further technological integration. This study aims to assess the influence of digital radiography on diagnostic accuracy among emergency department clinicians by explicitly examining the relationship between digital radiographic use and diagnostic correctness, timeliness, and clinical decision-making. The specific objectives of the study are to (1) determine the level of diagnostic accuracy achieved with digital radiography compared to conventional radiography, (2) identify factors mediating or moderating this relationship, including clinician experience and training, (3) evaluate the impact of digital radiography on diagnostic turnaround times, and (4) explore clinicians' perceptions of digital radiography’s influence on diagnostic confidence and decision-making processes. The overarching aim is to generate evidence-based insights on how digital radiography systems affect diagnostic outcomes and operational efficiency in emergency settings. This research adopts a mixed-methods design, integrating quantitative and qualitative approaches. Quantitatively, a cross-sectional analytical study will be conducted involving 200 radiologists and emergency physicians sampled through stratified random sampling from two major urban hospitals equipped with digital radiography systems. Data collection instruments include a structured diagnostic accuracy assessment tool—comprising review of radiographic images and clinical records—augmented by a questionnaire measuring perceptions and experiences regarding digital radiography. For qualitative data, purposively selected focus group discussions and semi-structured interviews with 30 clinicians will explore in-depth the contextual factors influencing diagnostic processes. Content validity and internal consistency reliability (Cronbach’s alpha) exceeding 0.8 will be established for all instruments prior to data collection. Quantitative data will be analyzed using SPSS version 26, employing descriptive statistics, paired t-tests, and multivariate regression analysis to compare diagnostic accuracy rates, assess predictors, and evaluate relationships between variables such as clinician experience and diagnostic outcomes. Thematic analysis will be conducted on qualitative transcripts following Braun and Clarke’s methodology, facilitated by NVivo software, to elucidate clinicians’ perceptions and insights into system usability and decision confidence. Expected findings include statistically significant improvements in diagnostic accuracy and reduced turnaround times associated with digital radiography, particularly among clinicians with recent training and higher familiarity with digital workflows. It is anticipated that digital radiography will bolster diagnostic confidence and facilitate faster clinical decisions, although potential challenges such as technical difficulties or initial adaptation barriers may be identified. The study aims to contribute novel empirical evidence to the body of knowledge regarding the operational and clinical benefits of digital radiography in emergency contexts. It will enhance understanding of the factors influencing diagnostic performance, inform targeted training programs, and underpin strategic investments in radiographic technology integration. Ultimately, the research will offer actionable recommendations for optimizing digital radiography deployment, including policy guidelines and clinician education strategies to maximize diagnostic accuracy. In conclusion, this investigation will demonstrate that digital radiography, when effectively integrated into emergency department workflows, substantially improves diagnostic accuracy, reduces delays, and enhances clinical decision-making. The findings will serve as a basis for evidence-based policy formulation and future research avenues aimed at refining radiographic practice within emergency medicine, thereby strengthening patient care quality and operational effectiveness.