Abstract
BACKGROUND: High-quality diagnostic imaging is critical to patient safety and effective healthcare. This study assesses the quality of plain chest X-rays (CXR) for expatriates in Jordan, with a focus on complying to American College of Radiology (ACR) and European Commission (EC) criteria at 12 healthcare facilities. METHODS: A retrospective cross-sectional evaluation of 1020 CXR radiographs from 2023 was performed. A quantitative classification approach was used to assess CXR for ACR and EC compliance, which included exposure, anatomical visibility, organ superimposition, and image annotation. RESULTS: Only 15% of CXRs passed all of the quality standards. While exposure and anatomical visualization demonstrated adequate compliance, organ superimposition and image annotation were much lower, at 23% and 29%, respectively, revealing gaps that may impact diagnostic accuracy and patient safety. CONCLUSION: Significant discrepancies in CXR quality highlight the need for enhanced training, rigorous adherence to imaging protocols, and robust quality control to improve diagnosis accuracy and patient outcomes, especially in expatriate screening programs.