Radiological Findings of Chest X-Rays During the Hajj Seasons 1444–1445 H/2023–2024 G: Diagnostic Quality and Gender Differences in Interpretation Concordance

Ghadah Sulaiman Alsaleh (), Abdulaziz Almosabahi, Abdulaziz S. Alhomod, Mohamed Elgaria, Haifa Alharbi, Mohamed Sabry, Mohammed Elttanikhy, Ebtsam Kamal, Hassel Mohammed Alasmary, Khalid Alsuhaibani, Fahad A. Alamri, Reem Hasan and Anas Khan ()
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Ghadah Sulaiman Alsaleh: Global Center for Mass Gathering, Ministry of Health, Riyadh 12382, Saudi Arabia
Abdulaziz Almosabahi: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Abdulaziz S. Alhomod: Emergency Medical Administration, King Fahad Medical City, Riyadh 11525, Saudi Arabia
Mohamed Elgaria: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Haifa Alharbi: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Mohamed Sabry: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Mohammed Elttanikhy: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Ebtsam Kamal: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Hassel Mohammed Alasmary: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Khalid Alsuhaibani: Radiology Department, Seha Virtual Hospital, Ministry of Health, Riyadh 12382, Saudi Arabia
Fahad A. Alamri: Global Center for Mass Gathering, Ministry of Health, Riyadh 12382, Saudi Arabia
Reem Hasan: Global Center for Mass Gathering, Ministry of Health, Riyadh 12382, Saudi Arabia
Anas Khan: Global Center for Mass Gathering, Ministry of Health, Riyadh 12382, Saudi Arabia

IJERPH, 2025, vol. 22, issue 9, 1-13

Abstract: Background : Mass gatherings like the Hajj pilgrimage present unique challenges for radiological services, with high patient volumes and increased respiratory disease risks necessitating reliable chest X-ray interpretation. Objectives : The objective of this study is to assess the diagnostic quality, abnormality rates, and peer-review concordance of chest X-rays in patients transferred during the Hajj seasons of 1444–1445 H/2023–2024 G, with an additional focus on gender-based differences in radiological interpretation. Methods and Materials : A cross-sectional analysis of 2093 chest X-rays from Hajj healthcare facilities was conducted. Two blinded radiologists independently reinterpreted images using standardized criteria. Data included demographic variables, radiographic findings (quality, opacities, nodules, cardiomegaly, effusions), and tuberculosis likelihood. Results : Among interpretable films (89.7% acceptable quality), 69.2% showed abnormalities, primarily opacities (56.4%) and cardiomegaly (27.0%). Tuberculosis was considered probable by radiographic appearance in 21.0% of cases. Peer review demonstrated 94.2% overall concordance. Regression analysis identified the presence of any abnormality (OR = 10.67, p < 0.001) and female gender (OR = 2.97, p = 0.003) as significant independent predictors of interpretive discordance. A trend towards higher discordance was noted for pulmonary nodules, though it was not statistically significant (9.4% vs. 5.6%, p = 0.062). Conclusions : While chest X-rays proved reliable for Hajj screening, gender disparities in interpretation and challenges in certain assessments, such as nodule evaluation, highlight opportunities to refine radiological protocols in mass gatherings.

Keywords: Hajj; chest X-ray; concordance; gender bias; mass gathering medicine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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