Yıl: 2022 Cilt: 22 Sayı: 2 Sayfa Aralığı: 89 - 95 Metin Dili: İngilizce İndeks Tarihi: 07-07-2022

Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases

Öz:
OBJECTIVE: The aim of this study is to evaluate the accuracy levels of the emergency physicians (EPs) managing the patient in the interpretation of the urgent‑emergent pathological findings in thoracic and abdominal computed tomography (CT) scans. METHODS: The EPs interpreted the CT scans of patients who visited the emergency department because of nontraumatic causes. Then, a radiology instructor made final assessments of these CT scans. Based on the interpretation of the radiology instructor, the false‑positive rate, false‑negative rate, sensitivity, specificity, positive predictive value, negative predictive value, and kappa coefficient (κ) of the EPs’ interpretations of the CT scans were calculated. RESULTS: A total of 268 thoracics and 185 abdominal CT scans were assessed in our study. The overall sensitivity and specificity of the EPs’ interpretation of the thoracic CT scans were 90% and 89%, respectively, whereas the abdominal CT interpretation was 88% and 86%, respectively. There was excellent concordance between the EPs and the radiology instructor with regard to the diagnoses of pneumothorax, pulmonary embolism, pleural effusion, parenchymal pathology, and masses (κ: 0.90, κ: 0.87, κ: 0.71, κ: 0.79, and κ: 0.91, respectively) and to the diagnoses of intraabdominal free fluid, intraabdominal free gas, aortic pathology, splenic pathology, gallbladder pathology, mesenteric artery embolism, appendicitis, gynecological pathology, and renal pathology (κ: 1, κ: 0.92, κ: 0.96, κ: 0.88, κ: 0.80, κ: 0.79, κ: 0.89, κ: 0.88, and κ: 0.82, respectively). CONCLUSION: The EPs are successful in the interpretation of the urgent‑emergent pathological findings in thoracic and abdominal CT scans.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Swartzberg K, Goldstein LN. High positive computed tomography yields in the emergency department might not be a positive finding. S Afr Med J 2018;108:230‑4.
  • 2. IkegamiY, SuzukiT, NemotoC, TsukadaY, HasegawaA, Shimada J, et al. Establishment and implementation of an effective rule for the interpretation of computed tomography scans by emergency physicians in blunt trauma. World J Emerg Surg 2014;9:40.
  • 3. Kartal ZA, Kozacı N, Çekiç B, Beydilli İ, Akçimen M, Güven DS, et al. CT interpretations in multiply injured patients: Comparison of emergency physicians and on‑call radiologists. Am J Emerg Med 2016;34:2331‑5.
  • 4. Wildman‑Tobriner B, Allen BC, Maxfield CM. Common resident errors when interpreting computed tomography of the abdomen and pelvis: A review of types, pitfalls, and strategies for improvement. Curr Probl Diagn Radiol 2019;48:4‑9.
  • 5. Walls J, Hunter N, Brasher PM, Ho SG. The DePICTORS Study: Discrepancies in preliminary interpretation of CT scans between on‑call residents and staff. Emerg Radiol 2009;16:303‑8.
  • 6. Ruchman RB, Jaeger J, Wiggins EF 3rd, Seinfeld S, Thakral V, Bolla S, et al. Preliminary radiology resident interpretations versus final attending radiologist interpretations and the impact on patient care in a community hospital. AJR Am J Roentgenol 2007;189:523‑6.
  • 7. Hochhegger B, Alves GR, Chaves M, Moreira AL, Kist R, Watte G, et al. Interobserver agreement between radiologists and radiology residents and emergency physicians in the detection of PE using CTPA. Clin Imaging 2014;38:445‑7.
  • 8. Harding J, Craig M, Jakeman N, Young R, Jabarin C, Kendall J. Emergency physician interpretation of head CT in trauma and suspected subarachnoid haemorrhage‑is it viable? An audit of current practice. Emerg Med J 2010;27:116‑20.
  • 9. Kang MJ, Sim MS, Shin TG, Jo IJ, Song HG, Song KJ, et al. Evaluating the accuracy of emergency medicine resident interpretations of abdominal CTs in patients with non‑traumatic abdominal pain. J Korean Med Sci 2012;27:1255‑60.
  • 10. Guven R, Akca AH, Caltili C, Sasmaz MI, Kaykisiz EK, Baran S, et al. Comparing the interpretation of emergency department computed tomography between emergency physicians and attending radiologists: A multicenter study. Niger J Clin Pract 2018;21:1323‑9.
  • 11. Bagheri‑Hariri S, Ayoobi‑Yazdi N, Afkar M, Farahmand S, Arbab M, Shahlafar N, et al. Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists’ report and its impact on patients’ outcome. Emerg Radiol 2017;24:675‑80.
  • 12. Selvarajan SK, Levin DC, Parker L. The increasing use of emergency department imaging in the United States: Is it appropriate? AJR Am J Roentgenol 2019;213:W180‑4.
  • 13. Evans O, Rea B, Shareef T. Identifying emergency pathology on abdominopelvic CT for non‑radiologists. Br J Hosp Med (Lond) 2019;80:C140‑5.
APA KARAKOYUN Ö, Kozaci N, Avci M, Uzunay H (2022). Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. , 89 - 95.
Chicago KARAKOYUN Ömer Faruk,Kozaci Nalan,Avci Mustafa,Uzunay Hüseyin Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. (2022): 89 - 95.
MLA KARAKOYUN Ömer Faruk,Kozaci Nalan,Avci Mustafa,Uzunay Hüseyin Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. , 2022, ss.89 - 95.
AMA KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. . 2022; 89 - 95.
Vancouver KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. . 2022; 89 - 95.
IEEE KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H "Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases." , ss.89 - 95, 2022.
ISNAD KARAKOYUN, Ömer Faruk vd. "Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases". (2022), 89-95.
APA KARAKOYUN Ö, Kozaci N, Avci M, Uzunay H (2022). Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. Turkish journal of emergency medicine (Online), 22(2), 89 - 95.
Chicago KARAKOYUN Ömer Faruk,Kozaci Nalan,Avci Mustafa,Uzunay Hüseyin Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. Turkish journal of emergency medicine (Online) 22, no.2 (2022): 89 - 95.
MLA KARAKOYUN Ömer Faruk,Kozaci Nalan,Avci Mustafa,Uzunay Hüseyin Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. Turkish journal of emergency medicine (Online), vol.22, no.2, 2022, ss.89 - 95.
AMA KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. Turkish journal of emergency medicine (Online). 2022; 22(2): 89 - 95.
Vancouver KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases. Turkish journal of emergency medicine (Online). 2022; 22(2): 89 - 95.
IEEE KARAKOYUN Ö,Kozaci N,Avci M,Uzunay H "Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases." Turkish journal of emergency medicine (Online), 22, ss.89 - 95, 2022.
ISNAD KARAKOYUN, Ömer Faruk vd. "Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases". Turkish journal of emergency medicine (Online) 22/2 (2022), 89-95.