A Multicenter Study to Improve Emergency Medicine Residents’ Recognition of Intracranial Emergencies on Computed Tomography

Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists

“…While interpretations reported by EPs had higher sensitivity (86.5% versus 71.4%), residents provided higher specificity in their CT interpretations (91.8% versus 81.4%). Neither our study nor others have been able to find any correlation between the number of years of practice and the accuracy of interpretations of radiologic studies (6, 10, 14). Nonetheless, it has been shown that attending a 1-2 hour workshop can significantly increase the skills of physicians (3, 5) and this improvement can last as long as a year (18, 27, 28).…”

“…Based on the aforementioned criteria, we found a 16.2% and 15.8% discrepancy in reading brain CT scan studies by attending EPs and senior emergency medicine residents, respectively. In the review of the literature we found that higher number of abnormalities found in the studies is associated with higher interpretation discrepancies (1, 14, 18, 24). The proportion of abnormal findings in our study (47.6%) was comparable to Arendt et al (43%) (4) and Alfaro et al (47.6%) (2).…”

“…The proportion of abnormal findings in our study (47.6%) was comparable to Arendt et al (43%) (4) and Alfaro et al (47.6%) (2). Different researchers have also defined unfavorable consequences differently; thus the reported results differ vastly in some cases (3, 6, 14, 17-19, 25). Some have held all the false positive cases as non-significant (6, 8, 10, 11, 17), and false negatives were only considered as important discrepancies when they had caused adverse effects (8, 10, 13, 16, 26).…”

‘Out of hours’ adult CT head interpretation by senior emergency department staff following an intensive teaching session: a prospective blinded pilot study of 405 patients

“…This study was limited by the relatively artificial environment of an exam situation and small numbers; from the starting 30 residents, only 18 completed the post-test exam. The same authors performed another study a year later with 83 ED staff that also demonstrated a significant improvement in post-test score results but again this study was limited for the same reasons 3. A study by Levitt et al also found a significant improvement in the accuracy rate of reporting following a 1-h educational session in a small number of ED residents 4…”

Performance of emergency medicine residents in the interpretation of radiographs in patients with trauma

“…These studies typically compared the performance of emergency medicine residents/specialists with that of a radiologist and found their performance to be satisfactory in some cases2 8 9 but unsatisfactory in others 1 5 7. There are also studies on the performance of physicians from other specialties such as anaesthesiology or general surgery 10 11…”