Comparing the accuracy of initial head CT reporting by radiologists, radiology trainees, neuroradiographers and emergency doctors

Gallagher, Ferdia A.; Tay, KH; Vowler, SL; Szutowicz, H.; Cross, Justin; McAuley, Duncan; Antoun, N.M.

doi:10.1259/bjr/24581602

Cited by 17 publications

(12 citation statements)

References 15 publications

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“…Furthermore, the rate of CSMs for radiology trainees (0.001–0.025) is consistent with the approximate CT misinterpretation rate of 0.02 that is reported in the radiology literature 28. Gallagher et al ,34 who were excluded from quantitative analysis, directly compared the performance of radiologists, radiology trainees, neuroradiographers and emergency clinicians and found that the latter had the highest error rate for CTB interpretation. As noted previously, the ACEM concept of ‘expert proficiency’ correlates practically with the level of skill expected of a consultant in that field.…”

Section: Discussionsupporting

confidence: 77%

Emergency department interpretation of CT of the brain: a systematic review

Evans

Fitzgerald

Mitra

et al. 2016

Postgraduate Medical Journal

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Section: Discussionsupporting

confidence: 77%

Emergency department interpretation of CT of the brain: a systematic review

Evans

Fitzgerald

Mitra

et al. 2016

Postgraduate Medical Journal

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“…There is an ongoing debate regarding this issue as it relates to both radiology trainees and general radiologists who routinely interpret cranial CTs . However, given that inter‐rater agreement between neuroradiologists is imperfect to a similar degree as compared to general radiologists, it is unclear that such safeguards would truly improve the overall accuracy of cranial CT interpretation . A second issue is that certain locations of hemorrhage may be more likely overlooked, particularly the interpeduncular cistern, such that improved awareness of such specific pitfalls for subtle SAH findings may improve detection .…”

Section: Discussionmentioning

confidence: 99%

False‐negative Interpretations of Cranial Computed Tomography in Aneurysmal Subarachnoid Hemorrhage

Mark

Sonne

Jun

et al. 2016

Academic Emergency Medicine

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Objectives: Prior studies examining the sensitivity of cranial computed tomography (CT) for the detection of subarachnoid hemorrhage (SAH) have used the final radiology report as the reference standard. However, optimal sensitivity may have been underestimated due to misinterpretation of reportedly normal cranial CTs. This study aims to estimate the incidence of missed CT evidence of SAH among a cohort of patients with aneurysmal SAH (aSAH).Methods: We performed a retrospective chart review of emergency department (ED) encounters within an integrated health delivery system between January 2007 and June 2013 to identify patients diagnosed with aSAH. All initial noncontrast CTs from aSAH cases diagnosed by lumbar puncture (LP) and angiography following a reportedly normal noncontrast cranial CT (CT-negative aSAH) were then reviewed in a blinded, independent fashion by two board-certified neuroradiologists to assess for missed evidence of SAH. Reviewers rated the CT studies as having definite evidence of SAH, probable evidence of SAH, or no evidence of SAH. Control patients who underwent a negative evaluation for aSAH based on cranial CT and LP results were also included at random in the imaging review cohort.Results: A total of 452 cases of aSAH were identified; 18 (4%) were cases of CT-negative aSAH. Of these, seven (39%) underwent cranial CT within 6 hours of headache onset, and two (11%) had their initial CTs formally interpreted by board-certified neuroradiologists. Blinded independent CT review revealed concordant agreement for either definite or probable evidence of SAH in nine of 18 (50%) cases overall and in five of the seven (71%) CTs performed within 6 hours of headache onset. Inter-rater agreement was 83% for definite SAH and 72% for either probable or definite SAH.Conclusions: CT evidence of SAH was frequently present but unrecognized according to the final radiology report in cases of presumed CT-negative aSAH. This finding may help explain some of the discordance between prior studies examining the sensitivity of cranial CT for SAH.ACADEMIC EMERGENCY MEDICINE 2016;23:591-598

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“…The statistical data of the study showed that there was no significant difference between the reports of different groups, but the best results belonged to neuro-radiographists, radiologists, and EM physicians, respectively. Researchers recommended that more studies need to be done on these issues (21). Shaker et al conducted a study for investigating the agreement value of brain CT scan interpretation in trauma patients by EM service along with radiology service.…”

Section: Discussionmentioning

confidence: 99%

Emergency Medicine Service Can Interpret Abdomino-Pelvic Ct Scans With Close to the Same Accuracy as Radiology Service

2020

jcr

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Background: Interpreting abdomino-pelvic Computed Tomography (CT) scanning is substantially important in clinical decision making for emergency medicine (EM) physicians in Emergency department, where radiologist's report is not available all the time. The current research aimed to determine the diagnostic accuracy of EM physicians in the interpretation of abdomino-pelvic CT scan in trauma patients. Material and Methods:This observational study carried out at a teaching hospital in 2018. The results of abdomino-pelvic CT scans of patients admitted to Emergency Department with abdomino-pelvic trauma, interpreted by EM and radiology physicians were compared. Sensitivity, specificity, positive and negative predictive values and the diagnostic accuracy of EM service interpretation were calculated. kappa coefficient (κ) was obtained to examine the level of concurrence. Results: A total of Six hundred ninety-nine patients (mean age 34.54; 11% female, %89 male) enrolled. Totally, 183 positive (abnormal) findings were reported by EM physicians, including 170 true positive and 13 false positive. Out of 516 negative reporting, 494 were true negative and 22 were false negative. The sensitivity, specificity, accuracy, positive and negative predictive values of emergency medicine service interpretation were %88.54, %97.44, %95.00, %92.90, and %95.74, respectively. A high agreement level was found between interpretation of EM and radiology services. Conclusion: The results showed that EM physicians' qualification on of abdomino-pelvis CT scan interpretation is considerable, and they can act on their own judgment and independent from radiologist report, when they are not available. Yet, because of some misinterpretation, more systematic training of abdomino-pelvis CT scan interpretation is needed to optimize the accuracy of the EM physicians.

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Comparing the accuracy of initial head CT reporting by radiologists, radiology trainees, neuroradiographers and emergency doctors

Cited by 17 publications

References 15 publications

Emergency department interpretation of CT of the brain: a systematic review

Emergency department interpretation of CT of the brain: a systematic review

False‐negative Interpretations of Cranial Computed Tomography in Aneurysmal Subarachnoid Hemorrhage

Emergency Medicine Service Can Interpret Abdomino-Pelvic Ct Scans With Close to the Same Accuracy as Radiology Service

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