How Accurate are Emergency Department Medical Staff in the Interpretation of Head Injury Related Computed Tomography?

Abstract

How accurate are emergency department medical staff in the interpretation of head injury related computed tomography?急診科醫務人員在判讀與頭部受傷相關的電腦斷層掃描有多準確呢？ LW Cheung 張立援, YN Shih 史有毅, CS Leung 梁展新, WS Lo 盧詠琛, M Leung 梁明, ACH Lit 列就雄 Introduction: Computed tomography (CT) brain has become a popular modality to detect head injury related problems for patients seen at the Emergency Departments (ED) in Hong Kong. This study aims to assess the diagnostic accuracy of local ED medical staff in interpretation of head injury related CT and to assess the association between years of working experience of ED medical staff and the diagnostic accuracy of CT brain interpretation. Methods: This is a retrospective cohort study reviewing all patients attending the ED of Princess Margaret Hospital in three years (from 2008 to 2010) with head injuries requiring CT brain during ED stay. The findings of CT brain by ED medical staff were compared with those by radiologists, the reference standard. Results: A total of 1716 cases were assessed. The overall sensitivity and specificity for detecting an abnormal CT were 0.

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

“…Among the remaining 10 studies, only Al-Reesi et al 11 and Cheung et al 16 conducted retrospective reviews and found the concordance between ED and the final radiology report to be 0.93 (95% CI 0.91 to 0.95) and 0.91 (95% CI 0.90 to 0.92), respectively. The eight studies that obtained data prospectively had significantly heterogeneous methods in regards to whether the ED interpretation was documented freehand or on a standard template, the blinding of participants to the clinical indication for the scan and the level of training of the participants.…”