Effects of training and experience in interpretation of emergency body CT scans.

Wechsler, Richard J.; Spettell, Claire M.; Kurtz, A B; Lev-Toaff, Anna S.; Halpern, E J; Nazarian, Levon N.; Feld, Rick I.; Needleman, Laurence; Alexander, Archie A.

doi:10.1148/radiology.199.3.8637994

Cited by 119 publications

(47 citation statements)

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“…This finding is not intuitive, because error rates would be expected to decrease with more experience. Similar traineelevel patterns of discrepancies have been described by other researchers with body CT (major discrepancies) 16 and head CT 5 interpretations. Because of the small number of cases read by residents in this study, bias from sampling error cannot be discounted as a cause.…”

Section: Discussionsupporting

confidence: 84%

Trainee Misinterpretations on Pediatric Neuroimaging Studies: Classification, Imaging Analysis, and Outcome Assessment

Guimaraes

Leach²,

Jones³

2011

AJNR Am J Neuroradiol

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Section: Discussionsupporting

confidence: 84%

Trainee Misinterpretations on Pediatric Neuroimaging Studies: Classification, Imaging Analysis, and Outcome Assessment

Guimaraes

Leach²,

Jones³

2011

AJNR Am J Neuroradiol

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“…First, the various rates of discordance may be due, in part, to the varying prevalence of CT abnormalities. Several studies have reported that the proportion of abnormal studies influences concordance, because the discordant rate for abnormal studies is higher than for normal studies (3,13). The proportion of abnormal scans in our series (86.7%) was markedly higher than the 35%-42% rate of positive findings described in previous studies (2-4).…”

Section: Discussioncontrasting

confidence: 70%

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Kim

Yoon²,

Lee³

et al. 2014

Diagn Interv Radiol

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NEURORADIOLOGYORIGINAL ARTICLE PURPOSE Three-dimensional (3D) reformatted images provide a more inclusive representation of abnormalities than transverse images in cranial computed tomography (CT). The purpose of this study was to assess the value of 3D reformations for radiology residents in the interpretation of emergency cranial CTs. MATERIALS AND METHODSIn total, 218 consecutive patients who underwent emergency cranial CT scans with 3D reformation were included in this retrospective study. Four blinded readers (three radiology residents and a neuroradiologist) interpreted the transverse and 3D images in two separate sessions. Each reader assessed 1) abnormal finding(s) and the confidence score(s) (5-point scale) for transverse and 3D images, 2) added value score of 3D images (5-point scale), and 3) interpretation time for both transverse and 3D images. We analyzed discordance between each radiology resident and the neuroradiologist on a lesion-by-lesion basis. RESULTSIn total, 509 lesions were detected in 218 patients. Discordance rates between the three residents and the neuroradiologist were 11.4%-20.2% (mean, 15.0%) and 8.8%-16.9% (mean, 12.1%) in the interpretation of transverse and 3D images, respectively. Confidence scores were higher for 3D images than for transverse images for all readers. The added value scores for the 3D images were relatively higher for the inexperienced residents. Interpretation times for 3D images were significantly higher than for transverse images for all readers. CONCLUSIONThe 3D reformations assist radiology residents in the interpretation of emergency cranial CT examinations. U nenhanced cranial computed tomography (CT) is the primary imaging modality for the emergency evaluation of patients with acute neurological deficits because of its wide availability, speed, costeffectiveness, and ability to assess less stable patients (1). Although some institutions may have 24-hour CT interpretation by an experienced neuroradiologist, many hospitals provide overnight coverage for CT studies by an on-call radiology resident. The final interpretation is then provided by attending neuroradiologists, usually the next day. Thus, accurate initial interpretation of cranial CT scans by the resident is critical for proper patient management.A few studies have investigated discordance between radiology residents and neuroradiologists in the interpretation of unenhanced cranial CT scans and they reported discordance rates in the range of 2.1%-8.3% (2-4). This discordance rate may be influenced by several factors, such as the resident's level of training, prevalence and type of disease, and imaging technique (e.g., resolution, display, image plane).A few studies have assessed the added value of three-dimensional (3D) reformations versus transverse plane views in the evaluation of cranial CT examinations (5, 6). To our knowledge, however, no reported study has evaluated the effect of 3D reformatted images on radiology residents' performance.The aim of this study was to assess the value of 3D ref...

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“…Its high specificity and sensitivity were maintained even when reported by an on-call radiology registrar and were comparable to results obtained by experienced consultant radiologists. In contrast, a previous study showed that interpretation of CT scans in the emergency setting, both of trauma and nontrauma injuries, was related to the level of training of the radiologist 25 .…”

Section: Discussionmentioning

confidence: 69%

Accuracy of computed tomography in the detection of blunt bowel and mesenteric injuries

Elton

Riaz

Young

et al. 2005

British Journal of Surgery

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Effects of training and experience in interpretation of emergency body CT scans.

Abstract: Experience appeared to decrease discrepancy rates. Trainees were more likely to miss findings than to read normal scans as abnormal.

Cited by 119 publications

References 0 publications

Trainee Misinterpretations on Pediatric Neuroimaging Studies: Classification, Imaging Analysis, and Outcome Assessment

Trainee Misinterpretations on Pediatric Neuroimaging Studies: Classification, Imaging Analysis, and Outcome Assessment

Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images

Accuracy of computed tomography in the detection of blunt bowel and mesenteric injuries

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