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

Abstract

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.