Evaluating the Accuracy of Emergency Medicine Resident Interpretations of Abdominal CTs in Patients with Non-Traumatic Abdominal Pain

Abstract

Abdominal computed tomography (CT) is widely used as a diagnostic tool in emergency medicine (EM) to accurately diagnose abdominal pain. EM residents must be able to offer preliminary interpretations of CT imaging. In this study, we evaluated the preliminary interpretation ability of a sample of emergency residents presented with adult abdominal CT images, and compared their results with those of radiology residents. We conducted a prospective observational study from November 16, 2008 to June 30, 2009. During this time, we gathered preliminary interpretations of consecutive abdominal CT made by emergency and radiology residents. We assessed the discrepancy rates of both samples by comparing their findings to the final reports from attending radiologists. A total of 884 cases were enrolled in the present study. The discrepancy rates of emergency and radiology residents were 16.7% and 12.2%, respectively. When female genital organs, peritoneum, adrenal glands, or the musculoskeletal system were abnormal, we found that emergency residents' preliminary interpretations of CT images were insufficient compared to those of radiology residents. Therefore more formal education is needed to emergency residents. If possible, the preliminary interpretations of radiology attending physicians are ideal until improving the ability of interpretations of emergency residents in abdomen CT.

Recognizing Acute Appendicitis Criteria on Abdominal CT: Do Emergency Physicians Need a Preliminary Report?

“…With less experienced readers, the sensitivity of CT for AA is considerably lower [16,22]. In this study, observers performed their interpretation in the ED to mimic original judgment conditions.…”

“…For the diagnosis of AA, recent reports have supported the widespread use of CT in the evaluation of patients with suspected AA, citing sensitivity, specificity, and accuracy rates of 98%, 97%, and 98%, respectively [7][8][9][10][11][12]. Although recent literature has established the capability of radiology residents or fellows to interpret radiologic images in the ED, only a few studies have been published regarding the capability of emergency physicians to do so as well [13][14][15][16].…”

A Retrospective Analysis of Patients Receiving Teleradiology Consultations for Computed Tomography in the Emergency Department

“…One study examining the increasing use of tomography revealed that the highest increase in requests in 1996-2007 was for abdominal CT, involving a 10fold rise (13). However, another study also observed that EPs incorrectly evaluated radiological images and abdominal CT significantly more than radiologists (14,15). Moreover, the most significant discrepancy with images evaluated by radiologists was seen in tomographies of the neck and abdomen (16).…”

Discrepancies in interpretation of night-time emergency computed tomography scans by radiology residents

“…Rather extensive research has been done on the accuracy and discrepancies of preliminary CT reports given by radiology residents ( 9 – 14 ). Most of the earlier studies have been carried out in large centers with busy emergency radiology units.…”