Radiological misinterpretations by emergency physicians in discharged minor trauma patients

Abstract

Despite a relatively low CSD rate, careful interpretation is recommended considering age and body areas imaged. A modified model would be needed as a supportive tool for training and improving the quality of care. A further development of the modified system for efficient use of resources will be needed to focus on quality improvement and education in each hospital.

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

“…There were no significant differences for these parameters between patients who were diagnosed accurately or inaccurately by emergency residents. Our data of clinical effect are consistent with other study (7, 11, 12, 23). It seems that EM residents are relying on other available data (patient's history, physical examination, observation and consultation) to prevent clinical mistakes.…”

“…If possible, the preliminary interpretations of radiology physicians are needed to make up for the interpretation of emergency residents. Some studies (22, 23) reported that the importance of systematic support to reduce the discrepancy in radiology imaging. Therefore we think that we could reduce the discrepancy of emergency residents by systematic support.…”

Anatomical and/or pathological predictors for the “incorrect” classification of red dot markers on wrist radiographs taken following trauma

“…Given the lack of previous research, three other anatomical/ pathological characteristics were selected as potential predictors of error in image interpretation, measured by correct or incorrect red dot classification. Degenerative change has been linked to radiograph misinterpretation, 24 whilst epiphyseal growth plates may obscure paediatric fracture detection. 28,35 Old fractures also present susceptibility to error, as they may be misinterpreted as acute injuries or confused with tumours, warranting inclusion in this study.…”

“…The subjective nature of this decreases internal validity, but if validated by other groups, these conditions extrinsic to the interpreted images may have wider implications for radiographers and red dot performance. Kim et al 24 identified patient age as a predictor for discordant radiograph interpretation and was the only study to propose a pathological factor (presence of degenerative change) as a reason for error. However, this was suggested alongside difficulties in history taking and physical examination and warrants further investigation.…”

Adverse Events from Emergency Physician Pediatric Extremity Radiograph Interpretations: A Prospective Cohort Study

“…Studies often included all types of pediatric radiograph images or include a mix of adult and pediatric radiographs, resulting in a relatively small sample of pediatric MSK radiographs. [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Furthermore, most research to date in this area was conducted using a retrospective design, which may be prone to unstandardized methods of recording diagnostic interpretations and result in incorrect estimates. The published estimates to date also emphasize ED physician interpretation errors that miss a fracture/dislocation (false negatives) and have excluded the errors that occur when a fracture/dislocation is reported but not confirmed by radiology review (false positives).…”