Resident Interpretation of Emergency Computed Tomographic Scans

Roszler, Myer H.; McCarroll, Kathleen; Rashid, Tariq; Donovan, Kate; Kling, George A.

doi:10.1097/00004424-199104000-00016

Cited by 61 publications

(30 citation statements)

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“…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)(3)(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).…”

Section: Resultsmentioning

confidence: 99%

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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Section: Resultsmentioning

confidence: 99%

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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“…The six studies (948 scans) that documented observer agreement as either proportions in agreement or percentage accuracy, tended to mirror more closely real clinical situations 223,[286][287][288][289][290] ( interpretation of scans by emergency physicians noted 87-98% accuracy for all pathological lesions. 286,287 Accuracy fell to 67% when emergency physicians were asked to identify lesions pertinent to the interpretation of ischaemia and haemorrhage only.…”

Section: Interobserver Agreement In Ct Scan Interpretation In Cerebramentioning

confidence: 99%

“…286,287 Accuracy fell to 67% when emergency physicians were asked to identify lesions pertinent to the interpretation of ischaemia and haemorrhage only. 289 In this study, neurologists and radiologists interpreted ischaemia and haemorrhage on scans with greater accuracy (83%).…”

Section: Interobserver Agreement In Ct Scan Interpretation In Cerebramentioning

confidence: 99%

What is the best imaging strategy for acute stroke?

Wardlaw

Keir²,

Seymour³

et al. 2004

Health Technol Assess

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAWhat is the best imaging strategy for acute stroke? NHS R&D HTA ProgrammeT he NHS R&D Health Technology Assessment (HTA) Programme was set up in 1993 to ensure that high-quality research information on the costs, effectiveness and broader impact of health technologies is produced in the most efficient way for those who use, manage and provide care in the NHS.Initially, six HTA panels (pharmaceuticals, acute sector, primary and community care, diagnostics and imaging, population screening, methodology) helped to set the research priorities for the HTA Programme. However, during the past few years there have been a number of changes in and around NHS R&D, such as the establishment of the National Institute for Clinical Excellence (NICE) and the creation of three new research programmes: Service Delivery and Organisation (SDO); New and Emerging Applications of Technology (NEAT); and the Methodology Programme.This has meant that the HTA panels can now focus more explicitly on health technologies ('health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care) rather than settings of care. Therefore the panel structure was replaced in 2000 by three new panels: Pharmaceuticals; Therapeutic Procedures (including devices and operations); and Diagnostic Technologies and Screening.The HTA Programme will continue to commission both primary and secondary research. The HTA Commissioning Board, supported by the National Coordinat...

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“…Therefore, the errors in emergency radiology are multivariable [19,20]. Since MDCT's implementation in the evaluation of the patients with polytrauma, the cause for different and recurrent types of errors in addition to their rationale has been discussed extensively [21][22][23][24].…”

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confidence: 99%

Errors in imaging of traumatic injuries

Scaglione

Iaselli

Sica³

et al. 2015

Abdom Imaging

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The advent of multi-detector computed tomography (MDCT) has drastically improved the outcomes of patients with multiple traumatic injuries. However, there are still diagnostic challenges to be considered. A missed or the delay of a diagnosis in trauma patients can sometimes be related to perception or other non-visual cues, while other errors are due to poor technique or poor image quality. In order to avoid any serious complications, it is important for the practicing radiologist to be cognizant of some of the most common types of errors. The objective of this article is to review the various types of errors in the evaluation of patients with multiple trauma injuries or polytrauma with MDCT.

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Resident Interpretation of Emergency Computed Tomographic Scans

Cited by 61 publications

References 0 publications

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

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

What is the best imaging strategy for acute stroke?

Errors in imaging of traumatic injuries

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