Research Article
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Acil hekimlerinin ve radyoloji uzmanlarının abdomen BT yorumlama düzeylerinin karşılaştırılması

Year 2019, , 1482 - 1491, 15.08.2019
https://doi.org/10.30569/adiyamansaglik.566746

Abstract

Amaç: BT acil serviste sıklıkla kullanılan bir tanı aracıdır. Hastalara erken ve doğru müdahale
yapabilmek için acil hekimlerinin çekilen BT leri belli düzeyde
yorumlayabilmeleri gerekmektedir. Bu
çalışmada acil hekimlerinin abdomen BT yorumlayabilme düzeylerini belirlemeyi
amaçladık.



Yöntem: 2018 yılı içerisinde travma nedeniyle acilde abdomen BT çekilen 234
hastanın görüntüleri acil hekimleri tarafından yorumlandı. Bu yorumlar önceden
yazılmış olan radyoloji doktoru raporlarlarıyla karşılaştırılarak uyum düzeyi
belirlendi. Bu karşılaştırma kappa istatistiği kullanılarak yapıldı.



Bulgular: Acil hekimlerinin abdomen bilgisayarlı tomografiyi değerlendirmede
radyologlarla uyum oranı 52.1% olarak belirlendi. Acil hekimlerinin abdomen
bilgisayarlı tomografiyi doğru değerlendirme oranı ise
59.22% (95% CI: 52.18-66) ve kappa değeri 0.24 olarak tespit
edildi. Acil hekimlerinin BT yorumlama ile ilgili sensitivite, spesifite,
pozitif prediktif değer ve negatif prediktif değeri sırasıyla
40.98%(95% CI: 32.17-50.25), 85.71%(95% CI: 76.38-92.39), 80.65%(95% CI: 70.30-88.00) ve 50%(95% CI:
45.72-54.28
) olarak belirlendi.



Sonuç: Acil hekimlerinin travma hastalarında abdomen BT değerlendirme düzeyleri
yetersizdir. Bu düzeyi yükseltmek için ilgili kuruluşların eğitim programları
düzenlemesi gerekir.

Supporting Institution

yok

Project Number

Adıyaman University Clinical Research Ethics Committee (Approval nu: 2019/2-13).

References

  • 1. Arhami Dolatabadi A, Baratloo A, Rouhipour A, et al. Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists. Trauma Mon. 2013;18(2):86-9
  • 2. Hussein W, Mullins PM, Alghamdi K, et al. Trends in Advanced Computed Tomography Use for Injured Patients in United States Emergency Departments: 2007–2010. Acad Emerg Med. 2015;22(6):663-9.
  • 3. Kirsch TD, Hsieh YH, Horana L, et al. Computed tomography scan utilization in emergency departments: a multi-state analysis. J Emerg Med. 2011;41(3):302-9Referans4. Wagner MG, Fischer MR, Scaglione M, et al. Subspecialisation in Emergency Radiology: Proposal for a harmonised European curriculum. GMS J Med Educ. 2017;34(5):61.
  • 5. Khan A, Qashqari S, Al-Ali AA. Accuracy of non-contrast CT brain interpretation by emergency physicians: A cohort study. Pak J Med Sci. 2013;29(2):549-53.
  • 6. Holdgate A, Chan T. How Accurate Are Emergency Clinicians at Interpreting Noncontrast Computed Tomography for Suspected Renal Colic? Acad Emerg Med. 2003;10(4):315-9.
  • 7. Ardic S, Guneysel O. Emergency medicine residents can assess cranial computed tomography scans consistently with radiologists. Journal of Acute Medicine 5 (2015) 92-5.
  • 8. Kwon JM, Kim J, Kim K, et al. Can emergency physicians reliably interpret cardiac CT images? A prospective observational study. Clin Exp Emerg Med. 2015;2(1):38-43.
  • 9. Hochhegger B, Alves GRT, Chaves M, et al. Interobserver agreement between radiologists and radiology residents and emergency physicians in the detection of PE using CTPA. Clin Imaging. 2014;38(4):445-447.
  • 10. Kang MJ, Sim MS, Shin TG, et al. Evaluating the Accuracy of Emergency Medicine Resident Interpretations of Abdominal CTs in Patients with Non-Traumatic Abdominal Pain. J Korean Med Sci. 2012;27(10):1255-60.
  • 11. Bagheri-Hariri S, Ayoobi-Yazdi N, Afkar M, et al. Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists’ report and its impact on patients’ outcome. Emerg Radiol. 2017;24(6):675-680.
  • 12. Hansen CK, Strayer RJ, Shy BD, et al. Prevalence of negative CT scans in a level one trauma center. Eur J Trauma Emerg Surg. 2018;44(1):29-33.
  • 13. Gupta M, Schriger DL, Hiatt JR, et al. Selective Use of Computed Tomography Compared With Routine Whole Body Imaging in Patients With Blunt Trauma. Ann Emerg Med. 2011;58(5):407-16.
  • 14. Wong C, Taubman K, Hoehne F, et al. The quality of surgical resident interpretation of after-hour CT scans of the head and abdomen in trauma. Am Surg. 2005;71(9):772-5.
  • 15. Alfaro D, Levitt MA, English DK, et al. Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program. Ann Emerg Med. 1995;25(2):169-74.

Comparison of abdominal ct interpretation levels of emergency physicians and radiologists

Year 2019, , 1482 - 1491, 15.08.2019
https://doi.org/10.30569/adiyamansaglik.566746

Abstract

Aim: Computerized tomography (CT) is a frequently used
diagnostic tool in the emergency department. In order to provide early and
appropriate intervention for the patients, emergency physicians should be able
to accurately interpret CT images at least to a certain degree. In this study,
we aimed to determine the accuracy of emergency physicians in evaluating an
abdominal CT.

Methods: In 2018, the images of 234 patients who underwent an
abdominal CT due to trauma were interpreted by emergency physicians(EP). The
level of agreement between emergency physicians and radiologists on these
abdominal CT was determined by comparing their evaluations.This comparison was
made using the kappa statistics.

Results: The rate of concordance in CT interpretations between
the EPs and radiologists was 52.1%. The accuracy rate of EP on interpretation
CT images was 59.22% (95% CI:
52.18-66) and the
kappa value was 0.24. For the CT interpretation of emergency physicians, the
sensitivity, specificity, positive predictive value and negative predictive
value were calculated as 40.98%(95% CI: 32.17-50.25), 85.71%(95% CI:
76.38-92.39), 80.65%(95% CI: 70.30-88.00) and 50%(95% CI:
45.72-54.28
), respectively.







Conclusion: Emergency physicians’ accuracy in interpreting CT
images is not at an adequate level. The institutions in emergency medicine
should organize educative programs to increase this level.

Project Number

Adıyaman University Clinical Research Ethics Committee (Approval nu: 2019/2-13).

References

  • 1. Arhami Dolatabadi A, Baratloo A, Rouhipour A, et al. Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists. Trauma Mon. 2013;18(2):86-9
  • 2. Hussein W, Mullins PM, Alghamdi K, et al. Trends in Advanced Computed Tomography Use for Injured Patients in United States Emergency Departments: 2007–2010. Acad Emerg Med. 2015;22(6):663-9.
  • 3. Kirsch TD, Hsieh YH, Horana L, et al. Computed tomography scan utilization in emergency departments: a multi-state analysis. J Emerg Med. 2011;41(3):302-9Referans4. Wagner MG, Fischer MR, Scaglione M, et al. Subspecialisation in Emergency Radiology: Proposal for a harmonised European curriculum. GMS J Med Educ. 2017;34(5):61.
  • 5. Khan A, Qashqari S, Al-Ali AA. Accuracy of non-contrast CT brain interpretation by emergency physicians: A cohort study. Pak J Med Sci. 2013;29(2):549-53.
  • 6. Holdgate A, Chan T. How Accurate Are Emergency Clinicians at Interpreting Noncontrast Computed Tomography for Suspected Renal Colic? Acad Emerg Med. 2003;10(4):315-9.
  • 7. Ardic S, Guneysel O. Emergency medicine residents can assess cranial computed tomography scans consistently with radiologists. Journal of Acute Medicine 5 (2015) 92-5.
  • 8. Kwon JM, Kim J, Kim K, et al. Can emergency physicians reliably interpret cardiac CT images? A prospective observational study. Clin Exp Emerg Med. 2015;2(1):38-43.
  • 9. Hochhegger B, Alves GRT, Chaves M, et al. Interobserver agreement between radiologists and radiology residents and emergency physicians in the detection of PE using CTPA. Clin Imaging. 2014;38(4):445-447.
  • 10. Kang MJ, Sim MS, Shin TG, et al. Evaluating the Accuracy of Emergency Medicine Resident Interpretations of Abdominal CTs in Patients with Non-Traumatic Abdominal Pain. J Korean Med Sci. 2012;27(10):1255-60.
  • 11. Bagheri-Hariri S, Ayoobi-Yazdi N, Afkar M, et al. Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists’ report and its impact on patients’ outcome. Emerg Radiol. 2017;24(6):675-680.
  • 12. Hansen CK, Strayer RJ, Shy BD, et al. Prevalence of negative CT scans in a level one trauma center. Eur J Trauma Emerg Surg. 2018;44(1):29-33.
  • 13. Gupta M, Schriger DL, Hiatt JR, et al. Selective Use of Computed Tomography Compared With Routine Whole Body Imaging in Patients With Blunt Trauma. Ann Emerg Med. 2011;58(5):407-16.
  • 14. Wong C, Taubman K, Hoehne F, et al. The quality of surgical resident interpretation of after-hour CT scans of the head and abdomen in trauma. Am Surg. 2005;71(9):772-5.
  • 15. Alfaro D, Levitt MA, English DK, et al. Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program. Ann Emerg Med. 1995;25(2):169-74.
There are 14 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Research Article
Authors

Kasim Turgut 0000-0003-2955-1714

Project Number Adıyaman University Clinical Research Ethics Committee (Approval nu: 2019/2-13).
Publication Date August 15, 2019
Submission Date May 17, 2019
Acceptance Date July 2, 2019
Published in Issue Year 2019

Cite

AMA Turgut K. Comparison of abdominal ct interpretation levels of emergency physicians and radiologists. ADYÜ Sağlık Bilimleri Derg. August 2019;5(2):1482-1491. doi:10.30569/adiyamansaglik.566746