The Interpretation Of Computed Tomography Pulmonary Angiography Evaluation Of Compliance Between Emergency Medical Assistants And Radiologists

Year 2024, , 620 - 625, 30.09.2024

Göksun Perver , Rıdvan Atilla , Naciye Sinem Gezer , Ahmet Çağdaş Acara , Gökay Gedik , Bahar Elif Güldali

https://doi.org/10.30621/jbachs.1452766

Abstract

Purpose: Computed tomography pulmonary angiography (CTPA) is an effective method far the evaluation of patients with suspected pulmonary thromboembolism (PTE) and should be interpreted quickly and accurately. We aimed ta determine the agreement between emergency medicine assistants (EMAs) and radiology assistants (RA) and specialists (RS) in the evaluation of CTPA
Materials and Methods: 11 EMAs, one RA and one RS participated in the study. 100 CTPA images were re-reported. The participating RA evaluated 100 CTPAs and 11 EMAs evaluated 20 randomised CTPAs aut of 100. The Kappa statistic was used ta assess agreement, and the Douglas G. Altman classifıcation (K<0.20 poor, K: 0.21-0.40 fair, K: 0.41-0.60 moderate, K: 0.61-0.80 good, K: 0.81-1.00 very good) was used ta grade consistency.
Results: The agreement between EMA and RS was 79.1% far the presence of PTE, 59.1% far the location, 84.5% far the parenchymal fınding, 70.0% far the name of the parenchymal fınding. Moderate agreement was found between EMA and RS in the assessment of the presence of PTE (Kappa: 0.590)
Conclusion: There is moderate agreement between EMA and RS in CTPA evaluation.

Keywords

Computed tomography pulmonary angiography, emergency medicine resident, radiologist

References

• Konstantinides SV, Meyer G, Becattini C, et al. 2019 ESC guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS) EurHeart J 2019; 00:1-61.
• Keller K, Hobohm L, Ebner M, et al. Trends in thrombolytic treatment and outcomes of acute pulmonary embolism in Germany. EurHeart J 2020;41(4):522-529.
• Gemicioğlu B, Börekçi Ş, Dilektaşlı AG, Ulubay G, Azap Ö, Saryal S. Turkish Thoracic Society Experts Consensus Report: Recommendations for Pulmonary Function Tests During and After COVID 19 Pandemic. Turk Thorac J. 2020 May;21(3):193-200.
• Guven R, Akca AH, Caltili C, et al. Comparing the interpretation of emergency department computed tomography between emergency physicians and attending radiologists: A multi center study. Niger J Clin Pract 2018;21(10):1323-1329.
• Stein PD, Fowler SE, Goodman LR, et al. Multi detector computed tomography for acute pulmonary embolism. N Engl J Med 2006;354(22):2317-2327.
• Yalçın K., Analysis of Parenchymal and Pleural Findings of Acute Pulmonary Embolism Detected with Thorax Computerized Tomography Angiography, BosphorusMed J 2019;6(2):37-43.
• Aydın SA, Bulut M, Topal NB, Akgoz S, Koksal O, Orcan S, Turan M, Aydın T, Gültekin E, Oncu MR, Durmus O, Eren B, Ozguç H. Performance of emergency medicine residents in the interpretation of radiographs with trauma. Emerg MEd J 2008 Aug;25(8):482-5.
• Hochhegger B, Alves GRT, Chaves M, et al. Inter observer agreement between radiologists and radiology residents and emergency physicians in the detection of PE using CTPA. ClinImaging 2014;38(4):445-447.
• Cervini P, Bell CM, Roberts HC, Provost YL, Chung TB, Paul NS. Radiology resident interpretation of on-call CT pulmonary angiograms. AcadRadiol 2008;15(5):556-562.
• Bedel C, Yolcu S, Albayrak L, Çetin NG, Tomruk O. Akut Pulmoner Embolide Klinik ve Laboratuvar Değerleri ile Trombüs Yerleşim Yeri Arasındaki İlişkinin Araştırılması. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi 2018;20(1):41-50.
• Duru S, Ergün R, Dilli A, Kaplan T, Kaplan B, Ardıç S. Clinical, laboratory and computed tomography pulmonary angiography results in pulmonary embolism. Anatolian Society of Cardiology 2012;12:(2);142-150.
• Arhami Dolatabadi A, Baratloo A, Rouhipour A, et al. Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists. TraumaMon 2013;18(2):86-89.
• Perron AD, Huff JS, Ullrich CG, Heafner MD, Kline JA. A multi center study to improve emergency medicine residents’ recognition of intracranial emergencies on computed tomography. AnnEmergMed 1998;32(5):554-562.