Evaluation of thoracic computed tomography interpretation by emergency medicine residents with regards to accuracy and confidence

Year 2023, , 698 - 703, 01.10.2023

Alten Oskay

https://doi.org/10.31362/patd.1353037

Abstract

Purpose: Interpration of thoracic computed tomography (CT) scans by emergency department (ED) physicians is important especially in crowded EDs. The aim of this study is to assess the proficiency and confidence of ED physicians with varying levels of experience in interpreting thoracic CT.
Materials and methods: A total of 25 pathological and 5 normal thoracic CT images were interpreted by 32 ED residents, initially without clinical information, then with. After each session the participants were asked to score their confidence on a scale of 1 to 10. At the end of the study, the results were compared between seniors and junior residents.
Results: The median age of the participants was 29 years (24–34). Twenty (62.5%) of the residents were junior residents. There were no significant differences between the two resident groups in terms of accurate diagnosis rates, regardless of the clinical information (p=0.307 and p=0.061). The physicians’ certainty of their own diagnosis mostly does not seem to be statistically different in these diagnoses. The seniors are more confident in the diagnosis of the CT scans they evaluated without clinical information (p=0.004), while when the clinical information is added, the confidence of the junior physicians also increase (p=0.087).
Conclusion: Both senior and junior emergency medical residents are able to interpret thoracic CT images with a high degree of accuracy, both for COVID-19 and for other emergency diagnoses. Senior physicians could confidently diagnose CT images solely by visual inspection, whereas junior residents display similar confidence when clinical information is available.

Keywords

Clinical information, confidence, emergency medicine, residents, thoracic computed tomography

Ethical Statement

Permission was obtained from Pamukkale University Non-Interventional Clinical Research Ethics Committee for the study (14.04.2020, 07).

Supporting Institution

None

Thanks

None

Acil tıp araştırma görevlilerinin, toraks bilgisayarlı tomografisi yorumlamada doğruluk ve özgüven açısından değerlendirilmesi

Abstract

Amaç: Özellikle kalabalık acil servislerde, toraks bilgisayarlı tomografisinin (BT) acil hekimleri tarafından yorumlanması önemlidir. Çalışmanın amacı, toraks BT'sinin yorumlanmasında farklı düzeylerde deneyime sahip acil tıp asistanlarının yeterliliklerini ve özgüvenlerini değerlendirmektir.
Gereç ve yöntem: Yirmibeş patolojik ve 5 normal toraks BT görüntüsü, başlangıçta klinik bilgi olmadan, daha sonra da klinik bilgi eklenerek 32 acil tıp asistanı tarafından yorumlanmıştır. Her oturumdan sonra katılımcılardan kararlarına olan güvenlerini 1 ila 10 arasında bir ölçekte puanlamaları istenmiştir. Çalışmanın sonunda, elde edilen sonuçlar çömez ve kıdemli asistanlar arasında karşılaştırılmıştır.
Bulgular: Katılımcıların ortanca yaşı 29 (24-34) idi. Asistanların 20’si (%62,5) çömezdi. İki asistan grubu arasında, klinik bilgiden bağımsız olarak, doğru tanı koyma oranları açısından anlamlı fark saptanmamıştır (p=0,307 ve p=0,061). Kıdemliler klinik bilgi olmadan toraks BT’lerini değerlendirirken, kendilerine çömez asistanlara göre daha fazla güvenmektedirler (p=0,004). Klinik bilgi eklendiğinde çömez asistanlar da kıdemliler kadar kendi tanılarına güvenmektedirler (p=0,087).
Sonuç: Hem kıdemli hem de çömez acil tıp asistanları, toraks BT görüntülerini hem COVID-19 hem de diğer acil teşhisler için yüksek derecede doğrulukla yorumlayabilmektedir. Kıdemli asistanlar BT görüntülerine klinik bilgi olmadan güvenle tanı koyabiliyorken, çömez asistanlar klinik bilgi eklendiğinde benzer bir güvene sahip olmaktadırlar.

Keywords

Acil tıp, asistan hekimler, klinik bilgi, özgüven, toraks bilgisayarlı tomografisi

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