TY - JOUR T1 - Comparison of abdominal ct interpretation levels of emergency physicians and radiologists TT - Acil hekimlerinin ve radyoloji uzmanlarının abdomen BT yorumlama düzeylerinin karşılaştırılması AU - Turgut, Kasim PY - 2019 DA - August Y2 - 2019 DO - 10.30569/adiyamansaglik.566746 JF - Adıyaman Üniversitesi Sağlık Bilimleri Dergisi JO - ADYÜ Sağlık Bilimleri Derg PB - Adıyaman Üniversitesi WT - DergiPark SN - 2458-9179 SP - 1482 EP - 1491 VL - 5 IS - 2 LA - en AB - Aim: Computerized tomography (CT) is a frequently useddiagnostic tool in the emergency department. In order to provide early andappropriate intervention for the patients, emergency physicians should be ableto accurately interpret CT images at least to a certain degree. In this study,we aimed to determine the accuracy of emergency physicians in evaluating anabdominal CT.Methods: In 2018, the images of 234 patients who underwent anabdominal CT due to trauma were interpreted by emergency physicians(EP). Thelevel of agreement between emergency physicians and radiologists on theseabdominal CT was determined by comparing their evaluations.This comparison wasmade using the kappa statistics.Results: The rate of concordance in CT interpretations betweenthe EPs and radiologists was 52.1%. The accuracy rate of EP on interpretationCT images was 59.22% (95% CI: 52.18-66) and thekappa value was 0.24. For the CT interpretation of emergency physicians, thesensitivity, specificity, positive predictive value and negative predictivevalue 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 CTimages is not at an adequate level. The institutions in emergency medicineshould organize educative programs to increase this level. KW - abdomen: KW - computerized tomography KW - sensitivity; KW - emergency physician N2 - Amaç: BT acil serviste sıklıkla kullanılan bir tanı aracıdır. Hastalara erken ve doğru müdahaleyapabilmek için acil hekimlerinin çekilen BT leri belli düzeydeyorumlayabilmeleri gerekmektedir. Buçalışmada acil hekimlerinin abdomen BT yorumlayabilme düzeylerini belirlemeyiamaçladık.Yöntem: 2018 yılı içerisinde travma nedeniyle acilde abdomen BT çekilen 234hastanın görüntüleri acil hekimleri tarafından yorumlandı. Bu yorumlar öncedenyazılmış olan radyoloji doktoru raporlarlarıyla karşılaştırılarak uyum düzeyibelirlendi. Bu karşılaştırma kappa istatistiği kullanılarak yapıldı.Bulgular: Acil hekimlerinin abdomen bilgisayarlı tomografiyi değerlendirmederadyologlarla uyum oranı 52.1% olarak belirlendi. Acil hekimlerinin abdomenbilgisayarlı tomografiyi doğru değerlendirme oranı ise 59.22% (95% CI: 52.18-66) ve kappa değeri 0.24 olarak tespitedildi. 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 düzeyleriyetersizdir. Bu düzeyi yükseltmek için ilgili kuruluşların eğitim programlarıdüzenlemesi gerekir. CR - 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 CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. CR - 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. UR - https://doi.org/10.30569/adiyamansaglik.566746 L1 - https://dergipark.org.tr/tr/download/article-file/778359 ER -