The role of consistency and experience among physicians from different specialties in the interpretation of brain tomography

Öz

Aim: This study examined the consistency rate among physicians and the factors affecting it when interpreting brain computed tomography (CT) scans of emergency department (ED) patients. Materials and Methods: This study retrospectively examined the records of patients who presented to the ED. For one month, all brain tomography requested from the emergency department due to cerebrovascular disease (stroke/CVD) or trauma were reviewed by the general practitioner, emergency medicine specialist, neurologist, and radiologists. Cohen’s Kappa statistics were used to measure consistency. The near the Kappa result is to 1, the higher the perceived level of consistency in the results. Results: The study analyzed brain CT interpretations of 291 patients. Radiologists detected bleeding in 12 patients (4.1%). In patients with bleeding, in the group with both trauma and CVD, a significant (p< 0.05) consistency was observed between all clinicians and radiologists. When consistency in patient outcomes according to the hospital was examined, a significant (p < 0.05) consistency was observed between the emergency medicine specialist, neurologist, and radiologists in the discharged and hospitalized groups. There was no consistency between the general practitioner and the radiologists in both groups. Conclusion: In this study, the general practitioner's consistency with the radiologists was low, while the consistency of the other clinicians was high. This result suggests that collaborating with the emergency medicine specialist and neurologist can reduce the misinterpretation rate.

Anahtar Kelimeler

• Brain tomography
• Consistency
• Haemorrhage
• Emergency department

Beyin tomografisinin değerlendirilmesinde farklı uzmanlık alanlarından hekimler arasındaki uyum ve deneyimin rolü

Öz

Amaç: Bu çalışmada, acil servis hastalarının beyin bilgisayarlı tomografisini (BT) yorumlarken hekimler arasındaki uyum oranı ve bunu etkileyen durumlar incelenmiştir. Gereçler ve Yöntemler: Bu çalışmada, Acil Servise başvuran hastaların kayıtları retrospektif olarak incelenmiştir. Bir ay boyunca, serebrovasküler hastalık (inme/SVH) veya travma nedeniyle acil servisten talep edilen tüm beyin tomografi görüntüleri, pratisyen hekim, acil tıp uzmanı, nörolog ve radyologlar tarafından incelenmiştir. Uyumluluğu ölçmek için Cohen'in Kappa istatistik yöntemi kullanıldı. Kappa sonucu 1'e ne kadar yakınsa, sonuçlardaki algılanan tutarlılık düzeyi o kadar yüksek kabul edildi. Bulgular: Çalışmada 291 hastanın beyin BT yorumları analiz edildi. Radyologlar 12 hastada (%4,1) kanama tespit etmiştir. Hem travma hem de inme olan grupta, kanaması olan hastalarda, tüm klinisyenler ve radyologlar arasında anlamlı (p< 0,05) bir uyum gözlenmiştir. Hastaların sonuçlarına göre uyum incelendiğinde, taburcu edilen ve hastaneye yatırılan grupta acil servis uzmanı, nörolog ve radyologlar arasında anlamlı (p< 0,05) bir uyum gözlendi. Her iki grupta da pratisyen hekim ve radyologlar arasında uyum yoktu. Sonuç: Bu çalışmada, pratisyen hekimin radyologlarla uyumu düşükken, diğer klinisyenlerin uyumu yüksekti. Bu sonuç, acil servis uzmanı ve nörologla iş birliği yapmanın yanlış yorumlama oranını azaltabileceğini düşündürmektedir.

Anahtar Kelimeler

• Beyin tomografisi
• Tutarlılık
• Kanama
• Acil servis

Kaynakça

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