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

Yıl 2026, Cilt: 4 Sayı: 1, 15 - 22, 28.02.2026
https://doi.org/10.61845/agrimedical.1784563
https://izlik.org/JA29CT99MB

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.

Etik Beyan

This study was approved by the Kırklareli University Faculty of Medicine Scientific Research Ethics Committee (P20210001-1/14.09.21) and conducted in accordance with the Declaration of Helsinki.

Kaynakça

  • Dolatabadi AA, Baratloo A, Rouhipour A, et al. Interpretation of computed tomography of the head: emergency physicians versus radiologists. Trauma Mon. 2013;18(2): 86. https://doi.org/10.5812/traumamon.12023
  • Mucci B, Brett C, Huntley LS, Green MK. Cranial computed tomography in trauma: the accuracy of interpretation by staff in the emergency department. EMJ BMJ 2005; 22(8): 538-40. https://doi.org/10.1136/emj.2003.013755
  • Erly WK, Berger WG, Krupinski E, Seeger JF, Guisto JA. Radiology resident evaluation of head CT scan orders in the emergency department. AJNR. 2002; 23(1): 103-7.
  • Khan A, Qashqari S, Al-Ali AA. Accuracy of non-contrast CT brain interpretation by emergency physicians: a cohort study. PJMS. 2013; 29(2): 549. https://doi.org/10.12669/pjms.292.3220
  • Cengel F, Gurkan O, Calik M, et al. Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians. HKJEM. 2021; 28(1): 15-21. https://doi.org/10.1177/1024907920968648
  • Ismail Y, Bughio S, Ahmed N. The Inter-Observer Agreement Between Resident and Consultant Radiologists in Reporting Emergency Head CT Scans. J Med Res Surg. 2024; 5(1): 17-21. https://doi.org/10.52916/jmrs244130
  • Kobkitsuksakul C, Tritanon O, Suraratdecha V. Interobserver agreement between senior radiology resident, neuroradiology fellow, and experienced neuroradiologist in the rating of Alberta Stroke Program Early Computed Tomography Score (ASPECTS). DIR. 2018; 24(2): 104. https://doi.org/10.5152/dir.2018.17336
  • Alfaro D, Levitt MA, English DK, Williams V, Eisenberg R. Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program. Ann. Emerg. Med. 1995; 25(2): 169-74. https://doi.org/10.1016/S0196-0644(95)70319-5
  • Arendts G, Manovel A, Chai A. Cranial CT interpretation by senior emergency department staff. JMIRO. 2003; 47(4): 368-74. https://doi.org/10.1046/j.1440-1673.2003.01204.x
  • McHugh ML. Interrater reliability: the kappa statistic. Biochemia Med. 2012; 22(3): 276-82.
  • Schriger DL, Kalafut M, Starkman S, Krueger M, Saver JL. Cranial computed tomography interpretation in acute stroke: physician accuracy in determining eligibility for thrombolytic therapy. Jama. 1998; 279(16): 1293-7. https://doi.org/10.1001/jama.279.16.1293
  • Güven R, Akça AH, Çaltılı Ç, et al. Comparing the interpretation of emergency department computed tomography between emergency physicians and attending radiologists: A multicenter study. NJCP. 2018; 21(10): 1323-9. https://doi.org/10.4103/njcp.njcp_22_18.
  • Akçay G, Özkaraca O, Güney B. Teleradyoloji web uygulaması ile güçlendirilmiş açık kaynak kodlu yazılım kullanarak uzaktan konsültasyon: Gerçek bir hastane uygulaması. Sağ. Aka. Derg. 2016; 3(1): 50-55. https://doi.org/10.5455/sad.13-1466500133
  • Lantsman CD, Barash Y, Klang E, et al. Trend in radiologist workload compared to number of admissions in the emergency department. EJRad. 2022; 149: 110195. https://doi.org/10.1016/j.ejrad.2022.110195
  • Huff JS, Jahar S. Differences in interpretation of cranial computed tomography in ED traumatic brain injury patients by expert neuroradiologists. AJEM. 2014; 32(6): 606-8. https://doi.org/10.1016/j.ajem.2014.03.010

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

Yıl 2026, Cilt: 4 Sayı: 1, 15 - 22, 28.02.2026
https://doi.org/10.61845/agrimedical.1784563
https://izlik.org/JA29CT99MB

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.

Kaynakça

  • Dolatabadi AA, Baratloo A, Rouhipour A, et al. Interpretation of computed tomography of the head: emergency physicians versus radiologists. Trauma Mon. 2013;18(2): 86. https://doi.org/10.5812/traumamon.12023
  • Mucci B, Brett C, Huntley LS, Green MK. Cranial computed tomography in trauma: the accuracy of interpretation by staff in the emergency department. EMJ BMJ 2005; 22(8): 538-40. https://doi.org/10.1136/emj.2003.013755
  • Erly WK, Berger WG, Krupinski E, Seeger JF, Guisto JA. Radiology resident evaluation of head CT scan orders in the emergency department. AJNR. 2002; 23(1): 103-7.
  • Khan A, Qashqari S, Al-Ali AA. Accuracy of non-contrast CT brain interpretation by emergency physicians: a cohort study. PJMS. 2013; 29(2): 549. https://doi.org/10.12669/pjms.292.3220
  • Cengel F, Gurkan O, Calik M, et al. Diagnosis of the coronavirus disease 2019 with chest computed tomography: A retrospective inter-observer agreement study between radiologists and clinicians. HKJEM. 2021; 28(1): 15-21. https://doi.org/10.1177/1024907920968648
  • Ismail Y, Bughio S, Ahmed N. The Inter-Observer Agreement Between Resident and Consultant Radiologists in Reporting Emergency Head CT Scans. J Med Res Surg. 2024; 5(1): 17-21. https://doi.org/10.52916/jmrs244130
  • Kobkitsuksakul C, Tritanon O, Suraratdecha V. Interobserver agreement between senior radiology resident, neuroradiology fellow, and experienced neuroradiologist in the rating of Alberta Stroke Program Early Computed Tomography Score (ASPECTS). DIR. 2018; 24(2): 104. https://doi.org/10.5152/dir.2018.17336
  • Alfaro D, Levitt MA, English DK, Williams V, Eisenberg R. Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program. Ann. Emerg. Med. 1995; 25(2): 169-74. https://doi.org/10.1016/S0196-0644(95)70319-5
  • Arendts G, Manovel A, Chai A. Cranial CT interpretation by senior emergency department staff. JMIRO. 2003; 47(4): 368-74. https://doi.org/10.1046/j.1440-1673.2003.01204.x
  • McHugh ML. Interrater reliability: the kappa statistic. Biochemia Med. 2012; 22(3): 276-82.
  • Schriger DL, Kalafut M, Starkman S, Krueger M, Saver JL. Cranial computed tomography interpretation in acute stroke: physician accuracy in determining eligibility for thrombolytic therapy. Jama. 1998; 279(16): 1293-7. https://doi.org/10.1001/jama.279.16.1293
  • Güven R, Akça AH, Çaltılı Ç, et al. Comparing the interpretation of emergency department computed tomography between emergency physicians and attending radiologists: A multicenter study. NJCP. 2018; 21(10): 1323-9. https://doi.org/10.4103/njcp.njcp_22_18.
  • Akçay G, Özkaraca O, Güney B. Teleradyoloji web uygulaması ile güçlendirilmiş açık kaynak kodlu yazılım kullanarak uzaktan konsültasyon: Gerçek bir hastane uygulaması. Sağ. Aka. Derg. 2016; 3(1): 50-55. https://doi.org/10.5455/sad.13-1466500133
  • Lantsman CD, Barash Y, Klang E, et al. Trend in radiologist workload compared to number of admissions in the emergency department. EJRad. 2022; 149: 110195. https://doi.org/10.1016/j.ejrad.2022.110195
  • Huff JS, Jahar S. Differences in interpretation of cranial computed tomography in ED traumatic brain injury patients by expert neuroradiologists. AJEM. 2014; 32(6): 606-8. https://doi.org/10.1016/j.ajem.2014.03.010
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma Makalesi
Yazarlar

Lale Tuna 0000-0003-4409-3459

Oya Güven 0000-0002-6389-4561

Emre Gedik 0000-0003-0033-9082

Mehmet Berk Çağan 0009-0006-2596-7930

Atakan Küskün 0000-0001-6559-5322

Gönderilme Tarihi 15 Eylül 2025
Kabul Tarihi 26 Ocak 2026
Yayımlanma Tarihi 28 Şubat 2026
DOI https://doi.org/10.61845/agrimedical.1784563
IZ https://izlik.org/JA29CT99MB
Yayımlandığı Sayı Yıl 2026 Cilt: 4 Sayı: 1

Kaynak Göster

AMA 1.Tuna L, Güven O, Gedik E, Çağan MB, Küskün A. The role of consistency and experience among physicians from different specialties in the interpretation of brain tomography. Ağrı Med J. 2026;4(1):15-22. doi:10.61845/agrimedical.1784563