Accuracy of emergency physicians' interpretation of computed tomography for urgent-emergent diagnoses in nontraumatic cases
Özet
OBJECTIVE: The aim of this study is to evaluate the accuracy levels of the emergency physicians (EPs)
managing the patient in the interpretation of the urgent‑emergent pathological findings in thoracic
and abdominal computed tomography (CT) scans.
METHODS: The EPs interpreted the CT scans of patients who visited the emergency department
because of nontraumatic causes. Then, a radiology instructor made final assessments of these CT
scans. Based on the interpretation of the radiology instructor, the false‑positive rate, false‑negative
rate, sensitivity, specificity, positive predictive value, negative predictive value, and kappa
coefficient (κ) of the EPs’ interpretations of the CT scans were calculated.
RESULTS: A total of 268 thoracics and 185 abdominal CT scans were assessed in our study. The
overall sensitivity and specificity of the EPs’ interpretation of the thoracic CT scans were 90% and 89%,
respectively, whereas the abdominal CT interpretation was 88% and 86%, respectively. There was
excellent concordance between the EPs and the radiology instructor with regard to the diagnoses of
pneumothorax, pulmonary embolism, pleural effusion, parenchymal pathology, and masses (κ: 0.90,
κ: 0.87, κ: 0.71, κ: 0.79, and κ: 0.91, respectively) and to the diagnoses of intraabdominal free fluid,
intraabdominal free gas, aortic pathology, splenic pathology, gallbladder pathology, mesenteric artery
embolism, appendicitis, gynecological pathology, and renal pathology (κ: 1, κ: 0.92, κ: 0.96, κ: 0.88,
κ: 0.80, κ: 0.79, κ: 0.89, κ: 0.88, and κ: 0.82, respectively).
CONCLUSION: The EPs are successful in the interpretation of the urgent‑emergent pathological
findings in thoracic and abdominal CT scans.
