Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists� report and its impact on patients� outcome

Bagheri-Hariri, S. and Ayoobi-Yazdi, N. and Afkar, M. and Farahmand, S. and Arbab, M. and Shahlafar, N. and Basirghafoori, H. and Seyedhoseini-Davarani, S. and Sedaghat, M. and Akhgar, A. (2017) Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists� report and its impact on patients� outcome. Emergency Radiology, 24 (6). pp. 675-680.

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Purpose: In this study, the impact of contrast-enhanced abdominopelvic CT scan interpretations by emergency medicine team on patients� morbidity and mortality was evaluated and their interpretations were compared to radiologists� reports. Methods: During a 3-month period, all patients who had undergone a contrast-enhanced abdominopelvic CT scan at the emergency department enrolled in this study. All CT scans were interpreted blindly by the emergency medicine (ED) attending physicians and the patients were treated accordingly. Radiologists reported all the CT scans within 12 h. Radiologists� reports were put into the agreement or disagreement group retrospectively. A panel of experts further evaluated the disagreement groups� medical charts and placed them in clinically significant or insignificant group based on the follow-up for 28 days. Results: In this study, 170 CT scans were interpreted. The agreement rate was 68.2. In the clinically significant disagreement group, eight patients did not receive the required treatment and three patients were over treated. Although the overall mortality rate was 5, none could have been prevented by a prompt radiologist�s report. The disagreement group had longer hospital stay (p = 0.006) and transfer to other wards (p = 0.035). The inter-rater reliability between emergency medicine attending physicians and attending radiologists was substantial (kappa = 0.77) and statistically significant (p < 0.0001). Conclusion: Our findings support the cautious use of ED physicians� CT scan interpretations for patients� management. Ideally, the ED physicians should utilize a real-time radiologist interpretation in critical patients. This collaboration will result in better patient management. © 2017, American Society of Emergency Radiology.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: abdominal pain; abdominopelvic computer assisted tomography; adolescent; adult; aged; Article; child; comparative study; computer assisted tomography; contrast-enhanced ultrasound; controlled study; emergency physician; female; follow up; hospital discharge; human; injury; major clinical study; male; morbidity; mortality; mortality rate; priority journal; prospective study; radiologist; retrospective study; survival; treatment outcome; very elderly; abdominal radiography; clinical competence; hospital emergency service; middle aged; observer variation; preschool child; reproducibility; x-ray computed tomography, contrast medium, Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Clinical Competence; Contrast Media; Emergency Service, Hospital; Female; Humans; Male; Middle Aged; Observer Variation; Prospective Studies; Radiography, Abdominal; Radiologists; Reproducibility of Results; Tomography, X-Ray Computed
Subjects: WN Radiology. Diagnostic Imaging
Depositing User: eprints admin
Date Deposited: 01 Jan 2019 13:10
Last Modified: 24 Aug 2019 08:15
URI: http://eprints.iums.ac.ir/id/eprint/7614

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