Al aseri Zohair
Department of Emergency Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia.
Emerg Radiol. 2009 Mar;16(2):111-4. doi: 10.1007/s10140-008-0763-9. Epub 2008 Sep 9.
Chest radiographs are one of the most complex imaging modalities to interpret. The objective of this study was to assess how accurately emergency physicians interpreted chest radiographs in relation to radiologist reports. Radiological descriptions of chest radiographs from 667 emergency department (ED) patients, aged 14 to 84 years, were retrospectively reviewed. The overall level of agreement and agreement for different categories (congestive heart failure, pneumonia, and other) were assessed in 312 cases for which reports were available. Statistical analysis was done using the chi-square test, and interobserver agreement was calculated. The proportion of agreement between emergency physician and radiologist reports for normal, congestive heart failure, and pneumonia cases was 84.3%, 41.4%, and 41.4%, respectively. Emergency department physicians frequently missed specific radiographic abnormalities, and there was considerable discrepancy between their interpretations and those of trained radiologists. The agreement for some diagnostic categories such as pneumonia and congestive heart failure was low. This study's findings emphasize the need for improving interpretive skills among ED physicians.
胸部X光片是最难解读的影像检查方式之一。本研究的目的是评估急诊医生对胸部X光片的解读与放射科医生报告相比的准确程度。回顾性分析了667例年龄在14至84岁之间的急诊科患者的胸部X光片的放射学描述。在有报告的312例病例中，评估了总体一致性以及不同类别（充血性心力衰竭、肺炎和其他）的一致性。采用卡方检验进行统计分析，并计算观察者间一致性。急诊医生与放射科医生报告在正常、充血性心力衰竭和肺炎病例上的一致性比例分别为84.3%、41.4%和41.4%。急诊科医生经常漏诊特定的影像学异常，他们的解读与训练有素的放射科医生的解读之间存在相当大的差异。对于某些诊断类别，如肺炎和充血性心力衰竭，一致性较低。本研究结果强调了提高急诊科医生解读技能的必要性。
