Platon Alexandra, Becker Minerva, Perneger Thomas, Varnay Gyorgi, Breguet Romain, Becker Christoph D, Poletti Pierre-Alexandre
From the *Department of Radiology and †Division of Clinical Epidemiology, University Hospital of Geneva, Geneva, Switzerland.
J Comput Assist Tomogr. 2016 Jan-Feb;40(1):177-82. doi: 10.1097/RCT.0000000000000317.
The aim of this study was to evaluate the accuracy of preliminary computed tomography (CT) interpretations made by radiology residents in the emergency department.
For 4 periods of 20 consecutive days, attending radiologists prospectively recorded any disparities between their own CT interpretations (reference standard) and the preliminary interpretations of emergency radiology residents. Misinterpretations were defined as major when related to a potentially life-threatening pathology if not immediately managed after CT. The rate of disparities was calculated for all CT examinations, separately for body and neuroradiological cases, and for working and on-call hours.
A total of 3044 emergency CT examinations were performed during the survey: 1568 (51%) body scans and 1476 (49%) neurological scans. Disparities were reported in 145 (4.8%) of all CT examinations, with 0.8% (24/3044) defined as major misinterpretations. There were 100 (6.3%) of 1568 disparities in body CT versus 45 (3.0%) of 1476 in neurological CT examinations (P = 0.001). No significant differences were found between disparities recorded during regular working hours (47/1083 [4.3%]) versus on-call hours (98/1961 [5.0%], P = 0.47).
There were typically more disparities between resident and attending interpretations in emergency body CT. Major disparities represented only a small proportion of all misinterpretations. The detailed analysis of our data enables benchmarking over time and offers a reference for optimizing the training of residents in emergency radiology.
本研究旨在评估急诊科放射科住院医师对计算机断层扫描（CT）初步解读的准确性。
在连续20天的4个时间段内，主治放射科医师前瞻性记录其自身CT解读（参考标准）与急诊放射科住院医师初步解读之间的任何差异。如果CT检查后未立即处理，与潜在危及生命的病理相关的误判被定义为重大误判。计算所有CT检查的差异率，分别针对身体和神经放射学病例，以及工作时间和值班时间。
调查期间共进行了3044次急诊CT检查：1568次（51%）身体扫描和1476次（49%）神经扫描。在所有CT检查中，有145次（4.8%）报告存在差异，其中0.8%（24/3044）被定义为重大误判。身体CT检查中有100次（6.3%）差异，而神经CT检查中有45次（3.0%）差异（P = 0.001）。在正常工作时间记录的差异（47/1083 [4.3%]）与值班时间记录的差异（98/1961 [5.0%]）之间未发现显著差异（P = 0.47）。
在急诊身体CT中，住院医师和主治医师的解读之间通常存在更多差异。重大差异仅占所有误判的一小部分。对我们数据的详细分析能够进行长期基准测试，并为优化急诊放射科住院医师培训提供参考。
