Department of Emergency Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye.
Department of Radiology, Gazi University Faculty of Medicine, Ankara, Türkiye.
Am J Emerg Med. 2024 Nov;85:123-129. doi: 10.1016/j.ajem.2024.08.038. Epub 2024 Sep 4.
To evaluate the accuracy and determine the factors influencing trauma CT interpretation proficiency among emergency medicine (EM) residents in Turkey through the TraCT-EM study (Interpretation of Trauma CT by EMergency Physicians).
This nationwide, multicenter, cross-sectional study was conducted in 29 academic emergency departments (EDs) from April 2023 to March 2024. A total of 401 senior EM residents participated in the study, each interpreting a standardized set of 42 trauma CT series (cranial, maxillofacial, and cervical) derived from seven patients. Interpretation accuracy was assessed, and factors predicting interpretation failure were analyzed using univariate and multivariate regression models.
The median accuracy rate of residents was 64.9 %, with higher accuracy in normal CT findings. Using the Angoff method, 14 % of residents scored below the passing threshold. Factors associated with interpretation failure included shorter interpretation times (OR, 0.97; 95 % CI, 0.95-0.99), lower self-confidence in detecting serious pathologies (OR, 2.50; 95 % CI, 1.42-4.42), reliance on in-hospital radiology department reports (OR, 3.45; 95 % CI, 1.47-8.05), and receiving final radiology reports for CT scans (OR, 3.30; 95 % CI, 1.67-6.52), and lack of in-department training programs (OR, 2.51; 95 % CI, 1.34-4.70).
The TraCT-EM study highlighted a 65 % accuracy rate for senior EM residents in trauma CT interpretation, with specific predictors of failure identified. These findings suggest a need for tailored radiology education strategies to enhance training and competency in trauma CT interpretation for EM residents. Further optimization of educational programs could address these gaps, ultimately improving patient outcomes in trauma care.
通过 TraCT-EM 研究（急诊医师解读创伤 CT）评估土耳其急诊医学（EM）住院医师在创伤 CT 解读方面的准确性，并确定影响其解读能力的因素。
这是一项全国性、多中心、横断面研究，于 2023 年 4 月至 2024 年 3 月在 29 个学术性急诊部进行。共有 401 名高级 EM 住院医师参与了该研究，每位住院医师均对来自 7 名患者的 42 个颅脑、颌面和颈椎创伤 CT 系列（标准系列）进行解读。使用单变量和多变量回归模型评估解读准确性，并分析预测解读失败的因素。
住院医师的中位数准确性为 64.9%，正常 CT 结果的准确性较高。使用 Angoff 方法，有 14%的住院医师得分低于及格线。与解读失败相关的因素包括解读时间较短（OR，0.97；95%CI，0.95-0.99）、对发现严重病变的自信心较低（OR，2.50；95%CI，1.42-4.42）、依赖院内放射科报告（OR，3.45；95%CI，1.47-8.05）以及收到 CT 扫描的最终放射科报告（OR，3.30；95%CI，1.67-6.52），以及缺乏部门内培训计划（OR，2.51；95%CI，1.34-4.70）。
TraCT-EM 研究表明，高级 EM 住院医师在创伤 CT 解读方面的准确性为 65%，确定了具体的失败预测因素。这些发现表明需要制定针对放射学的教育策略，以增强 EM 住院医师在创伤 CT 解读方面的培训和能力。进一步优化教育计划可以解决这些差距，最终改善创伤护理中患者的预后。
