Accuracy of emergency physicians’ interpretation of computed tomography for urgent‑emergent diagnoses in nontraumatic cases
Omer Faruk Karakoyun1(0000-0002-4476-798), Nalan Kozaci2
, Mustafa Avci3, Huseyin Uzunay4
1 Department of Emergency Medicine, Mugla Sıtkı Kocman University Education and Research Hospital, Mugla, Turkey
2Department of Emergency Medicine, Alanya Education and Research Hospital, Alanya Alaaddin Keykubat University, Antalya, Turkey
3Department of Emergency Medicine, Antalya Education and Research Hospital, University of Health Sciences, Antalya, Turkey
4Department of Emergency Medicine, Kas State Hospital, Antalya, Turkey
Keywords: Abdomen, chest, computed tomography, emergency department, emergency physician, interpretation, thorax
Abstract
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.