Literature DB >> 12760951

Evaluation of emergency CT scans of the head: is there a community standard?

William K Erly1, Boyd C Ashdown, Richard W Lucio, Raymond F Carmody, Joachim F Seeger, Jennifer N Alcala.   

Abstract

OBJECTIVE: This study was designed to assess the accuracy of general radiologists in the interpretation via teleradiology of emergency CT scans of the head.
MATERIALS AND METHODS: We studied the interpretations of 716 consecutive emergency CT scans of the head by a group of 15 board-certified general radiologists practicing in the community (as opposed to an academic setting). The scans were sent via teleradiology, and the preliminary interpretations were made. Three of the general radiologists were functioning as nighthawks, and the remaining 12 were acting as on-call radiologists in addition to their normal daytime duties. Each CT examination was interpreted by one of five neuroradiologists the day after the initial interpretation had been performed. The findings of the final interpretation and the preliminary interpretation were categorized as showing agreement, insignificant disagreement, or significant disagreement. The reports in the two categories indicating disagreement were reviewed and reclassified by a consensus of three university-based neuroradiologists.
RESULTS: Agreement between the initial interpretation by the general radiologist and the final interpretation by the neuroradiologist was found in 95% of the CT scans. The interpretations were judged to show insignificant disagreement in 3% (23/716) of the scans and to show significant disagreement in 2% (16/716). Of the 16 significant errors, five were false-positive findings and 11 were false-negative findings. Forty-seven CT scans depicted significant or active disease, and in 11 (23%) of these scans, the final report differed significantly from the preliminary interpretation. Three patients had pituitary masses, none of which had been described on the preliminary interpretation.
CONCLUSION: The rate of significant discordance between board-certified on-call general radiologists and neuroradiologists in the interpretation of emergency CT scans was 2%, which was comparable to previously published reports of residents' performance. The pituitary gland may be a blind spot, and additional attention should be focused on this area.

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Year:  2003        PMID: 12760951     DOI: 10.2214/ajr.180.6.1801727

Source DB:  PubMed          Journal:  AJR Am J Roentgenol        ISSN: 0361-803X            Impact factor:   3.959


  17 in total

1.  Quality control in neuroradiology: discrepancies in image interpretation among academic neuroradiologists.

Authors:  L S Babiarz; D M Yousem
Journal:  AJNR Am J Neuroradiol       Date:  2011-10-27       Impact factor: 3.825

2.  Comparing the accuracy of initial head CT reporting by radiologists, radiology trainees, neuroradiographers and emergency doctors.

Authors:  F A Gallagher; K Y Tay; S L Vowler; H Szutowicz; J J Cross; D J McAuley; N M Antoun
Journal:  Br J Radiol       Date:  2011-11       Impact factor: 3.039

3.  Radiological error: analysis, standard setting, targeted instruction and teamworking.

Authors:  Richard FitzGerald
Journal:  Eur Radiol       Date:  2005-02-23       Impact factor: 5.315

4.  Overnight resident preliminary interpretations on CT examinations: should the process continue?

Authors:  William M Strub; Achala A Vagal; Thomas Tomsick; Jonathan S Moulton
Journal:  Emerg Radiol       Date:  2006-07-25

5.  Accuracy of radiographer reporting of paediatric brain CT.

Authors:  Andrew Brandt; Savvas Andronikou; Nicki Wieselthaler; Brand Louw; Tracy Kilborn; Gerrit Dekker; Jessica Bertelsman; Catherine Dreyer
Journal:  Pediatr Radiol       Date:  2007-02-01

6.  The misinterpretation rates of radiology residents on emergent neuroradiology magnetic resonance (MR) angiogram studies: correlation with level of residency training.

Authors:  Christopher G Filippi; Russell E Meyer; Keith Cauley; Joshua P Nickerson; Heather N Burbank; Jason M Johnson; Grant J Linnell; Gray F Alsofrom
Journal:  Emerg Radiol       Date:  2009-06-05

7.  Comparison of emergency cranial CT interpretation between radiology residents and neuroradiologists: transverse versus three-dimensional images.

Authors:  Eun Soo Kim; Dae Young Yoon; Ha-yeon Lee; You Jin Ku; Ari Han; Soo Jeong Yoon; Heung Cheol Kim
Journal:  Diagn Interv Radiol       Date:  2014 May-Jun       Impact factor: 2.630

8.  Risk Factors for Perceptual-versus-Interpretative Errors in Diagnostic Neuroradiology.

Authors:  S H Patel; C L Stanton; S G Miller; J T Patrie; J N Itri; T M Shepherd
Journal:  AJNR Am J Neuroradiol       Date:  2019-07-11       Impact factor: 3.825

9.  Head injury while on anticoagulation: Small numbers, big risks.

Authors:  Katherine I Nearing; Jack W Tsao
Journal:  Neurol Clin Pract       Date:  2017-08

10.  Overnight preliminary head CT interpretations provided by residents: locations of misidentified intracranial hemorrhage.

Authors:  W M Strub; J L Leach; T Tomsick; A Vagal
Journal:  AJNR Am J Neuroradiol       Date:  2007-09-20       Impact factor: 3.825

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