J Korean Med Sci.  2012 Oct;27(10):1255-1260. 10.3346/jkms.2012.27.10.1255.

Evaluating the Accuracy of Emergency Medicine Resident Interpretations of Abdominal CTs in Patients with Non-Traumatic Abdominal Pain

• Kang MJ
• Sim MS
• Shin TG
• Jo IJ
• Song HG
• Song KJ
• Jeong YK

• KMID: 1778835
• DOI: http://doi.org/10.3346/jkms.2012.27.10.1255

Abstract

Abdominal computed tomography (CT) is widely used as a diagnostic tool in emergency medicine (EM) to accurately diagnose abdominal pain. EM residents must be able to offer preliminary interpretations of CT imaging. In this study, we evaluated the preliminary interpretation ability of a sample of emergency residents presented with adult abdominal CT images, and compared their results with those of radiology residents. We conducted a prospective observational study from November 16, 2008 to June 30, 2009. During this time, we gathered preliminary interpretations of consecutive abdominal CT made by emergency and radiology residents. We assessed the discrepancy rates of both samples by comparing their findings to the final reports from attending radiologists. A total of 884 cases were enrolled in the present study. The discrepancy rates of emergency and radiology residents were 16.7% and 12.2%, respectively. When female genital organs, peritoneum, adrenal glands, or the musculoskeletal system were abnormal, we found that emergency residents' preliminary interpretations of CT images were insufficient compared to those of radiology residents. Therefore more formal education is needed to emergency residents. If possible, the preliminary interpretations of radiology attending physicians are ideal until improving the ability of interpretations of emergency residents in abdomen CT.

Keyword

Abdominal Pain; CT Scan; Emergency Medicine; Radiographic Image Interpretation

MeSH Terms

Abdominal Pain/*radiography
Adult
Aged
Diagnostic Errors/prevention & control
Emergency Medicine/*education
Female
Humans
Internship and Residency
Logistic Models
Male
Medical Staff, Hospital
Middle Aged
Prospective Studies
Radiology/education
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 A comparison of the discrepancy rate between emergency medicine and radiology residents according to the abnormal organ. *There were statistically significant differences for female genital organs and miscellaneous organs. ER, Emergency resident; RA, Radiology resident; Uterus adnexa, Female genital organs (uterus, adnexa, ovary, pelvic cavity); Hollow viscera, Hollow viscera except appendix; Miscellaneous, Peritoneum, adrenal gland, musculoskeletal system; NSAP, Non-specific abdominal pain (no radiological abnormality).

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