Discrepancies of Emergency Medicine Residents' Preliminary Interpretation of Abdominal CT and Feedback Image Education

Lim, Woo Sup; Kim, Jong Kun; Ahn, Jae Yun

Abstract

PURPOSE
For the differential diagnosis of acute abdomen, abdominal computed tomography (CT) is commonly performed in the emergency department (ED). Rapid and accurate interpretation after CT is essential; however, final interpretation of the images by a board-certified radiologist for 24 hours a day is nearly impossible. Therefore, a preliminary interpretation is mainly made by emergency physicians in the ED, which may result in some discrepancy with the interpretations of board-certified radiologists. This study was conducted to determine the discrepancy rate of emergency medicine (EM) residents' preliminary interpretation and any reduction in discrepancy through feedback imaging education programs by attending radiologists.
METHODS
This was a before-and-after study, including 540 cases of abdominal CT scans performed in the ED between November 1, 2014 and April 30, 2015. Residents first documented their preliminary interpretation of 300 cases for 3 months. Board-certified radiologists then provided feedback image education to EM residents for these cases for 1 month. After feedback education, preliminary interpretations of 240 cases were documented for 2 months. Discrepancy rates before and after feedback education were then analyzed.
RESULTS
Total and major discrepancy rates before feedback image education were 28% and 11.7%, respectively, which declined to 14.6% and 4.6%, respectively, after feedback image education (p<0.05).
CONCLUSION
Feedback image education was effective in reducing the discrepancy rate of the interpretation of abdominal CT scans by EM residents.