ORIGINAL ARTICLES
Can middle grade and consultant emergency physicians accurately interpret computed tomography scans performed for head trauma? Cross-sectional study
1 Addenbrookes Hospital, Cambridge, UK
2 Emergency Medicine, Eastern Region, Cambridge, UK
3 Luton and Dunstable Hospital, Luton, UK
Correspondence to:
Dr A Boyle, Addenbrookes Hospital, Cambridge, UK; Adrian.boyle{at}addenbrookes.nhs.uk
Background: There has been an increasing demand for computed tomography (CT) scans of the head following trauma over the past 10 years. This has placed radiology services under pressure.
Aims: This study aimed to see whether middle grade and consultant doctors with no particular training in radiology working in the emergency department could interpret CT scans performed for trauma with adequate sensitivity and specificity to allow safe discharge. The secondary aim was to describe which abnormalities, if any, were missed.
Methods: Study participants were middle grade and consultant emergency physicians. A comparison was made of the ability to identify any abnormality on CT and a clinically important brain injury on CT, compared with a gold standard of a neuroradiology report.
Results: 243 consecutive CT scans performed for trauma were reviewed by 17 doctors, including five consultants. The overall sensitivity and specificity for detecting clinically important brain injuries was 87.8 (95% CI 73.8 to 95.9) and 80.2 (95% CI 75.2 to 85.3), respectively. All the missed abnormalities were around the base of the brain. The most commonly overdiagnosed abnormality was diffuse cerebral oedema.
Conclusions: Emergency physicians should not interpret CT scans for trauma without extra training.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
- Primary survey
- Geoff Hughes
Emerg. Med. J. 2009 26: 547.[Extract] [Full Text] [PDF]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Google Scholar
PubMed
Topic Collections
-
Clinical diagnostic tests
-
Radiology (diagnostics)
-
Radiology
-
Trauma
- Trauma CNS / PNS
- Relevant Article
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
