Abbreviated Educational Session Improves Cranial Computed Tomography Scan Interpretations by Emergency Physicians☆,☆☆,★
Section snippets
INTRODUCTION
Cranial computed tomography (CT) scans are commonly ordered by emergency physicians in the evaluation of ED patients. It has been reported that radiologists are not available in many hospitals on a 24-hour basis for CT scan interpretations.1 Therefore it is important that emergency physicians develop interpretation skills for cranial CT scans as they have for plain radiographs.
Previously published research at this institution demonstrated a 38.7% misinterpretation rate of cranial CT scans by
MATERIALS AND METHODS
Highland General Hospital is the county medical facility with approximately 70,000 patient visits per year. This hospital supports a 4-year emergency medicine residency program. It is a Level II trauma center (there are no Level I centers in Alameda County, California). There are 10 full-time and 4 part-time faculty members, all of whom are emergency medicine residency trained, board certified in emergency medicine, and all of whom participated in both phases of the study. The entire study
RESULTS
A total of 879 scans on ED patients undergoing cranial CT were interpreted by 14 attending level emergency physicians during both phases. During phase I 555 CT scans were interpreted and 324 scans during phase II. Phase I patients were characterized by a mean age of 42.9±8.8 years and phase II patients by a mean age of 46.1±8.1 years (P=NS). The difference in gender distribution between phase I (35.7% female, 64.3% male subjects) and phase II (34.7% female, 65.3% male subjects) was not
DISCUSSION
Various aspects of clinical performance of physicians are constantly being evaluated. This is of obvious importance to ensure that quality health care is being delivered to patients. Our previous study tested the accuracy of emergency physicians in interpreting cranial CT scans.2 We demonstrated a 38.7% nonconcordance rate between emergency physicians and radiologists. The study was strict in definition of concordance in that the findings by both physicians had to match exactly. The study also
Acknowledgements
We thank Dr Jack Ellis for his continuous quality improvement review of the patients who were enrolled in this study and Jacquelyn Alejandrez for her help in manuscript preparation.
References (9)
- et al.
Physician assessments of practice patterns in emergency department radiographic interpretation
Ann Emerg Med
(1988) - et al.
Accuracy of interpretation of cranial computed tomography scans in an emergency medicine residency program
Ann Emerg Med
(1995) - et al.
Prospective study of the impact of continuing medical education and quality assurance programs on use of prophylaxis for venous thromboembolism
Arch Intern Med
(1994) - et al.
Reducing the use of H 2- receptor antagonists in the long-term-care setting
J Am Geriatr Soc
(1992)
Cited by (22)
A novel approach to improving the interpretation of CT brain in trauma
2018, InjuryCitation Excerpt :The need for strategies directed towards improving the ability of emergency clinicians in this important area is clear. Current literature focuses almost exclusively on education as the sole method of enhancing performance, with modest improvement at best [9–11]. This study aimed to evaluate the effect that the use of an evidence-based reporting template has on the accuracy of CTB interpretation.
Imaging of the Central Nervous System
2012, Emergency Medicine: Clinical Essentials, SECOND EDITIONA multicenter study to improve emergency medicine residents' recognition of intracranial emergencies on computed tomography
1998, Annals of Emergency MedicineAccuracy of Brain Computed Tomography Diagnosis by Emergency Medicine Physicians
2022, Computational Intelligence and NeuroscienceRethinking Radiology: An Active Learning Curriculum for Head Computed Tomography Interpretation
2022, Western Journal of Emergency MedicineThe benefits and limitations of targeted training in flexible transnasal laryngoscopy diagnosis
2017, JAMA Otolaryngology - Head and Neck Surgery
- ☆
From the Departments of Emergency Medicine* and Radiology,‡ Alameda County Medical Center—Highland Campus, Oakland, CA; and the Division of Emergency Medicine, University of California, San Francisco, San Francisco, CA§
- ☆☆
Reprint no. 47/1/85426
- ★
Address for reprints: M Andrew Levitt, DO, FACEP, Department of Emergency Medicine, Alameda County Medical Center–Highland Campus, 1411 East 31st Street, Oakland, CA 94602