Investigation of accuracy of cranial computerised tomographies interpretatated by emergency physicians

Computerized Axial Tomography (CAT) is frequently used to evaluate patients in emergency rooms. It has been reported that three percent of all have undergone CAT imaging in the emergency rooms. Interpretation of CAT imagings have an important role on patients mortality and morbidity as they alters the physicians decision. Our study conducted prospectively in Dokuz Eylül University Hospital Department of Emergency Medicine between June Is and July 30, 2000. The validity of CAT scan interpretation of emergency physicians is investigated according to the radiologist interpretations which were accepted as gold standart. The data were analysed with SPSS 8.0 statistical program and p<0.005 was accepted as significant threshold. The number of patients who met to inclusion criteria were 209. CAT scanning was performed to 67 patients because of trauma, to 43 patients because of neurologic deficits, to 26 as patients because of alterations in mental status, to 22 patients because of headache, to 19 patients because of seizures and the rest of 20 patients undergone because of various complaints. All CAT scan imaging more interpretated by both emergency physicians and radiologists seperately. The ratio of misinterpretations were found %42 of patients. However the ratio of misinterpretations which had clinically potential importance were %31. Sensitivity of emergency physicians were %63 and %41 in major and minor findings accordingly to radiologist consequently. Cerebral infarction was the most misinterpretated finding in both major false negatif and major false positive groups. Calsification is the most omitted finding in the minor false negative group. Emergency physicians did not have a formal education on radiologic imaging interpretation. The high ratio of misinterpretation could be declined by a fast condensed education program. Further studies should be better to evaluate for the emergency physicians CAT scan interpretation after an educational program.