The diagnostic value of the emergency medicine physicians radiological interpretation in patients who had diffusion-weighted mr imaging with the suspected ischemic stroke at emergency department

Introduction: Many patients present to emergency departments with neurological symptoms. Ischemic stroke accounts for the majority of these applications. Imaging methods are of great importance in the diagnosis of ischemic stroke. The imaging modalities requested for patients with acute ischemic stroke are first evaluated by emergency medicine physicians and their treatment is planned accordingly. The aim of this study is to investigate the diagnostic value of DWI interpretation of emergency medicine physician. Materials and Methods: 649 DWI of patients admitted to the emergency department of Akdeniz University Hospital between 01.01.2021 and 31.12.2021 who were pre-diagnosed with ischemic stroke and underwent DWI were retrospectively scanned. These images were shared among 44 emergency medicine physicians and evaluated and compared with radiology evaluation. One hour of theoretical and practical training was given to all physicians before the study. Results: The sensitivity of detecting findings consistent with acute-subacute infarction of emergency medicine physicians in DWI was 80%, specificity 85%; positive predictive value (PPD) was 68% and negative predictive value (NPD) was 91%. When the correlation of the success of interpreting the ischemic area in DWI of the emergency medicine physicians according to the radiology interpretation, a statistically moderate correlation was found (r=0.6187, p=0.001). Conclusion: In this retrospective study, which was performed on patients who applied to the emergency department with a pre-diagnosis of stroke and underwent DWI; it is understood that all emergency medicine residents who participated in the study, using DWI technique, excluded the diagnosis of acute ischemic stroke at a high level, but could make a moderate diagnosis. As the working time of resident physicians increased, the rate of correct evaluation of DWI increased. It would be the right approach to devote more space to the evaluation of advanced imaging methods in the emergency medicine education curriculum.