A comparison of emergency medicine and radiology physicians' interpretations on thoracoabominanal computerized tomography of patients admitted to the emergency department with multitrauma

Trauma is one of the most common reasons for patient admission to the emergency department. Accurate diagnosis and the rapid implementation of definitive treatment are vital in the management of trauma patients. Therefore, evaluation of abdominal and thorax CT images by the emergency medicine specialists is paramount in the management of patients. In contrast to this necessity, there are very few studies done that evaluate the knowledge and skills of emergency physicians on this subject. The primary aim of this study is to determine the compatibility between the interpretation of abdominal and thorax tomography images of emergency medicine specialty students and the interpretation of the radiology specialists. The reports and images of 2442 patients who were admitted to the Akdeniz University Emergency Service between 01.01.2018 and 31.10.2021, and underwent abdominal and thorax CT's were reviewed. The images of 47 patients with acute pathology detected and not detected on CT imaging were chosen. Twelve emergency medicine specialists were asked to interpret these images. Each of the selected images were evaluated by the emergency medicine specialists involved in the study without the clinical information and examination findings of the patients, and the findings were recorded on a prepared document. Emergency medicine specialists were grouped according to their seniority. The interpretations of each group were compared with the radiologist's interpretation, and the compatibility of the two groups' interpretations was analyzed. In this study, the compatibility of EMA's abdominal CT interpretations with radiology specialists' interpretations was 90% (n=3942) with a Kappa coefficient of 0.38. The compatibility of Thorax CT EMA interpretations with radiology specialists' interpretations was 86% (n=2820) with a Kappa coefficient of 0.58. When the abdominal and thorax CT interpretations were evaluated in conjunction, the compatibility was 88% (n=6762) with a Kappa coefficient of 0.51. In addition, for all of the CT interpretations, the compatibility of the senior EMA group with the radiology specialist's interpretation, compared to the non-senior EMA group, was higher. Compatibility rates can be further incremented with the increase of practical and theoretical training on CT interpretation in emergency medicine education. This study displays that a physician who has just started emergency medicine assistantship will, at the end of the training period, become an expert in CT interpretation with sensitivity and selectivity that's close to the radiologists' interpretations. Keywords: abdominal tomography, thorax tomography, multitrauma, emergency medical assistant, compatibility