Comparison of computed tomography image reports and emergency medical assistants' comments in paediatric head traumas

Aim: The aim of this study was to examine cranial computed tomography (CT) images of pediatric patients presenting to the emergency department with head trauma through evaluations performed by emergency medicine residents, and to identify possible causes of discrepancies by comparing these interpretations with the official reports of radiology specialists. Materials and Methods: This study included 624 pediatric patients who presented with head trauma to the Emergency Department of Gaziantep University Şahinbey Research and Training Hospital and underwent brain computed tomography (CT). CT images were evaluated by emergency medicine residents with at least three years of experience, and their interpretations were compared with the official reports prepared by radiology specialists. The evaluations were made on predefined parameters in a binary form ("present/absent"). Statistical analyses were performed using Chi-square, McNemar, and Cohen's Kappa tests. Results: Across all parameters including contusion, fracture, subdural, epidural, subarachnoid, intraparenchymal and intraventricular hemorrhage, as well as pneumocephalus, the agreement between emergency medicine residents and radiology reports was found to be low. McNemar's test revealed significant differences in all parameters, while Cohen's Kappa values were consistently low or negative. Particularly, the sensitivity of residents was low in detecting subdural and subarachnoid hemorrhages. Conclusion: The ability of emergency medicine residents to interpret pediatric head trauma CT scans was found to be insufficient. These findings highlight the need to strengthen training programs, integrate internationally validated clinical decision rules, and implement strategies to reduce unnecessary CT utilization in pediatric head trauma cases. Keywords:Emergency, Medicine,ComputedTomography,HeadTrauma, Pediatrics