Evaluating accuracy of cervical spine computed tomography interpretation by emergency trainees with the use of a structured protocol

IF 1.7 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2024-12-11 DOI:10.1111/1742-6723.14545

Geetika Malhotra MD, Dinesh Varma MBBS, FRANZCR, Biswadev Mitra MBBS (Melb), MHlthServMt, PhD, FACEM

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引用次数: 0

Abstract

Objective

Radiological evaluation of cervical spine injury with computed tomography (CT) scanning is a fundamental component of the assessment of major trauma. Accurate interpretation of scans is essential for safe clearance or diagnosis of injuries. However, delays in radiologist reporting often result in prolonged spinal immobilisation. The aim of the present study was to evaluate a simple, structured reporting tool to improve assessment of CTs of the cervical spine by emergency medicine trainees.

Methods

A prospective pre- and post-intervention cohort study was undertaken within a major metropolitan ED. Participants in the pre-intervention phase interpreted a set of randomly selected cervical spine CTs. The post-intervention phase presented the same task with the additional provision of a structured cervical spine CT reporting template designed in collaboration with radiologists and emergency physicians. Interpretation by trainees was evaluated for concordance with the final radiology report by two blinded assessors.

Results

A total of 155 cervical spine CT scans were reported by the 46 participants. Participants in the cohorts were similar with regards to experience and country of primary medical degree. Concordance with the radiology report in the pre-intervention phase was 60% (95% CI 0.48–0.71), compared with a concordance of 54% (95% CI 0.42–0.65) in the post-intervention phase (P = 0.46).

Conclusions

Interpretation of cervical spine CT scans by trainees was inferior compared to radiologists and did not improve with a structured reporting template. Other innovative strategies towards timely reporting of CT scans by radiologists of the cervical spine are indicated for earlier definitive diagnosis.

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使用结构化方案评估急诊受训者颈椎计算机断层扫描解释的准确性。

目的：利用计算机断层扫描（CT）对颈椎损伤进行放射学评价是评估重大创伤的基本组成部分。准确的扫描解释对于安全清除或诊断损伤至关重要。然而，放射科医生报告的延误往往导致长时间的脊柱固定。本研究的目的是评估一种简单、结构化的报告工具，以改善急诊医学学员对颈椎ct的评估。方法：在一个大城市急诊科进行了一项前瞻性干预前和干预后队列研究。干预前阶段的参与者解释了一组随机选择的颈椎ct。干预后阶段提出了同样的任务，并提供了与放射科医生和急诊医生合作设计的结构化颈椎CT报告模板。由两名盲法评估员评估受训者的解释与最终放射学报告的一致性。结果：46名参与者共报告155次颈椎CT扫描。队列中的参与者在经验和初级医学学位的国家方面相似。干预前阶段与放射学报告的一致性为60% (95% CI 0.48-0.71)，干预后阶段的一致性为54% (95% CI 0.42-0.65) （P = 0.46）。结论：与放射科医生相比，培训生对颈椎CT扫描的解释较差，并且没有通过结构化报告模板得到改善。其他创新的策略，及时报告CT扫描的放射科医生的颈椎指早期明确诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.