Agreement between emergency medicine residents and radiologists in RSNA-Based chest CT interpretation.

IF 1.2 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Emergency Radiology Pub Date : 2026-10-01 Epub Date: 2026-06-18 DOI:10.1007/s10140-026-02505-y

Senol Ardic, Recep Dede, Ozgen Gonenc Cekic, Suna Ibrahimoglu, Eser Bulut, Ali Küpeli

{"title":"Agreement between emergency medicine residents and radiologists in RSNA-Based chest CT interpretation.","authors":"Senol Ardic, Recep Dede, Ozgen Gonenc Cekic, Suna Ibrahimoglu, Eser Bulut, Ali Küpeli","doi":"10.1007/s10140-026-02505-y","DOIUrl":null,"url":null,"abstract":"Background: Standardized interpretation of chest computed tomography (CT) is essential for clinical decision-making in patients presenting to the emergency department with suspected coronavirus disease 2019 (COVID-19).Objectives: This study evaluated interobserver agreement between emergency medicine residents (EMRs) and radiologists using the Radiological Society of North America (RSNA) classification and examined the effect of training level.Methods: This retrospective single-center study included 1,104 patients with suspected COVID-19 who underwent chest CT between December 1, 2020, and January 1, 2021. CT findings were classified as typical, indeterminate, atypical, or negative for pneumonia according to RSNA criteria. A total of 23 EMRs independently evaluated 48 CT examinations each. Resident interpretations were compared with routine radiology reports. Interobserver agreement among radiologists was additionally assessed by independent re-evaluation of 100 CT scans. Agreement was measured using Cohen's kappa (κ) coefficient. Diagnostic performance of the typical category was assessed using real time polymerase chain reaction (RT-PCR) as the reference standard.Results: The mean patient age was 59.2 years, and 50.9% were male. RT-PCR positivity was 79.1%. Overall agreement between EMRs and radiologists was good (κ = 0.705; 95% CI, 0.671-0.740; p < 0.001). Agreement was very good for typical (κ = 0.827; 95% CI, 0.793-0.859) and negative (κ = 0.804; 95% CI, 0.765-0.847) categories, but lower for indeterminate (κ = 0.340; 95% CI, 0.253-0.428) and atypical (κ = 0.341; 95% CI, 0.216-0.456) categories. Agreement among radiologists was also good (κ = 0.730; 95% CI, 0.610-0.840; p < 0.001). Agreement improved with increasing training level.Conclusion: RSNA-based chest CT classification shows good overall agreement. Lower agreement in indeterminate and atypical patterns highlights the need for targeted training and closer radiology collaboration.","PeriodicalId":11623,"journal":{"name":"Emergency Radiology","volume":" ","pages":"1109-1116"},"PeriodicalIF":1.2000,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Radiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s10140-026-02505-y","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/18 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Standardized interpretation of chest computed tomography (CT) is essential for clinical decision-making in patients presenting to the emergency department with suspected coronavirus disease 2019 (COVID-19).

Objectives: This study evaluated interobserver agreement between emergency medicine residents (EMRs) and radiologists using the Radiological Society of North America (RSNA) classification and examined the effect of training level.

Methods: This retrospective single-center study included 1,104 patients with suspected COVID-19 who underwent chest CT between December 1, 2020, and January 1, 2021. CT findings were classified as typical, indeterminate, atypical, or negative for pneumonia according to RSNA criteria. A total of 23 EMRs independently evaluated 48 CT examinations each. Resident interpretations were compared with routine radiology reports. Interobserver agreement among radiologists was additionally assessed by independent re-evaluation of 100 CT scans. Agreement was measured using Cohen's kappa (κ) coefficient. Diagnostic performance of the typical category was assessed using real time polymerase chain reaction (RT-PCR) as the reference standard.

Results: The mean patient age was 59.2 years, and 50.9% were male. RT-PCR positivity was 79.1%. Overall agreement between EMRs and radiologists was good (κ = 0.705; 95% CI, 0.671-0.740; p < 0.001). Agreement was very good for typical (κ = 0.827; 95% CI, 0.793-0.859) and negative (κ = 0.804; 95% CI, 0.765-0.847) categories, but lower for indeterminate (κ = 0.340; 95% CI, 0.253-0.428) and atypical (κ = 0.341; 95% CI, 0.216-0.456) categories. Agreement among radiologists was also good (κ = 0.730; 95% CI, 0.610-0.840; p < 0.001). Agreement improved with increasing training level.

Conclusion: RSNA-based chest CT classification shows good overall agreement. Lower agreement in indeterminate and atypical patterns highlights the need for targeted training and closer radiology collaboration.

查看原文本刊更多论文

急诊住院医师与放射科医师在基于rna的胸部CT解读上的共识。

背景：胸部计算机断层扫描（CT）的标准化解释对于到急诊室就诊的疑似冠状病毒病2019 （COVID-19）患者的临床决策至关重要。目的：本研究使用北美放射学会（RSNA）分类评估急诊住院医师（emr）和放射科医师之间的观察者间一致性，并检验培训水平的影响。方法：本回顾性单中心研究纳入了2020年12月1日至2021年1月1日期间接受胸部CT检查的1104例疑似COVID-19患者。根据RSNA标准，CT表现分为典型、不确定、非典型或阴性肺炎。共有23个emr独立评估48个CT检查。将住院医师解释与常规放射学报告进行比较。另外，通过对100个CT扫描的独立重新评估来评估放射科医师之间的观察者间一致性。采用Cohen’s kappa （κ）系数衡量一致性。采用实时聚合酶链反应（RT-PCR）作为参考标准，评估典型类别的诊断性能。结果：患者平均年龄59.2岁，男性占50.9%。RT-PCR阳性率为79.1%。EMRs与放射科医师的总体一致性较好（κ = 0.705; 95% CI, 0.671-0.740; p）结论：基于rsna的胸部CT分类总体一致性较好。不确定和非典型模式的一致性较低，突出了有针对性的培训和更密切的放射学合作的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Emergency Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

4.60

自引率

4.50%

发文量

期刊介绍： To advance and improve the radiologic aspects of emergency careTo establish Emergency Radiology as an area of special interest in the field of diagnostic imagingTo improve methods of education in Emergency RadiologyTo provide, through formal meetings, a mechanism for presentation of scientific papers on various aspects of Emergency Radiology and continuing educationTo promote research in Emergency Radiology by clinical and basic science investigators, including residents and other traineesTo act as the resource body on Emergency Radiology for those interested in emergency patient care Members of the American Society of Emergency Radiology (ASER) receive the Emergency Radiology journal as a benefit of membership!