Comparison of tomographic reports by radiologists and non-radiologists in trauma and interferences in management in a trauma reference center

ABSTRACT Objective: diagnostic errors during the interpretation of an imaging test by the physician can lead to increased mortality and length of hospital stay for patients. The rate of divergence in the report given by a radiologist and an Emergency Physicians (EP) can reach over 20%. The objective of this study was to compare the unofficial tomographic reports issued by EP with the official reports issued by radiologists. Methods: a cross-sectional study, in which interpretations of the exams (documented in the medical records by the EP) of all patients undergoing computed tomography (CT) of the chest, abdomen or pelvis performed in the emergency room, at an interval of 8 months, were evaluated. These data were compared with the official reports of the radiologist (gold standard). Results: 508 patients were included. The divergence between EP and the radiologist occurred in 27% of the cases. The most common type of divergence was the one not described by the EP, but described by the radiologist. The chance of having divergence in a case of multiple trauma is 4.93 times greater in relation to the case of only blunt trauma in one segment. A statistically relevant difference was also found in the length of stay of patients who had different interpretations of the CT scans. Conclusion: the study found a relatively high divergence rate between the EP report and the official radiologist report. However, less than 4% of these were considered to be clinically relevant, indicating the ability of the EP to interpret it satisfactorily.

摘要
研究目的：医师在解读影像检查过程中出现的诊断失误，可导致患者死亡率升高及住院时长增加。放射科医师与急诊医师（Emergency Physicians，EP）出具的报告分歧率可达20%以上。本研究旨在对比急诊医师所出具的非正式断层扫描报告，与放射科医师出具的正式报告。
研究方法：本研究为横断面研究，纳入某急诊科室8个月周期内完成胸部、腹部或盆腔计算机断层扫描（CT）的全部患者，由急诊医师将检查解读结果记录于病历中，本研究对上述解读结果进行评估，并与放射科医师出具的官方报告（金标准）进行比对。
研究结果：本研究共纳入508例患者。急诊医师与放射科医师的报告分歧率为27%。最常见的分歧类型为急诊医师未描述的影像学异常，而放射科医师在正式报告中予以标注。多发伤患者出现报告分歧的概率，较仅单部位钝性伤患者高4.93倍。此外，CT解读结果存在分歧的患者，其住院时长存在统计学显著性差异。
研究结论：本研究发现，急诊医师报告与放射科官方报告之间存在相对较高的分歧率，但其中仅不到4%被认定为具有临床相关性，这表明急诊医师具备较为出色的影像解读能力。