Are emergency physicians competent to interpret the cranial CT of patients younger than the age of 2 years with mild head trauma?

• Published in: The American journal of emergency medicine Vol. 33; no. 9; pp. 1175 - 1177
• Main Authors: İdil, Hasan, MD, Kırımlı, Güven, MD, Korol, Güler, MD, Ünlüer, Erden Erol, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2015
• Subjects: Clinical Competence; Craniocerebral Trauma - diagnostic imaging; Emergency; Emergency Medicine - standards; Emergency Service, Hospital - standards; Female; Glasgow Coma Scale; Humans; Infant; Male; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Tomography, X-Ray Computed
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2015.05.024

Abstract Objective The aim of this study is to detect the accuracy rate of emergency physicians' (EPs') interpretations of cranial computed tomography (CT) of a special patient group, the patients younger than the age of 2 years with mild head trauma. Methods The study took place in a research and training hospital within a period of 3 months and included a total of 156 patients. The scans were interpreted by the EPs, and the predicted results were recorded in the patients' files; simultaneous interpretations of the on-call radiologist were also recorded. The interpretations were scanned retrospectively at the end of each month, compared, and recorded. Results With reference to the radiologists' reports, the sensitivity and the specificity of EPs' interpretations of cranial CT were 76.9% and 95.1%, respectively. Concordance of both groups' interpretations was 93.6%. The area under the curve (AUC) value in receiver operating characteristic (ROC) analysis, which reflects these results, was calculated as 0.860 (95% confidence interval, 0.740-0.981). This value was found to be statistically significant ( P < .001). False-negative and false-positive values were 23% and 4.9%, respectively. No negative clinical outcomes were observed due to nonconcordance interpreted cases (6.4%). Conclusions Emergency physicians can interpret safely the cranial CTs of patients younger than the age of 2 years with mild head trauma, until the radiologists' reports are obtained. However, the anatomic diversities of these patients' age group should be taken into consideration.