Document Detail

Out of hours multidetector computed tomography pulmonary angiography are specialist resident reports reliable?
MedLine Citation:
PMID:  22212421     Owner:  NLM     Status:  In-Data-Review    
RATIONALE AND OBJECTIVES: The purposes of this study were to assess the accuracy of trainee radiologists' reports for computed tomographic pulmonary angiographic (CTPA) imaging and to determine agreement or discrepancy with final verified consultant reports.
MATERIALS AND METHODS: A total of 100 consecutive out-of-hours CTPA examinations were prospectively analyzed. Fifty-one male and 49 female subjects were included in the study. The mean age of patients scanned was 63.7 years (range, 17-98 years).
RESULTS: Eighteen of the 100 subjects (18%) had findings positive for pulmonary embolism. The interobserver agreement for pulmonary embolism between on-call radiology residents and consultant radiologists was almost perfect (κ = 0.932; 95% confidence interval, 0.84-1.0; P < .0001). There was one false-negative CTPA report. Eighty-two CTPA scans (82%) were reported as negative for pulmonary embolism by consultant radiologists. In this group, there was a single false-positive interpretation by the on-call specialist resident. The interobserver agreement for all findings between resident and consultant reports was almost perfect (weighted κ = 0.87; 95% confidence interval, 0.79-0.96; P < .0001). The overall discrepancy rate, including both false-positive and false-negative findings, between the on-call radiology resident and consultant radiologist was 8% (eight of 100).
CONCLUSIONS: CTPA reports by radiology residents can be relied and acted upon without any major discrepancies. There is a relatively much higher proportion of patients with alternative diagnoses, mainly infective consolidation and heart failure presenting with similar symptoms and signs as pulmonary emboli. It is imperative for trainees to be systematic and review all images if observational omissions are to be reduced.
George C Jakanani; Rajesh Botchu; Sumit Gupta; James Entwisle; Amrita Bajaj
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic radiology     Volume:  19     ISSN:  1878-4046     ISO Abbreviation:  Acad Radiol     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440159     Medline TA:  Acad Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.
Glenfield Hospital, Groby Road, Leicester, United Kingdom.
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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