Thesis on accuracy of emergency and critical care residents in interpreting emergency cranial CT scans as compared to neuroradiologist experience from two medical schools in Ethiopia

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Addis Abeba University


Introduction: Emergency departments are crucial entry points to healthcare services and usually overcrowded. A computed tomography is a diagnostic medical device with computers and rotating X-ray machines creating cross-sectional images of the body. It is often used in the emergency room. The use of cranial CT in ED patients could be influential in clinical decision making by improving diagnostic confidence and have impact on treatment plan. While the accuracy of interpretation of brain CT scan by emergency physicians is of crucial importance, many EM residency programs do not allocate enough time to brain CT scan interpretation training Objectives: was to determine competence of emergency medicine residents of TASH in the assessment of cranial CT scans, May 2019 Methodology: A prospective cross-sectional study employed on the EMCC residents of AAU, and St’ Paul MMC. Data collected from May 2019-June 2019 by using structured questionnaires as well as through radiant view software by displaying the full slices of the cranial CT scans. Data have entered, cleaned, edited and analyzed by using SPSS 20.0 version statistical software. And analysis was also done in SPSS & excel 2016. Results: Forty two EMCC residents were enrolled in this study. 24 from AAU and 18 from St’ P aul MMC. Over all accuracy rate in interpretation cranial CT scans was 57.6%. The overall di screpancy rate was very high (42.4%) compared to prior studies. The sensitivity of the residen ts in detecting normal radiographs was 62.6% with specificity of 96%, PPV of 66.3% and NP V of 95.3%. Most residents correctly identified haemorrhage (97.6%) & hydrocephalus (90.5 %). All residents miss CT scan of herniation and 92.9% of the residents miss meningeal enha ncement. There is moderate agreement between EMCC and neuroradiologist (kappa 0.5).The re is no factor identified that has significant statistical association with the outcome of the inte rpreting emergency cranial CT scans. Conclusion: The skills of residents in interpreting cranial CT results are very low regardless of the prevalence of the condition in the ER or the relative clinical importance of the conditions. Poor sensitivity and high false positive results with misinterpretations were common. This can result in potentially dangerous patient mismanagement.



Cranial CT scans, Emergency medicine residents, neuroradiologist