Scholarlink

Purpose <p>The use of computed tomography (CT) in the emergency department (ED) has been increasing due to its diagnostic value for emergency physicians (EPs). This study aimed to determine the predictors of EP interpretation errors (IEs) on CT scans leading to change in clinical management (IECM) in both endogenous and exogenous ED visits.</p> Methods <p>This single-center, retrospective cohort study included patients with consecutive ED visits initially managed by EPs at our institution over 6&#xa0;months. Patients who did not undergo CT imaging and presented with cardiopulmonary arrest upon arrival were excluded. CT images were interpreted by emergency radiologists immediately after acquisition, and IEs were identified. The primary outcome was IECM, determined by reference to the clinical management decisions made by EPs. A multivariate analysis was performed to determine the independent predictors of IECM.</p> Results <p>Among the 2,037 patients, 158 (8%) had IEs, whereas 52 (3%) had IECM. Multisite CT imaging was the strongest independent predictor for both IECM (OR: 2.25, 95% CI: 1.21–4.19, <i>P</i> = 0.011) and IEs (OR: 2.32, 95% CI: 1.61–3.36, <i>P</i> &lt; 0.001). Other predictors of IECM were prolonged ED stay and night-time ED visits as clinical factors. Additional predictors of overall IEs were contrast-enhanced CT and abdominopelvic CT as radiological factors.</p> Conclusion <p>Multisite CT imaging, which involve multiple organs and extensive diagnostic information, significantly increases the likelihood of misinterpretation, leading to change in clinical management by EPs.</p> Graphical Abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Predictors of diagnostic errors in computed tomography interpretation by emergency physicians leading to changes in clinical management in the emergency department

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年6月23日

查看全文
  • Naoaki Shibata,
  • Takafumi Yonemitsu,
  • Nozomu Shima,
  • Yuichi Miyake,
  • Tomoya Fukui,
  • Junya Fuchigami,
  • Akira Ikoma,
  • Tetsuo Sonomura,
  • Shigeaki Inoue

摘要

Purpose

The use of computed tomography (CT) in the emergency department (ED) has been increasing due to its diagnostic value for emergency physicians (EPs). This study aimed to determine the predictors of EP interpretation errors (IEs) on CT scans leading to change in clinical management (IECM) in both endogenous and exogenous ED visits.

Methods

This single-center, retrospective cohort study included patients with consecutive ED visits initially managed by EPs at our institution over 6 months. Patients who did not undergo CT imaging and presented with cardiopulmonary arrest upon arrival were excluded. CT images were interpreted by emergency radiologists immediately after acquisition, and IEs were identified. The primary outcome was IECM, determined by reference to the clinical management decisions made by EPs. A multivariate analysis was performed to determine the independent predictors of IECM.

Results

Among the 2,037 patients, 158 (8%) had IEs, whereas 52 (3%) had IECM. Multisite CT imaging was the strongest independent predictor for both IECM (OR: 2.25, 95% CI: 1.21–4.19, P = 0.011) and IEs (OR: 2.32, 95% CI: 1.61–3.36, P < 0.001). Other predictors of IECM were prolonged ED stay and night-time ED visits as clinical factors. Additional predictors of overall IEs were contrast-enhanced CT and abdominopelvic CT as radiological factors.

Conclusion

Multisite CT imaging, which involve multiple organs and extensive diagnostic information, significantly increases the likelihood of misinterpretation, leading to change in clinical management by EPs.

Graphical Abstract