Clinical prediction of emergency cranial computed tomography results.
OBJECTIVE
To determine the ability of clinicians to predict the results of emergency head computed tomography (CT) scans.


METHODS
Clinicians requesting cranial CT scans from the emergency department prospectively filled out a form detailing their patients' complaints, possible diagnoses, and the likelihood of finding those diagnoses on CT. The results of the scans were catalogued according to diagnosis and classified as acutely abnormal, chronically abnormal, or normal.


RESULTS
Analysis of 536 consecutive patients showed a significant direct correlation between clinical prediction of CT abnormality and scan results. No definite differences in the ability to predict scan results were observed among different physician training levels. Thirty-six patients had acute abnormalities on CT despite a clinical prediction of remote or low likelihood.


CONCLUSIONS
Although clinical predictions of CT abnormality correlate with actual CT results, the correlation is not adequately refined to rely on for selection of patients for emergency cranial CT scans.
Reinus
W R
WR
Department of Radiology, Jewish Hospital, Washington University Medical Center, St Louis, Missouri.
Zwemer
F L
FL
D000208:Acute Disease; D000704:Analysis of Variance; D001927:Brain Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D002908:Chronic Disease; D002983:Clinical Competence / Q000592:standards*; D006259:Craniocerebral Trauma / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D004522:Educational Status; D004630:Emergencies; D005163:Factor Analysis, Statistical; D006801:Humans; D016013:Likelihood Functions; D008505:Medical Staff, Hospital / Q000193:education / Q000592:standards*; D009460:Neurologic Examination; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000592:standards*