Effects of training and experience in interpretation of emergency body CT scans.
OBJECTIVE
To determine the effects of level of training and other factors on the rate of discrepant interpretation of emergency body computed tomographic (CT) scans by trainees and staff radiologists.


METHODS
Five hundred ninety-eight consecutive emergency CT studies were prospectively interpreted by radiology residents or board-certified body imaging fellows over a 12-month period. Each interpretation was reviewed within 12 hours by an attending body CT radiologist. Major discrepancies between staff radiologists' and trainees' interpretations were defined and those with the potential to affect immediate patient therapy; minor discrepancies were defined ad those without such potential. The effects on discrepancy rates were examined for abnormal versus normal CT findings and trauma versus nontrauma cases.


RESULTS
Major and minor discrepancy rates were 1.2% and 6.5%, respectively, between interpretations made by the trainee and the staff radiologist. Overall, fellows demonstrated statistically significantly lower discrepancy rates than did senior of junior residents (5.9%, 13.7%, and 13.3%, respectively). The discrepancy rate was higher when CT findings were abnormal than when they were normal (13.5% vs 2.6%). There were no differences between discrepancy rates for trauma and nontrauma cases.


CONCLUSIONS
Experience appeared to decrease discrepancy rates. Trainees were more likely to miss findings than to read normal scans as abnormal.
Wechsler
R J
RJ
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia PA 19107, USA.
Spettell
C M
CM
Kurtz
A B
AB
Lev-Toaff
A S
AS
Halpern
E J
EJ
Nazarian
L N
LN
Feld
R I
RI
Needleman
L
L
Alexander
A A
AA
D002568:Certification; D003951:Diagnostic Errors; D004630:Emergencies; D006801:Humans; D007396:Internship and Residency; D011446:Prospective Studies; D011871:Radiology / Q000193:education*; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000000981:diagnostic imaging