title: Senior surgical residents can accurately interpret trauma radiographs.
abstract: Surgical residents routinely interpret radiographic studies during the evaluation of trauma patients, which directs further evaluation and invasive procedures. Official interpretations--"post-reading"--of radiographs by radiologists may be delayed by hours or even days. Trauma surgeons frequently act on their impressions before "official" readings are available. It has been demonstrated that surgical residents can accurately perform and interpret trauma ultrasound examinations. The purpose of this study was to evaluate the ability of senior surgery residents to interpret basic trauma radiographs. Interpretations of trauma radiographs (cervical spine, chest, pelvis, and CT of the brain) were recorded prospectively by the senior surgery resident present during trauma evaluations. These interpretations were compared with the findings of the radiologist as obtained from the official radiology report. Differing results were divided into clinically significant and clinically nonsignificant findings using defined criteria. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were determined. Interpretations of trauma radiographs by senior residents achieved an accuracy of 100 per cent for cervical spine radiographs, 95.9 per cent for chest radiographs, 98.0 per cent for pelvis radiographs, and 97.9 per cent for CT of the head. In aggregate senior residents interpreted trauma radiographs with 97.9 per cent accuracy. Differences that were considered clinically significant according to preset criteria occurred in 2.1 per cent of observations. We conclude that senior general surgical residents can accurately interpret trauma radiology, including CT of the brain. These results suggest that institutional policies for post-reading of trauma radiology should be reassessed.
authors.affiliation: Department of Surgery, The University of Kansas School of Medicine-Wichita and Via Christi Regional Medical Center, 67214, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Vorhies
authors.forename: Paul B
authors.initials: PB
authors.lastname: Harrison
authors.forename: R Stephen
authors.initials: RS
authors.lastname: Smith
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Helmer
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000000981:diagnostic imaging; D002983:Clinical Competence; D005069:Evaluation Studies as Topic; D005260:Female; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D007615:Kansas; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*