Computed tomography evaluation in acute stroke: retrospective study.
OBJECTIVE
To determine the accuracy with which 'frontline' hospital doctors interpret computed tomography brain scans.


METHODS
Retrospective study.


METHODS
University teaching hospital, Hong Kong.


METHODS
Medical and emergency room doctors.


METHODS
Accuracy in correctly identifying features of acute stroke on 18 computed tomography brain scans.


RESULTS
Computed tomography brain scan images showing easily detectable haemorrhage and infarct were identified in 91% and 90% of scans, respectively; but difficult-to-interpret scans with subtle features of haemorrhage or infarct were only correctly identified in 46% and 45% of readings, respectively. More experienced doctors did not perform better than junior doctors (P=0.69; 95% confidence interval, -1.84 to 2.73) and the mean total score for doctors from the emergency department did not differ significantly from that of doctors from the medical department (P=0.57; 95% confidence interval, -2.98 to 1.67).


CONCLUSIONS
Early signs of infarct and small bleeds on computed tomography brain scans are not well recognised by doctors, regardless of clinical exposure or seniority. Ineligible patients may be treated with thrombolytic therapy as a result of such computed tomography scan misinterpretation.
Hui
A C F
AC
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Man
C Y
CY
Tang
A S Y
AS
Au-Yeung
K M
KM
D000208:Acute Disease; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D006801:Humans; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed