title: Interpretation of Computed Tomography of the Head: Emergency Physicians versus Radiologists.
abstract: BACKGROUND
  Many patients are brought to crowded emergency departments (ED) of hospitals every day for evaluation of head injuries, headaches, neurologic deficits etc. CT scan of the head is the most common diagnostic measure used to search for pathologies. In many EDs the initial interpretation of images are performed by emergency physicians (EP). Since most decisions are made based on the initial interpretation of the images by emergency physicians and not the radiologists, it is necessary to assess the accuracy of interpretations made by the former group.
  
  
  OBJECTIVE
  The objective of this study was to compare the findings reported in the interpretation of head CTs by emergency physicians and compare to radiologists (the gold standard).
  
  
  METHODS
  This was a prospective cross sectional study conducted from March to May 2009 in a teaching hospital in Tehran, Iran. All non-contrast head CTs obtained during the study period were copied on DVDs and sent separately to a radiologist, 6 emergency medicine (EM) attending physicians and 14 senior EM residents for interpretation. Clinical information pertaining to each patient was also sent with each CT. The radiologist's interpretation was considered as the gold standard and reference for comparison. Data from EM physicians and residents were compared with the reference as well as with each other and statistical analysis was performed using SPSS 18.5.
  
  
  RESULTS
  Out of 544 CT scans, EM physicians had 35 false negatives and 53 false positives compared with radiologist's interpretations (P < 0.0001). EM residents had 74 false negatives and 12 false positives compared with radiologist's interpretations (P < 0.0001).
  
  
  CONCLUSIONS
  Both EPs and ER residents either missed or falsely called a significant number of pathologies in their interpretations. The interpretations of EPs and ER residents were more sensitive and more specific, respectively. These findings revealed the need for increased training time in head CT reading for residents and the necessity of attending continuing medical education workshops for emergency physicians.
authors.affiliation: Department of Emergency Medicine, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Arhami Dolatabadi
authors.affiliation: Department of Emergency Medicine, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Baratloo
authors.affiliation: Department of Pediatrics, Valiasr Hospital, Ghazvin University of Medical Sciences, Abyek, IR Iran.
authors.forename: Alaleh
authors.initials: A
authors.lastname: Rouhipour
authors.affiliation: Department of Family Medicine, University of Alberta, Edmonton, Canada.
authors.forename: Ali
authors.initials: A
authors.lastname: Abdalvand
authors.affiliation: Department of Emergency Medicine, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Hatamabadi
authors.affiliation: Department of Emergency Medicine, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammadmehdi
authors.initials: M
authors.lastname: Forouzanfar
authors.affiliation: Department of Emergency Medicine, Imam Hosein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Shojaee
authors.affiliation: Department of Emergency Medicine, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
authors.forename: Behrooz
authors.initials: B
authors.lastname: Hashemi
keywords: Brain; Emergencies; Interpretation; Radiologist; Tomography, X-Ray Computed