Acil hekimlerinin ve radyoloji uzmanlarının abdomen BT yorumlama düzeylerinin karşılaştırılması

Amaç: BT acil serviste sıklıkla kullanılan bir tanı aracıdır. Hastalara erken ve doğru müdahale yapabilmek için acil hekimlerinin çekilen BT leri belli düzeyde yorumlayabilmeleri gerekmektedir. Bu çalışmada acil hekimlerinin abdomen BT yorumlayabilme düzeylerini belirlemeyi amaçladık. Yöntem: 2018 yılı içerisinde travma nedeniyle acilde abdomen BT çekilen 234 hastanın görüntüleri acil hekimleri tarafından yorumlandı. Bu yorumlar önceden yazılmış olan radyoloji doktoru raporlarlarıyla karşılaştırılarak uyum düzeyi belirlendi. Bu karşılaştırma kappa istatistiği kullanılarak yapıldı. Bulgular: Acil hekimlerinin abdomen bilgisayarlı tomografiyi değerlendirmede radyologlarla uyum oranı 52.1% olarak belirlendi. Acil hekimlerinin abdomen bilgisayarlı tomografiyi doğru değerlendirme oranı ise 59.22% (95% CI: 52.18-66) ve kappa değeri 0.24 olarak tespit edildi. Acil hekimlerinin BT yorumlama ile ilgili sensitivite, spesifite, pozitif prediktif değer ve negatif prediktif değeri sırasıyla 40.98%(95% CI: 32.17-50.25), 85.71%(95% CI: 76.38-92.39), 80.65%(95% CI: 70.30-88.00) ve 50%(95% CI: 45.72-54.28) olarak belirlendi. Sonuç: Acil hekimlerinin travma hastalarında abdomen BT değerlendirme düzeyleri yetersizdir. Bu düzeyi yükseltmek için ilgili kuruluşların eğitim programları düzenlemesi gerekir.

Anahtar Kelimeler:

abdomen;, bilgisayarlı tomografi, sensitivite;, acil hekimi

Comparison of abdominal ct interpretation levels of emergency physicians and radiologists

Aim: Computerized tomography (CT) is a frequently used diagnostic tool in the emergency department. In order to provide early and appropriate intervention for the patients, emergency physicians should be able to accurately interpret CT images at least to a certain degree. In this study, we aimed to determine the accuracy of emergency physicians in evaluating an abdominal CT.Methods: In 2018, the images of 234 patients who underwent an abdominal CT due to trauma were interpreted by emergency physicians(EP). The level of agreement between emergency physicians and radiologists on these abdominal CT was determined by comparing their evaluations.This comparison was made using the kappa statistics.Results: The rate of concordance in CT interpretations between the EPs and radiologists was 52.1%. The accuracy rate of EP on interpretation CT images was 59.22% (95% CI: 52.18-66) and the kappa value was 0.24. For the CT interpretation of emergency physicians, the sensitivity, specificity, positive predictive value and negative predictive value were calculated as 40.98%(95% CI: 32.17-50.25), 85.71%(95% CI: 76.38-92.39), 80.65%(95% CI: 70.30-88.00) and 50%(95% CI: 45.72-54.28), respectively. Conclusion: Emergency physicians’ accuracy in interpreting CT images is not at an adequate level. The institutions in emergency medicine should organize educative programs to increase this level.

Keywords:

abdomen:, computerized tomography, sensitivity;, emergency physician,

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