Clinical radiology · 2026
Where can we improve? An evaluation of discrepancies between radiology resident and consultant reports for noncontrast head computed tomography (NCHCT) scans in the emergency department at a tertiary care centre.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Nash K, Bhebhe Z, Bow A, Hall M, Lowe D, Narbone M, OxCAIR, Romsauerova A, Ather S
Аннотация
AIM: To evaluate the discrepancy rates of acute findings on non-contrast computed tomography head scans (NCHCT) between radiology trainees and neuroradiology consultants at a tertiary care centre in the United Kingdom.
MATERIALS AND METHODS: All reports for NCHCT over a 4 month period conducted in the emergency department were extracted from the radiology information system and screened to identify scans reported by a registrar. Reports were manually coded for acute findings and discrepancies. Acute findings included all subtypes of intracranial haemorrhage (ICH), mass effect, midline shift, cranial fracture, acute/subacute infarct, hydrocephalus, and space occupying lesion.
RESULTS: In total, 2208 scans were included. Discrepancies for any acute finding were found in 94 cases (4.26%), including 38 disagreements related to intracranial haemorrhage. Specificity was over 99.5% for all acute findings. The highest sensitivity was observed for midline shift at 100% (95% confidence intervals 90.3-100.0%), intraventricular haemorrhage at 95.7% (78.1-99.9%) and mass effect at 92.8% (84.9-97.3%). Sensitivity was lowest at 66.7% for extradural haemorrhage (9.4-99.2%) and 57.1 for ICH of unclear location (18.4-90.1%), though the prevalence of these pathologies was low. Sensitivity was also lower for infarcts at 70% (57.9-80.4%) and subdural haemorrhage at 77.6 (63.4-88.2).
CONCLUSION: There is a high concordance between radiology registrar and subsequent consultant reports, supporting registrar on-call reporting. Registrars were highly specific in diagnosing key acute pathologies, meaning few patients would have received unnecessary treatment. Sensitivity varied significantly between pathologies, with certain areas for improvement identified, which can be used to inform local teaching and clinical review to reduce misdiagnoses.
MATERIALS AND METHODS: All reports for NCHCT over a 4 month period conducted in the emergency department were extracted from the radiology information system and screened to identify scans reported by a registrar. Reports were manually coded for acute findings and discrepancies. Acute findings included all subtypes of intracranial haemorrhage (ICH), mass effect, midline shift, cranial fracture, acute/subacute infarct, hydrocephalus, and space occupying lesion.
RESULTS: In total, 2208 scans were included. Discrepancies for any acute finding were found in 94 cases (4.26%), including 38 disagreements related to intracranial haemorrhage. Specificity was over 99.5% for all acute findings. The highest sensitivity was observed for midline shift at 100% (95% confidence intervals 90.3-100.0%), intraventricular haemorrhage at 95.7% (78.1-99.9%) and mass effect at 92.8% (84.9-97.3%). Sensitivity was lowest at 66.7% for extradural haemorrhage (9.4-99.2%) and 57.1 for ICH of unclear location (18.4-90.1%), though the prevalence of these pathologies was low. Sensitivity was also lower for infarcts at 70% (57.9-80.4%) and subdural haemorrhage at 77.6 (63.4-88.2).
CONCLUSION: There is a high concordance between radiology registrar and subsequent consultant reports, supporting registrar on-call reporting. Registrars were highly specific in diagnosing key acute pathologies, meaning few patients would have received unnecessary treatment. Sensitivity varied significantly between pathologies, with certain areas for improvement identified, which can be used to inform local teaching and clinical review to reduce misdiagnoses.