Appropriation Evaluation of Simple R a -diography Interpretation by EM Resident

ABSTRACT

PURPOSE: The accurate plain radiography interpretation was essential skill in emergency residency. We researched the accuracy and clinical significance of the interpretation of plain radiography by emergency medical residents, and so, it help our development the education program of emergency residency. METHODS: From 15, Dec 2000 to 15, Feb 2001 and during 1 month at Feb 2003, each two period all plain radiographs were interpreted by two EM resident who were trained for one year and by radiologists. The each results of interpretation were compared with the result of formal results which decided by EM staffs and radiology staffs. Misinterpreted groups were assigned based on the following criteria. According to Nature of discrepancy, Group M (underreaded); Subgroup M0 (not significant), M1 (minor effect on treatment), M2 (potential for injury or bad outcome), M3 (severe potential for injury or bad outcome) and Group Q (overread); Subgroup Q0 (not significant), Q1 (significant unsuitable additional modality and management). Then CSDR (clinically significant discrepancy rate) was defined as (M1+M2+M3 +Q1) / No. of Sudies. RESULTS: Total 889 radiographic studies were enrolled in 372 patients. Total EM residency misinterpretation rate was 3.9% and total CSDR was 2.3%. Total radiologist misinterpretation rate was 1.1%. In total 35 error cases, M1 were most frequent (14 studies). The CSDR were highest for KUB (5.2%), Head (3.9%), Shoulder (3.7%), Chest (3.6%), Rib (3.4%). CONCLUSION: Low overall misinterpretation rate and CSDR have implications for the medical practice and reimbursement of emergency residency for radiologic interpretation. But need for efforting reduce error rate then we propose establishment of interpretation radiography education program.