Thesis On Accuracy Of Emergency And Critical Care Residents In Interpreting Emergency Cranial Ct Scans As Compared To Neuroradiologist Experience From Two Medical Schools In Ethiopia

Introduction: Emergency departments are crucial entry points to healthcare services and usuallyrnovercrowded. A computed tomography is a diagnostic medical device with computers and rnrotating X-ray machines creating cross-sectional images of the body. It is often used in thernemergency room. The use of cranial CT in ED patients could be influential in clinical decisionrnmaking by improving diagnostic confidence and have impact on treatment plan. While thernaccuracy of interpretation of brain CT scan by emergency physicians is of crucial importance,rnmany EM residency programs do not allocate enough time to brain CT scan interpretationrntraining rnObjectives: was to determine competence of emergency medicine residents of TASH in thernassessment of cranial CT scans, May 2019 rnMethodology: A prospective cross-sectional study employed on the EMCC residents of AAU,rnand St’ Paul MMC. Data collected from May 2019-June 2019 by using structuredrnquestionnaires as well as through radiant view software by displaying the full slices of therncranial CT scans. Data have entered, cleaned, edited and analyzed by using SPSS 20.0 versionrnstatistical software. And analysis was also done in SPSS & excel 2016. rnResults: Forty two EMCC residents were enrolled in this study. 24 from AAU and 18 from St’ Prnaul MMC. Over all accuracy rate in interpretation cranial CT scans was 57.6%. The overall dirnscrepancy rate was very high (42.4%) compared to prior studies. The sensitivity of the residenrnts in detecting normal radiographs was 62.6% with specificity of 96%, PPV of 66.3% and NPrnV of 95.3%. Most residents correctly identified haemorrhage (97.6%) & hydrocephalus (90.5rn%). All residents miss CT scan of herniation and 92.9% of the residents miss meningeal enharnncement. There is moderate agreement between EMCC and neuroradiologist (kappa 0.5).Thernre is no factor identified that has significant statistical association with the outcome of the internrpreting emergency cranial CT scans. rnConclusion: The skills of residents in interpreting cranial CT results are very low regardless ofrnthe prevalence of the condition in the ER or the relative clinical importance of the conditions.rnPoor sensitivity and high false positive results with misinterpretations were common. This canrnresult in potentially dangerous patient mismanagement.

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