Keywords:
Head and neck, Musculoskeletal bone, Trauma, CT, Radiation safety
Authors:
R. Woodford1, P. Tran1, L. Green2; 1Footscray, VIC/AU, 2Parkville, VIC/AU
DOI:
10.26044/ranzcr2021/R-0213
Purpose
Initial evaluation of trauma patients involves identifying clinically important cervical spine injury (CSI) which if undiagnosed and untreated can lead to serious consequences such as quadriplegia and death. This often necessitates cervical imaging with cervical spine CT (CCT). Like many teaching hospitals in Australia, after-hours CT reporting at our institution is undertaken by the on-call radiology registrar. Many hospital protocols recommend patients to remain in spinal precautions until the report is finalised by a consultant, although there are very few studies to support this practice.
Several studies have assessed concordance between registrar and consultant reports for CT in a variety of settings1-4, and a metanalysis by Wu et al. demonstrated a 2.2% major discrepancy rate for radiology residents, relative to the 0.9% major discrepancy rate for staff radiologists5. Similar outcomes have been demonstrated for radiology trainees reporting after-hours CCTs. Studies from the United Kingdom and Canada have demonstrated major discrepancy rates for CCT of 0.5% and 1.0%, respectively6,7. Yan et al found the rate of clinically significant discrepancies to be 2.0% and sensitivity of senior trainees to be 97.0%8.
This study aims to evaluate the discrepancy rates between preliminary reports generated by radiology registrars and finalised consultant reports at our institution, with respect to cervical spine (CCT) performed after hours and referred from the emergency departments.