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
Results
A total of 1084 after-hours CCT studies were reviewed. The cohort comprised 1062 patients, with 615 males (56.7%) and 469 females (43.3%). The mean and median ages were 54.7 and 55.0 years respectively (range 16 -100 years). The number of cases positive for injury was 37 (3.4%). The total number of discrepancies was 14 (discrepancy rate 1.3%), including 4 overcalls (0.3%) and 10 misses (0.9%). The discrepancy rates for junior and senior registrars were 1.7% and 0.7%, respectively. Only 5 misses (0.5%) were considered clinically significant.
The sensitivity of junior and senior registrars was 63.2% and 83.3%, respectively, mirroring a trend found in several studies evaluating for correlation between registrar performance and experience. These results highlight the importance of continued supervision and feedback for registrars throughout all years of training, not only during the early years of practice.
To our knowledge, this is the first Australian study to specifically evaluate the accuracy of cervical spine CT interpretation by radiology registrars. Whilst the observed rates of discrepancy in our study are reassuring, these are also a product of the low incidence of positive studies, with only 37 cases (3.4%) found to have injury. The reason(s) for this low rate of injury are not entirely clear, although our institution’s designation as a non-major trauma centre is likely to have influenced this outcome.
Future work could explore patient outcomes such as neurological deficit, morbidity and mortality with report accuracy, ideally as a multi-centre study with inclusion of Level 1 trauma services.