Accuracy of brain computed tomography interpretation by internists at emergency room after official hour periods in HRH Princess Maha Chakri Sirindhorn Medical Center

Abstract

Accurate initial interpretations of brain computed tomography scan (CTs) by internists and primary care physicians remain critical in decision-making and the resulting quality of care. To determine the accuracy of interpretation of brain CTs by internists in radiology department after official hour periods at the HRH Princess Maha Chakri Sirindhorn Medical Center in Nakhon Nayok, Thailand. Between January 2011 and December 2012, 125 brain CTs imagings were requested, initially interpreted by internists and reviewed by 2 experienced radiologists. Compared interpretation results were calculated. Accurate percentages of brain CTs interpretation in ischemic stroke, intracranial hemorrhage, skull or facial fracture, intracranial mass, hydrocephalus, and brain herniation were 80.8%, 91.2%, 96.8%, 99.2%, 92%, and 92.8%, respectively. The numbers of patients in agreement interpretation were 83 (66.4%) in the agreement (AG) group, 27 (21.6%) in the disagreement significant (DS) group, and 15 (12.0%) in the disagreement insignificant (DI) group. Most interpretations of brain CTs done by the internists had shown a poor sensitivity but a high specificity. In conclusion, low accuracy of brain CTs interpretations by internists after official hour were in cases of ischemic stroke. Education in brain CTs interpretations for internists is necessary for improving the quality of treatment.