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Emergency Computed Tomography: How Misinterpretations Vary According to the Periods of the Nightshift?

紧急计算机断层扫描: 误解如何根据夜班时间而变化?

  • 影响因子:1.48
  • DOI:10.1097/RCT.0000000000001128
  • 作者列表:"Platon A","Etienne L","Herpe G","Yan D","Massoutier M","Perneger T","Becker M","Poletti PA
  • 发表时间:2021-03-01
Abstract

OBJECTIVE:To evaluate the accuracy of initial computed tomography (CT) interpretations made by radiology residents during nightshifts in the emergency department. METHODS:Preliminary CT reports performed by radiology residents during 120 consecutive nightshifts (08:30 pm to 08:30 am) were reviewed, attendings' final interpretation being the reference standard. Nightshifts were divided into four consecutive periods of 3 hours. Major misinterpretations were related to potentially life-threatening conditions if not treated immediately after CT. The rate of misinterpretations was calculated for all CT examinations, separately for nightshift's periods and for residents' training years. RESULTS:Misinterpretations were recorded in 155 (7.4%) of 2102 CT examinations, 0.6% (13/2102) were major. There were 2.2% (4/186) major misinterpretations that occurred during the last period of the nightshift versus 0.4% (9/1916) during the first periods of the night (P < 0.05). Of all misinterpretations, 8.5% (130/1526) were made by third- and fourth-year residents and 4.3% (25/576) by fifth-year residents (P < 0.005). CONCLUSIONS:Major misinterpretations occur at the end of the nightshift, which may be explained by the fatigue effect. The rate of misinterpretations is lower among fifth-year residents, which may be related to their prior experience in reading emergency cases.

摘要

目的: 评价放射科住院医师在急诊夜班时进行的初步计算机断层扫描 (CT) 判读的准确性。 方法: 回顾了放射科住院医师在连续120次夜班 (下午08:30至上午08:30) 期间进行的初步CT报告,以注意事项的最终解释作为参考标准。夜班被分为4个连续的3小时。如果CT后不立即治疗,主要的误解与潜在的危及生命的疾病有关。计算所有ct检查的误判率,分别为夜班期和住院医师培训年。 结果: 155例ct检查中7.4% 例 (2102) 出现误诊,0.6% 例 (13/2102) 为主要误诊。有2.2% (4/186) 的主要错误解释发生在夜班的最后一个时期与0.4% (9/1916) 在第一个时期的夜晚 (P <0.05)。在所有误解中,8.5% (130/1526) 是由第三和第四年居民做出的,4.3% (25/576) 是由第五年居民做出的 (P <0.005)。 结论: 主要的误解发生在夜班结束时,这可能是由疲劳效应解释的。第五年居民的误读率较低,这可能与他们以前阅读急诊病例的经验有关。

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