Finding
Ineligible patients may be treated with thrombolytic therapy as a result of such computed tomography scan misinterpretation.
Paper
Computed tomography evaluation in acute stroke: retrospective study.
Citations: 3
Full textAbstract
OBJECTIVE To determine the accuracy with which 'frontline' hospital doctors interpret computed tomography brain scans. DESIGN Retrospective study. SETTING University teaching hospital, Hong Kong. PARTICIPANTS Medical and emergency room doctors. MAIN OUTCOME MEASURE Accuracy in correctly identifying features of acute stroke on 18 computed tomography brain scans. RESULTS Computed tomography brain scan images showing easily detectable haemorrhage and infarct were identified in 91% and 90% of scans, respectively; but difficult-to-interpret scans with subtle features of haemorrhage or infarct were only correctly identified in 46% and 45% of readings, respectively. More experienced doctors did not perform better than junior doctors (P=0.69; 95% confidence interval, -1.84 to 2.73) and the mean total score for doctors from the emergency department did not differ significantly from that of doctors from the medical department (P=0.57; 95% confidence interval, -2.98 to 1.67). CONCLUSION Early signs of infarct and small bleeds on computed tomography brain scans are not well recognised by doctors, regardless of clinical exposure or seniority. Ineligible patients may be treated with thrombolytic therapy as a result of such computed tomography scan misinterpretation.
Authors
A. Hui, C. Y. Man, A. Tang
Journal
Hong Kong medical journal = Xianggang yi xue za zhi