X-ray Interpretation in Emergency Department, Do We Need the Radiologist?

Author(s): Fatimah Alherz, Fayez Alharthi, Fahad Almutari, Abdulrahman Alahmari, Amani Alsolami, Maha nojoom , Abdullah Al-Shamrani

Background: Diagnostic imaging plays an integral role in the evaluation of patients in the emergency department (ED), and its utilization has increased significantly in the last two decades. Chest x-ray (CXR) is an important diagnostic tool for diagnosing and monitoring a spectrum of diseases in the pediatric field, and decisions based on x- rays can have serious consequences for patients.

Method: This study was a cross sectional study among 110 health care providers working in the emergency department. Providers were requested to fill out an online questionnaire consisting of 10 different cases revised and approved by the research committee. Each question had at least two important observations whether related to the chest x-ray finding or subsequently related diagnosis.

Result: The health care providers were as follows: specialist 39 (27.3%), consultant 29 (26.4%), senior resident 22(20%), fellow 9 (8.2%), junior resident 15(13.6%), general practitioner 3(2.7%) and medical intern 2(1.8%) The highest score was 100% and lowest score was 30% with a mean score of 64.3% (13% sd). The consultants had the highest score with a mean of 72.2% (11.1% sd), followed by specialists 66.37(12.8), medical interns 62.5% senior residents 62.45%(9.8 sd), fellows 60.2% (15.6 sd). Meanwhile, while the lowest scoring groups were the junior residents and family practitioners (53.7 and 47.7, respectively). Seventy-three percent of the case patients had atypical pneumonia and 80% had inspiratory film and boat-shaped heart CXR, and 74.5% and 72.7% of the providers reached the correct diagnosis of tetralogy of fallout (TOF), respectively. A total of 64.5% of the health care providers correctly identified foreign body aspiration. In the chest mass case, 35% of the providers identified the type the film (AP); furthermore, 26.4% missed the potential diagnosis. In the tension pneumothorax case, hyperlucency was still misse