Accuracy of computed tomography of the kidneys, ureters and bladder interpretation by emergency physicians. (9th September 2013)

• Record Type: Journal Article
• Authors: Rafi, Momtaz; Shetty, Amith; Gunja, Naren
• Is Part Of: Emergency medicine Australasia. Volume 25:Number 5(2013:Oct.)
• Page Start: 422
• Page End: 426
• Publication Date: 2013-09-09
• Subjects: Emergency medicine -- Periodicals; Emergency medicine -- Australasia -- Periodicals; 616.025
• DOI: 10.1111/1742-6723.12117
• Languages: English
• ISSNs: 1742-6731

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="emm12117-sec-0001" sec-type="section"> <title>Objective</title> <p>The study aims to determine the interpretation accuracy of computed tomography of the kidneys, ureters and bladder (CT‐KUB) by emergency physicians (EPs) compared with the formal radiology report, as the reference standard, in patients with suspected acute urinary tract calculous disease.</p> </sec> <sec id="emm12117-sec-0002" sec-type="section"> <title>Methods</title> <p>A sample of 20 consecutive CT‐KUB scans for suspected acute calculous disease was compiled from the medical imaging department of an adult tertiary teaching hospital. Ten EPs with a minimum of 2 years' experience post‐Fellowship interpreted each scan using a template form. The total sample of 200 reports by EPs was compared with the formal radiology report for agreement in detecting renal tract stones, signs of obstruction and other clinical findings. Interrater agreement and the kappa statistic were used for comparative data analysis.</p> </sec> <sec id="emm12117-sec-0003" sec-type="section"> <title>Results</title> <p>There was a high level of agreement (%, kappa value) between EPs and radiologists for the detection of large (≥5 mm) calculi (94.5%, κ 0.89), signs of obstruction (93%, κ 0.86) and clinically significant findings (90%, κ 0.78). The level of agreement was low for the detection of small (<5 mm) calculi (79%, κ 0.48) and clinically non‐significant findings (67.5%, κ 0.33).</p> </sec> <sec id="emm12117-sec-0004" sec-type="section"> <title>Conclusion</title> <p>EPs can accurately detect clinically significant acute calculous disease and signs of obstruction on CT‐KUB, allowing for ongoing acute management and early disposition of the patient. However, their findings should be verified against the formal radiology report when available.</p> </sec> </abstract>