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Clinical prediction of emergency cranial computed tomography results
1Department of Radiology, Jewish Hospital, Washington University Medical Center, St Louis, Missouri.
Study Purpose:
To determine the ability of clinicians to predict the results of emergency head computed tomography (CT) scans.
Methods:
Clinicians requesting cranial CT scans from the emergency department prospectively filled out a form detailing their patients' complaints, possible diagnoses, and the likelihood of finding those diagnoses on CT. The results of the scans were catalogued according to diagnosis and classified as acutely abnormal, chronically abnormal, or normal.
Results:
Analysis of 536 consecutive patients showed a significant direct correlation between clinical prediction of CT abnormality and scan results. No definite differences in the ability to predict scan results were observed among different physician training levels. Thirty-six patients had acute abnormalities on CT despite a clinical prediction of remote or low likelihood.
Conclusion:
Although clinical predictions of CT abnormality correlate with actual CT results, the correlation is not adequately refined to rely on for selection of patients for emergency cranial CT scans.