HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: 2213010379v1 221/3/755    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lowe, L. H. Articles by Speroff, T. Search for Related Content PubMed PubMed Citation Articles by Lowe, L. H. Articles by Speroff, T.

Nonenhanced Limited CT in Children Suspected of Having Appendicitis: Prospective Comparison of Attending and Resident Interpretations¹

¹ From the Department of Radiology, Children’s Mercy Hospital and University of Missouri, 2401 Gillham Rd, Kansas City, MO 64108 (L.H.L.); and Department of Radiology and Radiological Sciences (K.S.D., M.H.S., R.M.H., S.M.S.), Center for Clinical Improvement (M.R.N., T.S.), and Department of Medicine (T.S.), Division of General Medicine Health Services Research, Vanderbilt Children’s Hospital and Medical Center, Nashville, Tenn. Received January 30, 2001; revision requested March 6; revision received April 23; accepted May 2. Address correspondence to L.H.L. (e-mail: llowe@cmh.edu).

PURPOSE: To prospectively compare resident and attending radiologic interpretations of nonenhanced limited computed tomographic (CT) scans obtained in children suspected of having appendicitis.

MATERIALS AND METHODS: Seventy-five consecutive children underwent nonenhanced limited CT for suspected appendicitis. The scans were prospectively interpreted by a resident and an attending radiologist, each unaware of the other’s interpretation. The probability that the findings indicated a diagnosis of appendicitis, level of certainty in the interpretation, and presence of an alternate diagnosis were statistically analyzed.

RESULTS: Nineteen children (25%) had appendicitis. The area under the receiver operating characteristic curve was not significantly different between residents (0.97 ± 0.02) and attendings (0.95 ± 0.04). The percentage agreement between residents and attendings was 91% ( = 0.73 ± 0.095). The average level of certainty tended to be higher for attendings (93% ± 15) than residents (89% ± 12). The sensitivity, specificity, and accuracy of resident interpretations were 63%, 96%, and 88%, respectively, compared with those of attending interpretations—95%, 98%, and 97%, respectively. Residents and attendings noted alternate diagnoses in 30% of children without appendicitis.

CONCLUSION: A high level of agreement exists between resident and attending radiologists in the interpretation of nonenhanced limited CT scans in children suspected of having appendicitis. Residents, however, tend to be less confident in their interpretations.

Index terms: Appendicitis, 751.291 • Children, gastrointestinal tract, 751.291 • Computed tomography (CT), in infants and children, 751.12111

This article has been cited by other articles:

				E. Carney, J. Kempf, V. DeCarvalho, A. Yudd, and J. Nosher Preliminary Interpretations of After-Hours CT and Sonography by Radiology Residents Versus Final Interpretations by Body Imaging Radiologists at a Level 1 Trauma Center Am. J. Roentgenol., August 1, 2003; 181(2): 367 - 373. [Abstract] [Full Text] [PDF]

				V. Raptopoulos, G. Katsou, M. P. Rosen, B. Siewert, S. N. Goldberg, and J. B. Kruskal Acute Appendicitis: Effect of Increased Use of CT on Selecting Patients Earlier Radiology, February 1, 2003; 226(2): 521 - 526. [Abstract] [Full Text] [PDF]

				P J Shorvon Imaging of appendicitis: a cautionary note Br. J. Radiol., September 1, 2002; 75(897): 717 - 720. [Full Text] [PDF]