Evidence map›Paper›PMID 40549188›Full record

ArticleEmergency radiology2025

Predictors of diagnostic errors in computed tomography interpretation by emergency physicians leading to changes in clinical management in the emergency department.

Naoaki Shibata, Takafumi Yonemitsu, Nozomu Shima, Yuichi Miyake, Tomoya Fukui, Junya Fuchigami, Akira Ikoma, Tetsuo Sonomura, Shigeaki Inoue

Abstract read
In one paragraph

Article in Emergency radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Naoaki ShibataDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Takafumi YonemitsuDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan. yonetwmed@gmail.com.ORCID http://orcid.org/0000-0001-6847-4307
Nozomu ShimaDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Yuichi MiyakeDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Tomoya FukuiDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Junya FuchigamiDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Akira IkomaDepartment of Radiology, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Tetsuo SonomuraDepartment of Radiology, Wakayama Medical University, Kimiidera, Wakayama, Japan.
Shigeaki InoueDepartment of Emergency and Critical Care Medicine, Wakayama Medical University, Kimiidera, Wakayama, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe use of computed tomography (CT) in the emergency department (ED) has been increasing due to its diagnostic value for emergency physicians (EPs). This study aimed to determine the predictors of EP interpretation errors (IEs) on CT scans leading to change in clinical management (IECM) in both endogenous and exogenous ED visits.

methodsThis single-center, retrospective cohort study included patients with consecutive ED visits initially managed by EPs at our institution over 6 months. Patients who did not undergo CT imaging and presented with cardiopulmonary arrest upon arrival were excluded. CT images were interpreted by emergency radiologists immediately after acquisition, and IEs were identified. The primary outcome was IECM, determined by reference to the clinical management decisions made by EPs. A multivariate analysis was performed to determine the independent predictors of IECM.

resultsAmong the 2,037 patients, 158 (8%) had IEs, whereas 52 (3%) had IECM. Multisite CT imaging was the strongest independent predictor for both IECM (OR: 2.25, 95% CI: 1.21-4.19, P = 0.011) and IEs (OR: 2.32, 95% CI: 1.61-3.36, P < 0.001). Other predictors of IECM were prolonged ED stay and night-time ED visits as clinical factors. Additional predictors of overall IEs were contrast-enhanced CT and abdominopelvic CT as radiological factors.

conclusionMultisite CT imaging, which involve multiple organs and extensive diagnostic information, significantly increases the likelihood of misinterpretation, leading to change in clinical management by EPs.

Indexed as

Diagnostic ErrorsEmergency Service, HospitalTomography, X-Ray ComputedAdultAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsRetrospective StudiesComputed tomographyEmergency departmentEmergency physicianRadiological misinterpretationRadiologist

Identifiers

PMID40549188
PMCPMC12328500

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.