New emergency reporting system passes test

Radiologists and doctors in the Brown University emergency department developed a simple five-category system for triage of imaged emergency patients based on their radiology reports, and testing of the system by the team. showed very good agreement between observers.

Radiologist David Swenson, MD, Emergency Physician David Portelli, MD, and colleagues describe their work in an article posted online Oct. 8 in Emergency radiology.

Called RADCAT, the system classifies imaging exams into categories ranging from normal to life-threatening.

The team developed and tested the approach in the emergency room at Rhode Island Hospital / Hasbro Children’s Hospital, affiliated with Brown, in Providence.

In the pilot phase, four radiologists used the real-time system to categorize approximately 400 emergency radiology reports.

From this set of reports, researchers semi-randomly selected 58 to de-identify, stripped of their original categorization, and reclassified based on the narrative radiology report by six rads and six ED docs.

The team found substantial agreement among radiologists and emergency department physicians (κ = 0.73, p 0.60, p

The lowest concordance levels were seen with RADCAT-3, which indicated “important but not urgent”, while the highest concordance was with RADCAT-1, for normal imaging exams showing no abnormalities.

“Our RADCAT system is understandable between radiologists and emergency department physicians to categorize a wide range of imaging studies, and warrants further evaluation and validation,” write the authors. “Based on these pilot results, we plan to adopt this RADCAT program and further evaluate its performance. “


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