However, the present interpretation system for CT has not kept up with

the modality’s technological development, STA-9090 cell line and real-time interpretation by radiologists is not available in many institutions in Japan because of a nationwide shortage of radiologists. Many EPs, therefore, must make decisions regarding trauma treatment plans without radiological support. Hunter et al. reported that only wet reading was available in the majority of medical institutions surveyed and that emergency CT was usually supported only by radiology residents even in university hospitals [15]. Torreggiani et al. reported that real-time interpretation by radiologists was not available in many institutions and that, in some, radiologist interpretation took more than 48 hours to prepare [16]. They also reported that EPs and radiologists felt very differently about whether the interpretation system was adequate. Many EPs complained of a deficiency in the current interpretation system. Such problems are likely to continue into the long term unless effective

measures are taken. Our hope is that this study may provide an effective CT interpretation system for EPs to use in blunt trauma cases. In this study, EPs misinterpreted 40 of 1606 cases (2.5%) in the first period. Seven of the 365 total patients (1.9%) were most likely placed at a disadvantage by a major misinterpretation; these patients were categorized as gravity level 2 or 3, and they required additional treatments (such as emergency surgery). Chung et al. studied the accuracy of 4768 Belinostat in vitro interpretation reports of torso CT performed by a radiology resident [9]. In this study, serious misdiagnosis occurred in 2.0% of the cases, and changes in treatment were required in 0.3%. Petinaux et al. reported major discrepancies between the interpretations

from EPs and radiologists in 3% of cases (for plain chest and abdominal X-rays) [17]. Most of the discrepancies were considered misdiagnoses, and changes Ribose-5-phosphate isomerase in treatment were required in 0.05% of the cases. Gray comprehensively surveyed the occurrence of diagnostic mistakes in the ED [18] and found that 79.7% of mistakes were associated with bone trauma and that most misdiagnoses could likely be avoided by careful interpretation. There were no large differences in the number and level of diagnostic mistakes between these studies and our study. However, even a small misinterpretation by the EP may lead to irrelevant treatment or a potentially fatal delay in appropriate treatment. This must be avoided wherever possible, but is difficult to Poziotinib achieve in actuality. One solution is to further train EPs to improve their interpretations of CT results. However, a high level of skill is required to interpret CT results, and we believe that it would be almost impossible to improve interpretation ability with unsystematic short-term training. Keijzers et al.