MP26: Rate and outcome of incidental findings among abdominal computed tomography scans in the emergency department
Notice bibliographique
Résumé
Introduction: With the increased accessibility of computed tomography (CT), use in the emergency department has increased. Increased use has lead to a reduction in missed diagnoses but also an increase in radiation burden and the increased likelihood of incidental findings. In this study, we sought to characterize the use of abdominal CTs at an academic tertiary center in order to quantify the rate and clinical significance incidental findings. Methods: This was a retrospective chart review of radiological database of all abdominal CT ordered by the emergency department from January 1 st to March 21 st 2015. Incidental findings requiring follow up were defined by the American college of radiology guidelines. Clinically significant incidental findings were defined as those that resulted in a finding of malignancy or comparably serious disease. Abdominal CTs were excluded if they were ordered together with CT thorax. The data was abstracted by one trained reviewer using a standardized data collection sheet and 10% of the data was verified by a second reviewer. Inter-rater reliability reported by Kappa statistic. Data were reported as mean and standard deviation. A sample size of 770 was calculated based on an expected difference in prevalence between significant and non-significant incidental findings of 80% (α=5%, Power=90%). Results: A total of 1882 imaging studies were included (56.3% female, age 59.4 years (16.3), CTAS 3 (1.3). The most common presenting complaints: abdominal pain (980, 52.1%), flank pain (196, 10.4%) and nausea/vomiting (111, 6%). Indications included rule out (r/o) obstructing renal stones/colic (329; 17.5%), r/o diverticulitis/colitis (307; 16.4%) and abdominal pain not yet differentiated (283; 15.1%). The most common final diagnoses as a result of CT were renal stone/colic (212, 11.3%), colitis/diverticulitis (191, 10.2%), and bowel obstruction (111, 6%).Incidental findings recommending further imaging occurred in 93 (4.9%). Of these, 43 were completed, and 15 resulted in clinically significant findings: cancer of the colon (2), lung (2), bladder (2), metastatic cancer (2), adnexa (4), endometrium (1), lymphoma (1), and venous thrombus (1). Conclusion: Incidental findings are far less common (5%) then previously reported (as high as 30%) and rarely clinically significant.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».