A comparison between emergency physicians and radiologists on the interpretation of computed tomography in acute appendicitis

Background/Aim: Appendicitis is a common acute abdominal disease seen in the emergency department (ED). Early diagnosis of appendicitis can reduce time to treatment and prevent complications. In this study, we aimed to compare the interpretation of computer tomography (CT) scans between emergency physicians and radiologists. Methods: We conducted a retrospective cohort study that enrolled patients with CT scans for suspected acute appendicitis in an academic hospital from July 2019 to May 2020. Analysis of the accuracy of the diagnosis of appendicitis and time from completion of CT scan were compared between emergency physicians and radiologists. Results: A total of 318 patients with appendicitis were included. Patients arriving at the hospital during off-hours were younger (mean difference: 5, P=0.016) and more commonly had normal C-reactive protein (chi-square: 11.19, P<0.001). Neither group’s interpretation of appendicitis was affected by arrival time, and both groups performed differential diagnosis well (emergency physician area under curve [AUC]: 0.912 vs. radiologist AUC: 0.911). Time to CT interpretation by emergency physicians was significantly lower than by radiologists (mean difference: -217.37 min, P<0.001). Conclusions: The interpretation of abdominal CT scans for acute appendicitis by emergency physicians was more efficient and equally accurate compared to interpretation by radiologists.