Assessment of Accuracy of Emergency and Critical Care Medicine Residents in Head Computed Tomography Scan Reading and Associated Factors

Abstract

Summary Background: Computed tomography (CT) interpretation in the emergency department is one of the vital issues that should be carried out rapidly and accurately. Very little is known whether current curriculum of emergency medicine is guarantees higher accuracy of in the interpretation of emergency cranial CT scans. Objectives: Aim the study was to assess the accuracy of Head CT interpretations by Emergency and critical care residents and associated factors at three teaching institutions with ECCM residency in Addis Ababa, Ethiopia. Methods: Institution based Cross-sectional study used to assess the accuracy of Head CT interpretations by Emergency and critical care residents and associated factors radiologist as gold standard at three teaching institutions with ECCM residency in Addis Ababa, Ethiopia. Data was collected with semi-structured questioner by using google form from August 1 2025 to September 30 2025. ECCM resident will presented with YouTube video link of most common head CT finding at ED to interpret in the google form. Result: 55 residents participated in the research, 24 from AAU, 25 from SPHMMC, 6 from Yekatit 12 Hospital MC. Overall accuracy rate of Head CT scan interpretation is 68.0% which is mean of 10.2 correct interpretation out of 15 of CT scans (SD = 2.4). Most residents (65.5%) scored between 10-13 correct answers, while only 34.5% (n=19) achieved high performer status (≥80% accuracy). Year Three residents had 13 times higher odds of being high performers (OR = 13.01, 95% CI [1.48, 114.29], p = 0.022) compared to year two residents. The analysis of individual CT scan interpretations revealed substantial variation in diagnostic accuracy across different pathological findings. Performance ranged from excellent (96.4%) for common hemorrhages to very poor (10.9%) for advanced radiological signs like CVT and Meningeal enhancements. Conclusion: Emergency and critical care residents CT interpretation accuracy is suboptimal. There are variation in CTs interpretation for significant hemorrhages to subtle pathologies. Further formal training and radiology support are necessary to provide better standard of care. Keywords: Accuracy; Head computed tomography; Emergency and critical care medicine resident