Table 2 Checkpoints for the interpretation of each region and definitions
Checkpoint | Head | Skull fracture, Basal skull fracture, Brain contusion, Intracranial hemorrhage, Subarachnoid hemorrhage, Subdural hemorrhage, Epidural hemorrhage, Vascular injury |
Face | Bone injury (Ophthalmology wall, Maxilla, Mandible, Zygomatic, Nose), Eyeball injury, Optic nerve injury, Vascular injury (if enhanced) | |
Neck | Bone injury (Cervical spine, Spinous process, Transverse process), Pharyngeal injury, Bronchial injury, Vascular injury (if enhanced) | |
Chest | Bone injury (Rib, Clavicle, Scapula, Sternum), Thoracic spine injury, Pneumothorax, Hemothorax Pulmonary injury, Bronchial injury, Cardiac injury, Cardiac tamponade, Esophageal injury Diaphragmatic injury, Vascular injury (if enhanced) | |
Abdomen | Bone injury (Lumber spine), Parenchymal organ injury (Liver, Gallbladder, Pancreas, Spleen, Kidney, Adrenal gland), Digestive tract injury, Free air, Mesenteric injury, Ureteral injury, Vascular injury (if enhanced) | |
Pelvis | Bone injury (Lumber spine, Ilium, Sacrum, Pubis, Ischium, Acetabular cartilage, Femur), Bladder injury, Urinary tract injury, Genital organ injury, Vascular injury (if enhanced) | |
Definition of misinterpretation | ||
No misinterpretation | All checkpoints were accurately cleared. | |
Minor misinterpretation | Anatomical abnormalities were identified, but details were incomplete or incorrect. (e.g., rib fracture was identified but the injured number was misinterpreted; brain injury was pointed out, but the correct diagnosis such as subdural hemorrhage was not recorded.) | |
Major misinterpretation | Anatomical abnormality described on CT was apparently missed even if EP received support by radiologist. | |
Gravity level | The gravity level was determined upon review of the patient’s clinical course. | |
Level 1 | Clinical course was not affected by the EP’s interpretation. | |
Level 2 | Clinical course was affected by the EP’s misinterpretation. | |
1) More invasive treatment was required because of the delayed detection of organ injuries. | ||
2) Temporary functional disorders or persistent cosmetic problems | ||
3) The course of treatment was unavoidably changed. | ||
4) Hospital stay was prolonged. | ||
Level 3 | Clinical prognosis was seriously affected by the EP’s misinterpretation. | |
1) Permanent, severe functional disorders or cosmetic problems (e.g., persistent disorder of consciousness, limb palsy, large scars) | ||
2) Death | ||