Accuracy of physician gestalt in prediction of significant abdominal and pelvic injury in adult blunt trauma patients

Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant injury (CSI) in the abdomen and pelvis among blunt trauma patients presenting to the emergency department (ED). We...

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Bibliographic Details
Published in:Academic emergency medicine 2023-10, Vol.30 (10), p.1039-1046
Main Authors: Rodriguez, Nicole M, Mower, William R, Raja, Ali S, Gupta, Malkeet, Montoy, Juan Carlos, Parry, Blair, Chan, Virginia, Wong, Angela H K, Wilcox, James, Quiñones, Alexandra, Rodriguez, Robert M
Format: Article
Language:English
Subjects:
Abdomen
Emergency medical care
Injuries
Medical diagnosis
Pelvis
Physicians
Trauma
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Summary:Focusing on potential missed injury rates and sensitivity of low-risk of injury predictions, we sought to evaluate the accuracy of physician gestalt in predicting clinically significant injury (CSI) in the abdomen and pelvis among blunt trauma patients presenting to the emergency department (ED). We collected gestalt data on physicians caring for adult blunt trauma patients who received abdominal/pelvic computed tomography (CT) at three Level I and one Level II trauma centers. The primary outcome of CSI was defined as injury on abdominal/pelvic CT requiring hospitalization or intervention. Physicians evaluating trauma patients estimated the likelihood of CSI prior to abdominal/pelvic CT review (response choices: 40%). We evaluated potential missed injury rates (prevalence of CSI) and sensitivity for prediction categories, as well as calibration and area under the receiver operating characteristic (AUROC) curve for overall physician gestalt. Of 2030 patients, 402 (20%) had an injury on abdominal/pelvic CT and 270 (13%) had CSI. The
ISSN:1069-6563
1553-2712
DOI:10.1111/acem.14768