• Anne Heltborg, Christian Backer Mogensen, Helene Skjøt-Arkil, Matthias Giebner, Ayham Al-Masri, Usha Bc Khatry, Sangam Khatry, Ina Isabell Kathleen Heinemeier, Jonas Jannick Andreasen, Sanne Sarmila Sivalingam Hariesh, Tenna Termansen, Anna Natalie Kolnes, LorentzenMorten HjarnøMH0000-0002-3326-0904Department of Emergency Medicine, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark.Department of Regional Health Research, University of Southern Denmark, Odense, Denmar, Christian Borbjerg Laursen, Stefan Posth, Michael Brun Andersen, Bo Mussmann, Camilla Stræde Spile, and Ole Graumann.
• Department of Emergency Medicine, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200, Aabenraa, Denmark. SHS.Forskning@rsyd.dk.
• Scand J Trauma Resus. 2024 Aug 7; 32 (1): 6767.

BackgroundWithout increasing radiation exposure, ultralow-dose computed tomography (CT) of the chest provides improved diagnostic accuracy of radiological pneumonia diagnosis compared to a chest radiograph. Yet, radiologist resources to rapidly report the chest CTs are limited. This study aimed to assess the diagnostic accuracy of emergency clinicians' assessments of chest ultralow-dose CTs for community-acquired pneumonia using a radiologist's assessments as reference standard.MethodsThis was a cross-sectional diagnostic accuracy study. Ten emergency department clinicians (five junior clinicians, five consultants) assessed chest ultralow-dose CTs from acutely hospitalised patients suspected of having community-acquired pneumonia. Before assessments, the clinicians attended a focused training course on assessing ultralow-dose CTs for pneumonia. The reference standard was the assessment by an experienced emergency department radiologist. Primary outcome was the presence or absence of pulmonary opacities consistent with community-acquired pneumonia. Sensitivity, specificity, and predictive values were calculated using generalised estimating equations.ResultsAll clinicians assessed 128 ultralow-dose CTs. The prevalence of findings consistent with community-acquired pneumonia was 56%. Seventy-eight percent of the clinicians' CT assessments matched the reference assessment. Diagnostic accuracy estimates were: sensitivity = 83% (95%CI: 77-88), specificity = 70% (95%CI: 59-81), positive predictive value = 80% (95%CI: 74-84), negative predictive value = 78% (95%CI: 73-82).ConclusionThis study found that clinicians could assess chest ultralow-dose CTs for community-acquired pneumonia with high diagnostic accuracy. A higher level of clinical experience was not associated with better diagnostic accuracy.© 2024. The Author(s).

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