Ultrasound interpretation of hydronephrosis is improved by a brief educational intervention

Nineteen emergency medicine (EM) physicians (14 residents and 3 attendings) from an EM residency program which teaches ultrasound as part of the curri culum, were asked to rate 40 ultrasound scans showing different degrees of kidney hydronephrosis, first solely on the basis of their prior knowledge a nd experience. One week later, after a brief 15 minute lecture on a new obj ective method to read degrees of hydronephrosis, the same EM physicians wer e again asked to rate the 40 ultrasounds. One month later, to assess retent ion of the method, the same physicians were asked to read the same scans us ing the objective method presented 1 month prior. The three readings were c ompared with each other, and then each with a gold standard established for the study. Agreement of the group regarding scan interpretation improved a nd was maintained after the educational intervention (multirater kappa + .1 9, .32, and .32 for the three tests administered). When the differences bet ween each week's readings and the gold standard were assessed, differences decreased with each successive test, and were statistically significant wit h the third test (P = .029). We conclude that our brief educational interve ntion improves agreement among physicians in readings of ultrasound scans a nd also significantly increases accuracy in readings when compared with a g old standard. (Am J Emerg Med 2000;18:186-188. Copyright (C) 2000 by W.B. S aunders Company).