title: Does reporting of plain chest radiographs affect the immediate management of patients admitted to a medical assessment unit?
abstract: OBJECTIVE
  The purpose of our study was to investigate whether reporting of plain chest radiographs affects immediate management of patients admitted to a medical assessment unit.
  
  
  METHODS
  During a 3 month period we prospectively evaluated 200 patients who had a plain chest radiograph on admission. After the post on-call ward round, an independent medical specialist registrar reviewed the notes, retrieving relevant clinical details. The plain chest films were reported independently by a trainee radiologist and consultant, reaching a consensus report.
  
  
  RESULTS
  There was 93% agreement between trainee and consultant radiologists (95% CI=89-96%). Seventy percent had documented reports by the on-call medical team. There was disagreement between radiology and medical reports in 49% of reported films (95% CI=40-57%). The radiologist's report led to a direct change in the immediate management of 22 patients (11%).
  
  
  CONCLUSIONS
  Only 70% of films had documented reports in the clinical notes despite this being a legal requirement. Radiology reporting does cause a direct change in patient management. Chest radiographs of patients admitted to a medical admissions unit should be reported by a radiologist with the minimum of delay.
authors.affiliation: Department of Radiology, Leicester Royal Infirmary, Leicester, UK. nick@lisaandnick.freeserve.co.uk
authors.forename: L J
authors.initials: LJ
authors.lastname: Grosvenor
authors.forename: R
authors.initials: R
authors.lastname: Verma
authors.forename: R
authors.initials: R
authors.lastname: O'Brien
authors.forename: J J
authors.initials: JJ
authors.lastname: Entwisle
authors.forename: D
authors.initials: D
authors.lastname: Finlay
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008499:Medical Records / Q000592:standards*; D010347:Patient Care Planning / Q000458:organization & administration*; D011446:Prospective Studies; D013902:Radiography, Thoracic; D011872:Radiology Department, Hospital / Q000458:organization & administration