Does reporting of plain chest radiographs affect the immediate management of patients admitted to a medical assessment unit?
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.
Grosvenor
L J
LJ
Department of Radiology, Leicester Royal Infirmary, Leicester, UK. nick@lisaandnick.freeserve.co.uk
Verma
R
R
O'Brien
R
R
Entwisle
J J
JJ
Finlay
D
D
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