Do radiographs requested from a paediatric emergency department in New Zealand need reporting?

OBJECTIVES: To ascertain whether plain radiographs interpreted by doctors working in a paediatric ED need reporting by radiologists. METHODS: Prospective observational study based in a paediatric teaching hospital. RESULTS: The overall disagreement rate was 26.1%. The clinically significant disagreement rate was 4.8%. There was no relationship between seniority or confidence of ED doctor, and likelihood of disagreement. Disagreement was more likely where radiographs were interpreted during normal working hours (P < 0.05). Chest films, then abdominal films, then skeletal films were more likely to result in disagreement (P < 0.0001). However, this relationship was reversed when considering rates of clinically significant disagreement (P < 0.05). The highest risk of disagreement was in chest films initially thought to be normal, and the lowest in skeletal films initially thought to be abnormal. CONCLUSION: All radiographs requested on patients discharged from the paediatric ED should be reported. Reporting need not be immediate.