• I G Renwick, W P Butt, and B Steele.
• Department of Diagnostic Radiology, St James's University Hospital, Leeds.
• BMJ. 1991 Mar 9;302(6776):568-9.

ObjectiveTo assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments.DesignProspective study over six weeks.SettingTeaching hospital casualty x ray department.Patients3394 consecutive patients referred for radiography.InterventionsRadiographs were assessed by radiographers who were offered a four point triage scheme: normal, abnormal, insignificantly abnormal, or further advice required.Main Outcome MeasuresComparison of radiographers' assessments with an assessment made independently by the reporting radiologists.ResultsOverall disagreement between the radiographers and radiologists was 9.4%. There were 7% false positives and 14% false negatives. Most errors occurred in assessing radiographs of the skull, facial bones, chest, abdomen, and soft tissues.ConclusionUnselected radiographers can offer useful advice on radiographs to casualty officers, but their high rate of false positive diagnoses indicates that they cannot triage casualty radiographs sufficiently accurately to allow them to extend their current reporting role.

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