The importance of clinical details when reporting accident and emergency radiographs.

The effect of clinical information on the accuracy of reporting accident and emergency (A&E) radiographs was studied in two A&E officers and five radiologists involved in their daily reporting. Each was shown 50 sets of radiographs, 30 subtle fractures and 20 controls. In one half the clinical history and precise localization was provided, and in the other half no such information was given. After an interval of 6 months the radiographs were viewed again with the amount of information reversed. The observers were asked to determine the presence of injury, describe its site, and indicate how sure they were of their diagnosis. Correct diagnosis was improved from 72.3 per cent to 80.3 per cent overall, and from 68.1 per cent to 81.4 per cent in the fracture group. All observers improved their performance with clinical details. The results confirm that accurate clinical details improve injury location.