Clinical significance of discrepancies in roentgenographic film interpretation in an acute walk-in area.

To determine the clinical significance of discrepancies in roentgenographic film interpretation, housestaff's interpretations of 248 outpatient x-rays obtained in a walk-in/emergency room area were compared with the interpretations by radiologists. There was complete agreement for 134/248 (54%) films. Discrepancies for 114 films were classified as potentially significant (n = 28, 25%) or insignificant (n = 86, 75%). Most significant discrepancies (26 of 28) were related to the indication for the film. Most insignificant discrepancies (75 of 86) were unrelated to the film's indication. No discrepancies resulted in serious adverse patient outcomes, although one resulted in delayed treatment of a fractured humerus, one resulted in delay of antibiotic treatment, and three resulted in antibiotic use that may have been unnecessary. In two cases, the initial treatment plan was changed based on the final radiologist's report. These results indicate that while discrepancies in film interpretation are frequent, their clinical impact may be small.