Why do accident and emergency doctors request X-rays?

A prospective study was carried out to analyse all X-rays requested from the three accident and emergency departments in Sheffield during one week. There were 3253 patients examined, of which 1028 (31.6%) were X-rayed, 1251 sets of X-rays being performed. Few X-rays (4.5%) were requested for medico-legal reasons. Skull X-rays were studied in particular detail. Only 5 (4.5%) of 112 films were subsequently reported as abnormal by the radiologist. The accident and emergency doctor's ability to predict X-ray outcome was not very good, their false positive rate being high at 21% while their false negative rate was low at 5.5%. This indicates that the accident and emergency doctors tended to be over cautious to compensate for their lack of experience.