de Lacey G, Barker A, Wignall B, Reidy J, Harper J
Br Med J. 1979 Jun 16;1(6178):1595-7. doi: 10.1136/bmj.1.6178.1595.
A prospective study of 500 patients was performed to determine the reasons for requesting radiographs in an accident and emergency department. Most examinations were requested either to confirm a clinically suspected abnormality or because of difficulty in excluding a significant bone injury on clinical grounds alone. Several requests were also made to reassure the patient. Medicolegal reasons were relatively few, and those made purely because the doctor feared litigation probably accounted for only 5% of requests. Undue emphasis on the medicolegal aspects of accident and emergency radiography in the United Kingdom is unhelpful in that it directs attention away from the real reasons for x-ray referral. Although a reduction in the number of x-ray examinations is desirable on the grounds of expense and radiation exposure it is likely to be obtained only by improving experience and acumen in the clinical assessment of injuries.
对500名患者进行了一项前瞻性研究，以确定在急诊科要求进行X光检查的原因。大多数检查是为了确认临床上怀疑的异常情况，或者是因为仅根据临床理由难以排除严重的骨损伤。也有一些检查是为了让患者安心。医学法律方面的原因相对较少，那些纯粹因为医生担心诉讼而进行的检查可能仅占检查请求的5%。在英国，过度强调急诊X光检查的医学法律方面是无益的，因为它将注意力从X光转诊的真正原因上转移开了。尽管从费用和辐射暴露的角度来看，减少X光检查的数量是可取的，但这可能只有通过提高损伤临床评估的经验和敏锐度才能实现。
