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  1. R L Smyth1
  1. 1University of Liverpool, Institute of Child Health, Alder Hey Children's Hospital, Eaton Road, Liverpool L12 2AP, UK; r.l.smyth@liv.ac.uk

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Some years ago, when I was an SHO, I questioned a consultant about the reasons for requesting a routine chest x ray on a patient who was clinically well. I was told that it was important to “keep one step ahead of the patient”. That response satisfied me at the time, and I have used the quote from time to time when explaining to parents the reasons for undertaking investigations in children who have no overt clinical problems. Nowadays, clinicians and families are likely to require more tangible evidence of benefit before agreeing to children undergoing detailed investigations, particularly if these may be uncomfortable or distressing. Jaffe et al's retrospective review is therefore a welcome attempt to address this issue with respect to routine …

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