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Diagnostic Decision: The Utility of Routine Chest Radiographs
Abstract
Although admission and preoperative chest radiography has been done for many years in various settings, existing data do not support its utility in enhancing patient care. Calculations based on estimates of the accuracy of chest radiographs and the likelihood of disease suggest that routine chest radiography may result in many more misleading than helpful results. Patients in whom chest radiographs are likely to improve outcome are best identified by a careful history and physical examination. We recommend that the practice of doing routine chest radiographs on admission and preoperatively be stopped and that the procedure be reserved for patients with clinical evidence of chest disease and patients having intrathoracic surgery.
Article and Author Information
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▸From the General Medicine Unit, Department of Medicine, Strong Memorial Hospital, and the University of Rochester School of Medicine and Dentistry; Rochester, New York.
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▸This paper was commissioned by the Blue Cross-Blue Shield Medical Necessity Project, under auspices of the Society for Research and Education in Primary Care Internal Medicine (SREPCIM), and is the fifth in a series being published in the Diagnosis and Treatment section. Harold C. Sox, Jr., M.D., is the editor for the series, and these papers are also being reviewed by John M. Eisenberg, M.D., and Sankey V. Williams, M.D., our consultants for Diagnostic Decision papers, as well as by selected manuscript consultants. This series will be published in a collective reprint, the availability of which will be announced later. The reprint will include the introductory article by Dr. Sox, which appeared on pages 60-66 in the January issue.—The Editor.
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▸Requests for reprints should be addressed to Thomas G. Tape, M.D.; Department of Internal Medicine, University of Nebraska Medical Center, 42nd and Dewey Avenue, Omaha, NE 68105.
- © 1986 American College of Physicians
