Chest X-rays in COPD screening: Are they worthwhile?

Wallace, G M F; Winter, John; Winter, Jonathon; Taylor, Andrew; Taylor, Thomas; Cameron, Ray

doi:10.1016/j.rmed.2009.07.001

Cited by 14 publications

(15 citation statements)

References 12 publications

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“…As adequate treatment of asymptomatic osteoporosis can prevent fractures and death, more active reporting of these fractures on chest radiographs might be warranted. Differences in mean age between our study participants and participants in other studies might also explain the increased frequency of cardiac abnormalities (eg, 4% and 6%), 9,24 as well as the number of reported pulmonary abnormalities, eg, scars (14%) and pleural abnormalities (10%), 24 in previous publications compared with those reported in our study.…”

Section: Comparison With Other Studiescontrasting

confidence: 56%

Incidental Chest Radiographic Findings in Adult Patients With Acute Cough

Vugt

Broekhuizen

Zuithoff

et al. 2012

The Annals of Family Medicine

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PURPOSE Imaging may produce unexpected or incidental fi ndings with consequences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental fi ndings are lacking. We set out to describe the type and prevalence of incidental chest radiography fi ndings in primary care patients with acute cough. METHODSWe report on data from a cross-sectional study in 16 European primary care networks on 3,105 patients with acute cough, all of whom were undergoing chest radiography as part of a research study workup. Apart from assessment for specifi ed signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional fi nding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these fi ndings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status. RESULTSIncidental fi ndings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P <.001). Of all participants 3% had clinically relevant incidental fi ndings. Suspected nodules and shadows were reported in 1.8%. Incidental fi ndings were more common is older participants and smokers (P <.001).CONCLUSIONS Clinically relevant incidental fi ndings on chest radiographs in primary care adult patients with acute cough are uncommon, and prevalence varies by setting. Ann Fam Med 2012;10:510-515. doi:10.1370/afm.1384. INTRODUCTIONA cute cough is one of the most common reasons for consulting in primary care. 1,2 Prompt, accurate diagnosis of pneumonia in these patients is important to rule in the need for timely appropriate antibiotic treatment in some patients and to rule out the need for antibiotic treatment in others. Responsible general practitioners order chest radiographs in a minority of patients with acute cough. 3 These radiographs confi rm pneumonia in 5% to 19% and exclude pneumonia in most patients. 2,4,5 Imaging provides information relevant to the acute illness but may also reveal incidental fi ndings. 6-9 Such fi ndings can benefi t patients through earlier diagnosis and treatment, for example, in as yet undiagnosed heart failure or malignancy. Incidental fi ndings, however, may have unknown or doubtful clinical relevance and lead to patient anxiety, expensive workup, and potentially harmful investigations and treatment without improving quality and length of life. 10,11 The nature and prevalence of incidental fi ndings on chest radiographs of patients who consult their general practitioner for acute cough is unknown. Such data may inform decisions about clinical indications for ordering chest radiographs. We studied incidental fi ndings on chest radiographs obtained METHODSWe undertook a cross-sectional observational study using data from the GRACE-09/10a study (Genomics to comba...

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Section: Comparison With Other Studiescontrasting

confidence: 56%

Incidental Chest Radiographic Findings in Adult Patients With Acute Cough

Vugt

Broekhuizen

Zuithoff

et al. 2012

The Annals of Family Medicine

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“…[141142143] It is useful to exclude alternative diagnoses, and to identify other comorbidities and/or complications. [144]…”

Section: Introductionmentioning

confidence: 99%

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

et al. 2013

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Chronic obstructive pulmonary disease (COPD) is a major public health problem in India. Although several International guidelines for diagnosis and management of COPD are available, yet there are lot of gaps in recognition and management of COPD in India due to vast differences in availability and affordability of healthcare facilities across the country. The Indian Chest Society (ICS) and the National College of Chest Physicians (NCCP) of India have joined hands to come out with these evidence-based guidelines to help the physicians at all levels of healthcare to diagnose and manage COPD in a scientific manner. Besides the International literature, the Indian studies were specifically analyzed to arrive at simple and practical recommendations. The evidence is presented under these five headings: (a) definitions, epidemiology, and disease burden; (b) disease assessment and diagnosis; (c) pharmacologic management of stable COPD; (d) management of acute exacerbations; and (e) nonpharmacologic and preventive measures. The modified grade system was used for classifying the quality of evidence as 1, 2, 3, or usual practice point (UPP). The strength of recommendation was graded as A or B depending upon the level of evidence.

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“…58,59 The ability of lung MRI to provide such functional information regionally is a significant advantage over standard pulmonary function tests (PFTs). 60 As 3 He supply is limited due to the small amount of helium in the atmosphere, and because 3 He is required by the US Department of Homeland Security for neutron detection, 61 alternative agents are required to sustain functional lung MRI. Recently, 129 Xe has emerged as the most prominent alternative to 3 He MRI.…”

Section: Ct and The Characterization Of Lung Pathologies In Aatdmentioning

confidence: 99%

Imaging in alpha-1 antitrypsin deficiency: a window into the disease

Huang

Wencker²,

Driehuys

2021

Therapeutic Advances in Chronic Disease

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Imaging modalities such as plain chest radiograph and computed tomography (CT) are important tools in the assessment of patients with chronic obstructive pulmonary disease (COPD) of any etiology. These methods facilitate differential diagnoses and the assessment of individual lung pathologies, such as the presence of emphysema, bullae, or fibrosis. However, as emphysema is the core pathological consequence in the lungs of patients with alpha-1 antitrypsin deficiency (AATD), and because AATD is associated with the development of other lung pathologies such as bronchiectasis, there is a greater need for patients with AATD than those with non-AATD-related COPD to undergo more detailed assessment using CT. In the field of AATD, CT provides essential information regarding the presence, distribution, and morphology of emphysema. In addition, it offers the option to quantify the extent of emphysema. These data have implications for treatment decisions such as initiation of alpha-1 antitrypsin (AAT) therapy, or suitability for surgical or endoscopic interventions for reducing lung volume. Furthermore, CT has provided vital insight regarding the natural history of emphysema progression in AATD, and CT densitometry has underpinned research into the efficacy of AAT therapy. Moving forward, hyperpolarized xenon gas (129Xe) lung magnetic resonance imaging (MRI) is emerging as a promising complement to CT by adding comprehensive measures of regional lung function. It also avoids the main disadvantage of CT: the associated radiation. This chapter provides an overview of technological aspects of imaging in AATD, as well as its role in the management of patients and clinical research. In addition, perspectives on the future potential role of lung MRI in AATD are outlined.

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Chest X-rays in COPD screening: Are they worthwhile?

Cited by 14 publications

References 12 publications

Incidental Chest Radiographic Findings in Adult Patients With Acute Cough

Incidental Chest Radiographic Findings in Adult Patients With Acute Cough

Guidelines for diagnosis and management of chronic obstructive pulmonary disease: Joint ICS/NCCP (I) recommendations

Imaging in alpha-1 antitrypsin deficiency: a window into the disease

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