Lack of clinical relevance of routine chest radiography in acute psychiatric admissions

Gómez‐Gil, Esther; Trilla, Antoni; Corbella, Bàrbara; Fernández-Egea, Emilio; Luburich, Patricio; Pablo, Joan de; Raldúa, José Ferrer; Valdés, Manuel

doi:10.1016/s0163-8343(01)00179-7

Cited by 8 publications

(5 citation statements)

References 9 publications

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“…The utility of routine laboratory screening among acute psychiatric admissions has been under debate (34,35), and there are currently no specific guidelines about which somatic or toxicological tests should be routinely done. Electro cardiography and chest radiography should not be performed on a routine basis (36,37), and the utility of neuroimaging is under debate (38, 39).…”

Section: Initial Assessment Of Acute Psychiatric Conditionsmentioning

confidence: 99%

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Mordal

Bramness

Holm

et al. 2008

General Hospital Psychiatry

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Section: Initial Assessment Of Acute Psychiatric Conditionsmentioning

confidence: 99%

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Mordal

Bramness

Holm

et al. 2008

General Hospital Psychiatry

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“…Preoperative chest radiographs in young patients (< 70 years old) without clinical suspicion of preexisting cardiopulmonary conditions 52 53 54 55 56 57 58…”

Section: The Three Elements Of Sustainabilitymentioning

confidence: 99%

“…Verzicht auf eine präoperative Röntgen-Thorax-Aufnahme bei jungen Patienten (< 70Lj.) ohne den klinischen Verdacht auf kardiopulmonale Vorerkrankungen 52 53 54 55 56 57 58 .…”

Section: Die Drei Elemente Der Nachhaltigkeitunclassified

Sustainability and Climate Protection in Radiology – An Overview

Palm

Heye

Molwitz

et al. 2023

Rofo

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Background Sustainability is becoming increasingly important in radiology. Besides climate protection – economic, ecological, and social aspects are integral elements of sustainability. An overview of the scientific background of the sustainability and environmental impact of radiology as well as possibilities for future concepts for more sustainable diagnostic and interventional radiology are presented below.The three elements of sustainability:1. EcologyWith an annually increasing number of tomographic images, Germany is in one of the leading positions worldwide in a per capita comparison. The energy consumption of an MRI system is comparable to 26 four-person households annually. CT and MRI together make a significant contribution to the overall energy consumption of a hospital. In particular, the energy consumption in the idle or inactive state is responsible for a relevant proportion.2. EconomyA critical assessment of the indications for radiological imaging is important not only because of radiation protection, but also in terms of sustainability and “value-based radiology”. As part of the “Choosing Wisely” initiative, a total of 600 recommendations for avoiding unnecessary examinations were compiled from various medical societies, including specific indications in radiological diagnostics.3. Social SustainabilityThe alignment of radiology to the needs of patients and referring physicians is a core aspect of the social component of sustainability. Likewise, ensuring employee loyalty by supporting and maintaining motivation, well-being, and job satisfaction is an essential aspect of social sustainability. In addition, sustainable concepts are of relevance in teaching and research, such as the educational curriculum for residents in radiology, RADUCATION or the recommendations of the International Committee of Medical Journal Editors. Key points Citation Format

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“…CXR has been considered in certain institutions to be part of the routine process for hospital admission, emergency room presentation, and pre-operative care. 1 In the context of admission, several studies of the routine CXR, [13][14][15][16][17][18] found that findings were present less than half of the time, and even when findings were present, fewer than 4% of these findings led to a change in treatment.…”

mentioning

confidence: 99%

Choosing Wisely: Determining performance of unjustified imaging in a large healthcare system

et al. 2020

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Aims The Choosing Wisely Campaign identifies procedures and treatments that lack clinical justification for routine use according to expert opinion and evidence‐based medicine. This study describes the rates and features of two such examples over a 10‐year period. Methods This is a cross‐sectional rolling cohort study between 2008 and 2017 in Clalit Health Services, the largest healthcare delivery system in Israel, with seven main hospitals and over 4.5 million members nationwide. All adult members who visited a Clalit Emergency Department (ED), and all children members who visited a Clalit ED for abdominal pain or appendicitis were eligible to be included in this study. Our measures were routine chest radiograph (CXR) in the context of pre‐admission assessment for adults and abdominal computed tomography (CT) to rule out appendicitis for children. Results Of the 3 689 869 adult visits without a clinical indication for a CXR, 9.1% or 337 058 of them received a chest radiograph. Of the 35 973 children visits for presumed appendicitis, 7.2% of them had no imaging performed, 82.3% had an ultrasound (US), 6.9% had an US followed by a CT, and 3.6% or 1293 of them received a CT. There were several independent risk factors such as BMI, hospital, sex, year and diagnosis that are associated with having imaging that is not clinically indicated. Conclusions Overall, this study found that diagnostic imaging practices are applied inconsistently by hospital and by population. Intervention efforts should be focused on subpopulations at greatest risk to further reduce exposure to such imaging.

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Lack of clinical relevance of routine chest radiography in acute psychiatric admissions

Cited by 8 publications

References 9 publications

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Drugs of abuse among acute psychiatric and medical admissions: laboratory based identification of prevalence and drug influence

Sustainability and Climate Protection in Radiology – An Overview

Choosing Wisely: Determining performance of unjustified imaging in a large healthcare system

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