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Cited by 153Healthcare cost, quality, practicesRadiology practices and educationCardiac, Anesthesia and Surgical Outcomes

Value of routine preoperative chest x-rays: a meta-analysis

Open access
Archer, Chantai, Levy, Adrian R., McGregor, Maurice·1993·Canadian Journal of Anaesthesia
DOI 10.1007/bf03009471
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Abstract

The purpose of this study was to estimate the frequency with which routine postoperative chest x-rays lead to clinically relevant new information. All articles in English, French and Spanish relating to routine chest radiography in North American or European populations were reviewed, using the Medline database and references listed in reviews and periodicals published from 1966 to 1992, inclusive. Twenty-one reports which supplied sufficient information were included for meta-analysis. On average, abnormalities were found in 10% of routine preoperative chest films. In only 1.3% of films were the abnormalities unexpected, i.e., were not already known or would not otherwise have been detected (95% CI: 0 to 2.8%). These findings were of sufficient importance to cause modification of management in only 0.1% (95% CI: 0 to 0.6%). The frequency with which the new information influenced health could not be estimated. Assuming only the direct cost to the health care system of each radiograph ($23), each finding which influenced management in any way would cost $23,000. It is concluded that in North American or European populations when a reliable history and a clinical examination are carried out, the cost of this test is so high relation to the clinical information provided that it is no longer justifiable.

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Research works printed but not linked: 9

  1. 4 Royal College of Radiologists. Preoperative chest radiology. Lancet 1979; 2: 83-8.
  2. Michel C. Valeurs des examens prtoptratoires: 6tude pro- spective des radiographies de thorax et des ECG pr~optra- toires de 201 patients. Rev Med Suisse Romande 1989; 109: 225-33.
  3. Muskett AD, McGreevy J. Rational preoperative evalua- tion. Postgrad Med J 1986; 62: 925-8.
  4. Maigaard S, Ekljaer P, Stefansson T. Vaerdien af praeope- rativ rutinergintgenunders0gelse af thorax og ekg. (English abstract: Value of routine preoperative radiographic exami- nation of the thorax and ECG.) Ugeskrift for Laeger 1978; 140: 769-71.
  5. Lamers RJS, Van Engelshoven JMA, Pfaff A. Nogmaals, de routinematige preoperatieve thoraxfoto. Ned Tijdschr Geneeskd 1989; 133: 2288-91.
  6. Jeavons S J,, Siddle KJ, Mitchell C, O'Hare PM. Evaluation of preoperative chest X-ray. Australas Radiol 1987; 31: 256-9.
  7. Thomsen HS, Gottlieb J, Madsen JK, et al. Rutinemaessig rgtntgenundersCgelse af thorax inden kirurgiske indgreb i universel anaestesi. Ugeskrift for Laeger 1978; 140: 766-8.
  8. Haubek A, Cold G. Praeoperativ rOntgenundersOgelse af thorax, indikation og konsekvens. Ugesrift for Laeger 1978; 140: 772-3.
  9. Petterson $1~ Janower ML. Is the routine preoperative chest fdm of value? Applied Radiology 1977; 6: 70.

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Authors
Archer, C., Levy, A. R., & McGregor, M.
Affiliations
Royal Victoria Hospital (CA)
Venue
Canadian Journal of Anaesthesia
Publisher
Springer Science and Business Media LLC
Published
1993-11
Volume
40
Issue
11
Pages
1022-1027
ISSN
  • 0832-610X (ISSN-L)
  • 1496-8975
DOI
10.1007/bf03009471
OpenAlex
W2063735778
Cited by
153
References
47
Citations by year
2026: 1 · 2025: 2 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 6 · 2019: 2 · 2018: 8 · 2017: 5 · 2016: 8 · 2015: 6 · 2014: 7 · 2013: 6 · 2012: 9
FWCI
0.65
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Canadian Journal of Anesthesia/Journal canadien d anesthésie (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Healthcare cost, quality, practices
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiology practices and education
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Keywords
preoperative chest radiography, incidental finding, cost-effectiveness, preoperative assessment, diagnostic yield
MeSH terms
Age Factors, Aged, Aged, 80 and over, Costs and Cost Analysis, Humans, Preoperative Care, Prospective Studies, Retrospective Studies, Risk Factors, Thoracic Diseases, Radiography, Thoracic, Outcome Assessment, Health Care

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