Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department
Joint Authors
Boutros, Nabil
Jeanmonod, Donald
Jeanmonod, Rebecca
Weller, Karl
Reiter, Mark
Newsom, Case
Source
Advances in Emergency Medicine
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-5, 5 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-06-12
Country of Publication
Egypt
No. of Pages
5
Main Subjects
Abstract EN
Objectives.
We sought to validate and refine a decision rule for chest X-ray (CXR) utilization in nontraumatic chest pain (CP) patients presenting to the emergency department (ED).
Methods.
Retrospective review of ED patients presenting with CP who had CXR performed during three nonconsecutive months was performed.
The presence of 18 variables derived from history and exam was ascertained.
Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the original rule were calculated.
Refinement using additional variables was performed.
Results.
967 patient charts were reviewed.
89.9% of CXR were normal, 5.2% had insignificant findings, and 5.1% had significant findings.
Application of the criteria had a sensitivity/specificity of 74%/59% and a PPV/ NPV of 9%/98%.
Rule modification to obtain CXR for age ≥ 65 years, history of congestive heart failure and alcohol abuse, and exam findings of decreased breath sounds, fever, and tachypnea maintained sensitivity while improving specificity to 69%.
Conclusions.
Most CP patients have normal CXRs.
Narrowing a decision rule to obtain CXR in patients with age ≥ 65 years, history of congestive heart failure and alcohol abuse, and exam findings of decreased breath sounds, fever, and tachypnea maintain sensitivity while improving specificity and NPV.
American Psychological Association (APA)
Newsom, Case& Jeanmonod, Rebecca& Weller, Karl& Boutros, Nabil& Reiter, Mark& Jeanmonod, Donald. 2014. Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department. Advances in Emergency Medicine،Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-456677
Modern Language Association (MLA)
Newsom, Case…[et al.]. Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department. Advances in Emergency Medicine No. 2014 (2014), pp.1-5.
https://search.emarefa.net/detail/BIM-456677
American Medical Association (AMA)
Newsom, Case& Jeanmonod, Rebecca& Weller, Karl& Boutros, Nabil& Reiter, Mark& Jeanmonod, Donald. Validation of a Decision Rule and Derivation of a Modified Rule to Obtain Chest Radiograph in Patients with Nontraumatic Chest Pain in the Emergency Department. Advances in Emergency Medicine. 2014. Vol. 2014, no. 2014, pp.1-5.
https://search.emarefa.net/detail/BIM-456677
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-456677