VALUE OF ROUTINE PREOPERATIVE CHEST X-RAYS - A METAANALYSIS
VALUE OF ROUTINE PREOPERATIVE CHEST X-RAYS - A METAANALYSIS
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DOI：
10.1007/bf03009471
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发表时间：
1993-11-01
期刊：
影响因子：
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通讯作者：
MCGREGOR, M
中科院分区：
文献类型：
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作者：
ARCHER, C;LEVY, AR;MCGREGOR, M
本研究的目的是估计常规术后胸部 X 光检查获得临床相关新信息的频率。使用 Medline 数据库以及 1966 年至 1992 年出版的评论和期刊中列出的参考文献，对所有与北美或欧洲人群常规胸部 X 线摄影相关的英文、法文和西班牙文文章进行了审查。二十一份提供了足够信息的报告被纳入荟萃分析。平均而言，10% 的常规术前胸片发现异常。只有 1.3% 的影片出现了意外的异常情况，即。即，尚不为人所知或不会被检测到（95% CI：0 至 2 8%）。 这些发现足够重要，只有 0.1% 的人需要改变管理方式（95% CI：0 至 0.6%）。 新信息影响健康的频率无法估计。仅假设每张放射线照片对医疗保健系统造成的直接成本（23 美元），则以任何方式影响管理的每项发现将花费 23,000 美元。结论是，在北美或欧洲人群中，当进行可靠的病史和临床检查时，与所提供的临床信息相比，该测试的成本是如此之高，以至于不再合理。
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 in relation to the clinical information provided that it is no longer justifiable.