Rationale and Comments

Patients in intensive care units have historically had daily chest x-rays as part of routine management. Evidence suggests that this does not lead to change in management, unless there are specific clinical indications to obtain a chest x-ray. The use of routine daily chest x-rays leads to unnecessary test utilization, unwarranted exposure to radiation, and downstream testing.

Sponsoring Organizations

• Society of Hospital Medicine – Adult Hospital Medicine

Sources

• Systematic review

Disciplines

• Pulmonary medicine

References

• Ganapathy A, Adhikari NK, Spiegelman J, et al. Routine chest x-rays in intensive care units: a systematic review and meta-analysis. Crit Care. 2012;16(2):R68.
• Oba Y, Zaza T. Abandoning daily routine chest radiography in the intensive care unit: meta-analysis. Radiology. 2010;255(2):386-395.
• Keveson B, Clouser RD, Hamlin MP, et al. Adding value to daily chest x-rays in the ICU through education, restricted daily orders and indication-based prompting. BMJ Open Qual. 2017;6(2):e000072.