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April 1989

The Use of Follow-up Chest Roentgenograms Among Hospitalized Patients

Author Affiliations

From the Section of General Internal Medicine, Evans Memorial Department of Clinical Research, and the Department of Medicine, Boston University School of Medicine. Dr Berlowitz is now with the Veterans Administration Medical Center, Bedford, Mass.

Arch Intern Med. 1989;149(4):821-825. doi:10.1001/archinte.1989.00390040051010

• Follow-up chest roentgenograms are a commonly performed test. We prospectively evaluated their diagnostic and therapeutic influence at a tertiary care teaching hospital. When a follow-up chest roentgenogram was ordered, physicians indicated their reason for ordering the test, the likelihood that the roentgenogram would show changes, and expected alterations in therapy. After the roentgenogram was obtained, physicians described the help provided by the roentgenogram and what changes in therapy were performed. Using receiver operating characteristic curves, we have shown that physicians have difficulty in predicting which roentgenograms will show important changes. Unexpected findings are frequent (25.4%) and highly valued by the physician. Fifty-seven percent of these roentgenograms had a definite or possible influence on patient treatment. Further studies are indicated to define when follow-up chest roentgenograms are likely to be of benefit.

(Arch Intern Med 1989;149:821-825)

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