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Old habits die hard: chest radiography for screening purposes in primary care.

Old habits die hard: chest radiography for screening purposes in primary care.

Authors :
Mauri D
Kamposioras K
Proiskos A
Xilomenos A
Peponi C
Dambrosio M
Zacharias G
Koukourakis G
Pentheroudakis G
Pavlidis N
Source :
The American journal of managed care [Am J Manag Care] 2006 Nov; Vol. 12 (11), pp. 650-6.
Publication Year :
2006

Abstract

Objective: To assess whether the use of chest radiography for screening changes over time.<br />Design: Systematic review.<br />Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials, and handsearching of selected journals.<br />Review Methods: We evaluated whether the proportion of primary care physicians using chest radiography to screen for (1) malignancy in the general asymptomatic population, (2) malignancy in a high-risk subgroup, (3) any disease in the general population, and (4) any disease in a high-risk subgroup changed over time, using random-effects meta-regression analysis. Adjustments for the availability of national guidelines were also performed.<br />Results: Overall, 10% to 90% of primary care physicians reported using chest x-ray for screening. In unadjusted analyses, the proportion of physicians using chest radiography for cancer screening in the general population tended to increase by 0.9% per year (8 studies, n = 4313). The corresponding annual changes were -2.9% for cancer screening in high-risk subgroups (8 studies, n = 2784) and -0.4% regarding screening for any disease in the population (7 studies, n = 2627). No meta-regressions were run for outcome (4) (only 1 study). In the adjusted analyses, there was a decreasing nonsignificant trend for all outcomes.<br />Conclusions: Despite formal recommendations, many physicians still use chest x-ray for screening, with their number decreasing slowly over time. This practice may be harmful because the positive predictive value of chest radiography is low, and further evaluation of false-positive findings might be associated with increased cost and risk from additional diagnostic or therapeutic interventions.

Details

Language :
English
ISSN :
1088-0224
Volume :
12
Issue :
11
Database :
MEDLINE
Journal :
The American journal of managed care
Publication Type :
Academic Journal
Accession number :
17090221