TY - JOUR
T1 - Old habits die hard
T2 - Chest radiography for screening purposes in primary care
AU - Mauri, Davide
AU - Kamposioras, Konstantinos
AU - Proiskos, Anastasios
AU - Xilomenos, Apostolos
AU - Peponi, Christina
AU - Dambrosio, Mario
AU - Zacharias, Georgios
AU - Koukourakis, Georgios
AU - Pentheroudakis, George
AU - Pavlidis, Nicholas
PY - 2006/10
Y1 - 2006/10
N2 - Objective: To assess whether the use of chest radiography for screening changes over time. Design: Systematic review. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials, and handsearching of selected journals. 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. 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. 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.
AB - Objective: To assess whether the use of chest radiography for screening changes over time. Design: Systematic review. Data Sources: MEDLINE, ISI, Cochrane Central Register of Controlled Trials, and handsearching of selected journals. 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. 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. 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.
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M3 - Article
C2 - 17090221
AN - SCOPUS:33750987349
VL - 12
SP - 650
EP - 656
JO - American Journal of Managed Care
JF - American Journal of Managed Care
SN - 1088-0224
IS - 11
ER -