美国放射学会适宜性标准® 重症监护病房患者

ACR Appropriateness Criteria® Intensive Care Unit Patients.

作者信息

Suh Robert D, Genshaft Scott J, Kirsch Jacobo, Kanne Jeffrey P, Chung Jonathan H, Donnelly Edwin F, Ginsburg Mark E, Heitkamp Darel E, Henry Travis S, Kazerooni Ella A, Ketai Loren H, McComb Barbara L, Ravenel James G, Saleh Anthony G, Shah Rakesh D, Steiner Robert M, Mohammed Tan-Lucien H

机构信息

*Ronald Reagan UCLA Medical Center, Los Angeles, CA †Cleveland Clinic, Weston §§Mayo Clinic, Jacksonville †††University of Florida College of Medicine, Gainesville, FL ‡Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI §National Jewish Health, Denver, CO ∥Department of Radiology, Vanderbilt University Medical Center, Nashville, TN ¶Society of Thoracic Surgeons, Columbia University, New York ¶¶The American College of Chest Physicians, New York Methodist Hospital, Brooklyn ##North Shore University Hospital, Manhasset, NY #Department of Radiology and Imaging Services, Indiana University, Indianapolis, IN **Emory University Hospital, Atlanta, GA ††University of Michigan Medical Center, Ann Arbor, MI ‡‡Department of Radiology, University of New Mexico, Albuquerque, NM ∥∥Department of Radiology, Medical University of South Carolina, Charleston, SC ***Temple University Hospital, Philadelphia, PA.

出版信息

J Thorac Imaging. 2015 Nov;30(6):W63-5. doi: 10.1097/RTI.0000000000000174.

DOI:10.1097/RTI.0000000000000174

PMID:26439890

Abstract

Portable chest radiography is a fundamental and frequently utilized examination in the critically ill patient population. The chest radiograph often represents a timely investigation of new or rapidly evolving clinical findings and an evaluation of proper positioning of support tubes and catheters. Thoughtful consideration of the use of this simple yet valuable resource is crucial as medical cost containment becomes even more mandatory. This review addresses the role of chest radiography in the intensive care unit on the basis of the existing literature and as formed by a consensus of an expert panel on thoracic imaging through the American College of Radiology. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

摘要

便携式胸部X线摄影是危重症患者群体中一项基本且常用的检查。胸部X线片常常是对新出现的或迅速演变的临床发现进行及时的检查，以及对支撑管和导管的正确位置进行评估。随着医疗成本控制变得更加必要，认真考虑使用这一简单却有价值的资源至关重要。本综述基于现有文献，并根据美国放射学会胸成像专家小组的共识，探讨了胸部X线摄影在重症监护病房中的作用。美国放射学会适宜性标准是针对特定临床情况的循证指南，由多学科专家小组每3年进行一次审查。指南的制定和审查包括对同行评审期刊上当前医学文献的广泛分析，以及应用成熟的共识方法（改良德尔菲法）由专家小组对成像和治疗程序的适宜性进行评分。在缺乏证据或证据不明确的情况下，可采用专家意见来推荐成像或治疗。