National Jewish Health, Denver, Colorado.
Panel Chair, University of Chicago, Chicago, Illinois.
J Am Coll Radiol. 2023 May;20(5S):S224-S233. doi: 10.1016/j.jacr.2023.02.006.
Routine chest imaging has been used to identify unknown or subclinical cardiothoracic abnormalities in the absence of symptoms. Various imaging modalities have been suggested for routine chest imaging. We review the evidence for or against the use of routine chest imaging in different clinical scenarios. This document aims to determine guidelines for the use of routine chest imaging as initial imaging for hospital admission, initial imaging prior to noncardiothoracic surgery, and surveillance imaging for chronic cardiopulmonary disease. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision process support the systematic analysis of the medical literature from peer reviewed journals. Established methodology principles such as Grading of Recommendations Assessment, Development, and Evaluation or GRADE are adapted to evaluate the evidence. The RAND/UCLA Appropriateness Method User Manual provides the methodology to determine the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where peer reviewed literature is lacking or equivocal, experts may be the primary evidentiary source available to formulate a recommendation.
常规胸部影像学检查常用于在无症状的情况下识别未知或亚临床的心胸异常。各种影像学检查方法都被建议用于常规胸部影像学检查。我们回顾了在不同临床情况下常规胸部影像学检查的使用的证据。本文旨在确定常规胸部影像学检查作为入院初始影像学检查、非心胸手术前初始影像学检查以及慢性心肺疾病监测影像学检查的使用指南。美国放射学院适宜性标准是针对特定临床情况的循证指南，每年由多学科专家小组进行审查。指南的制定和修订过程支持对同行评议期刊的医学文献进行系统分析。既定的方法学原则，如推荐评估、制定和评估分级或 GRADE，被用于评估证据。兰德/UCLA 适宜性方法用户手册提供了用于确定特定临床情况下影像学和治疗程序适宜性的方法。在缺乏或存在争议的同行评议文献的情况下，专家可能是制定建议的主要证据来源。
