Evidence map›Paper›PMID 29024879›Full record

ArticleJournal of critical care2018

Single intervention for a reduction in portable chest radiography (pCXR) in cardiovascular and surgical/trauma ICUs and associated outcomes.

Joseph E Tonna, Kensaku Kawamoto, Angela P Presson, Chong Zhang, Mary C Mone, Robert E Glasgow, Richard G Barton, John R Hoidal, Yoshimi Anzai

Abstract read
In one paragraph

Article in Journal of critical care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Joseph E TonnaDivision of Cardiothoracic Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, United States; Division of Emergency Medicine, Department of Surgery, University of Utah, Salt Lake City, UT, United States. Electronic address: joseph.tonna@hsc.utah.edu.
Kensaku KawamotoDepartment of Biomedical Informatics, University of Utah, Salt Lake City, UT, United States. Electronic address: kensaku.kawamoto@utah.edu.
Angela P PressonDivision of Epidemiology, University of Utah, Salt Lake City, UT, United States. Electronic address: angela.presson@hsc.utah.edu.
Chong ZhangDivision of Epidemiology, University of Utah, Salt Lake City, UT, United States. Electronic address: Chong.Zhang@hsc.utah.edu.
Mary C MoneDivision of General Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, United States. Electronic address: Mary.Mone@hsc.utah.edu.
Robert E GlasgowDivision of General Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, United States. Electronic address: Robert.Glasgow@hsc.utah.edu.
Richard G BartonDivision of General Surgery, Department of Surgery, University of Utah, Salt Lake City, UT, United States. Electronic address: Richard.Barton@hsc.utah.edu.
John R HoidalDepartment of Medicine, University of Utah, Salt Lake City, UT, United States. Electronic address: John.Hoidal@hsc.utah.edu.
Yoshimi AnzaiDepartment of Radiology, University of Utah, Salt Lake City, UT, United States. Electronic address: Yoshimi.Anzai@hsc.utah.edu.

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
University of Utah Center for Clinical and Translational Science-UL1UL1TR000105 · NCATS · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2012 to 2013
$5.1M
NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538NCRR NIH HHS UL1 RR025764
6 · The paper itself

Abstract

purposeStudies suggest that "on-demand" radiography is equivalent to daily routine with regard to adverse events. In these studies, provider behavior is controlled. Pragmatic implementation has not been studied. MATERIALS AND

methodsThis was a quasi-experimental, pre-post intervention study. Medical directors of two intervention ICUs requested pCXRs be ordered on an on-demand basis at one time point, without controlling or monitoring behavior or providing follow-up.

resultsA total of 11,994 patient days over 18months were included. Combined characteristics: Age: 56.7, 66% male, 96% survival, APACHE II 14 (IQR: 11-19), mechanical ventilation (MV) (occurrences)/patient admission: mean 0.7 (SD: 0.6; range: 0-5), duration (hours) of MV: 21.7 (IQR: 9.8-81.4) and ICU LOS (days): 2.8 (IQR: 1.8-5.6). Average pCXR rate/patient/day before was 0.93 (95% CI: 0.89-0.96), and 0.73 (95% CI: 0.69-0.77) after. Controlling for severity, daily pCXR rate decreased by 21.7% (p<0.001), then increased by about 3%/month (p=0.044). There was no change in APACHE II, mortality, and occurrences or duration of MV, unplanned re-intubations, ICU LOS.

conclusionsIn critically ill adults, pCXR reduction can be achieved in cardiothoracic and trauma/surgical patients with a pragmatic intervention, without adversely affecting patient care, outside a controlled study.

Indexed as

AdultAgedAPACHECardiovascular DiseasesCritical IllnessFemaleHumansIntensive Care UnitsLength of StayMaleMiddle AgedPoint-of-Care SystemsRadiography, ThoracicRespiration, ArtificialSurvival AnalysisWounds and InjuriesChest radiography (CXR)DailyImagingPortable radiographyRoutine

Identifiers

PMID29024879
PMCPMC5831480

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.