ArticleJournal of hospital medicine2019
Deimplementation of Routine Chest X-rays in Adult Intensive Care Units.
Article in Journal of hospital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
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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.
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.
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Who cites it
8 citing papers in PubMed, 14 citations in OpenAlex.
- From carbon cost to climate care: Greening our intensive care units.World journal of critical care medicine · 2026Review
- Chest X-ray Overuse in Cardiothoracic Intensive Care Unit per American College of Radiology Criteria.Annals of thoracic surgery short reports · 2023Article
- Call to Action: Creating Resources for Radiology Technologists to Capture Higher Quality Portable Chest X-rays.Cureus · 2022Article
- Using theories and frameworks to understand how to reduce low-value healthcare: a scoping review.Implementation science : IS · 2022Article
- What strategies are used by clinician champions to reduce low-value care?SAGE open medicine · 2022Article
- Implementation science for the adductor canal block: A new and adaptable methodology process.World journal of orthopedics · 2021Article
- Lung Ultrasound: The Essentials.Radiology. Cardiothoracic imaging · 2021Article
- Behavioral and Psychological Aspects of the Physician Experience with Deimplementation.Pediatric quality & safetyArticle
Corrections and comments
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundChoosing Wisely® is a national initiative to deimplement or reduce low-value care. However, there is limited evidence on the effectiveness of strategies to influence ordering patterns.
objectiveWe aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies.
designWe aimed to describe the effectiveness of an intervention to reduce daily chest X-ray (CXR) ordering in two intensive care units (ICUs) and evaluate deimplementation strategies.
settingThe study was performed in the medical intensive care unit (MICU) and cardiovascular intensive care unit (CVICU) of an academic medical center in the United States from October 2015 to June 2016.
participantsThe initiative included the staff of the MICU and CVICU (physicians, surgeons, nurse practitioners, fellows, residents, medical students, and X-ray technologists). INTERVENTION COMPONENTS: We utilized provider education, peer champions, and weekly data feedback of CXR ordering rates. MEASUREMENTS: We analyzed the CXR ordering rates and factors facilitating or inhibiting deimplementation.
resultsSegmented linear time-series analysis suggested a small but statistically significant decrease in CXR ordering rates in the CVICU (P < .001) but not in the MICU. Facilitators of deimplementation, which were more prominent in the CVICU, included engagement of peer champions, stable staffing, and regular data feedback. Barriers included the need to establish goal CXR ordering rates, insufficient intervention visibility, and waning investment among medical residents in the MICU due to frequent rotation and competing priorities.
conclusionsIntervention modestly reduced CXRs ordered in one of two ICUs evaluated. Understanding why adoption differed between the two units may inform future interventions to deimplement low-value diagnostic tests.
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Registered trials
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.