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Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department : a multicentre randomised clinical trial. / Van Den Berk, Inge A.H.; Kanglie, Maadrika M.N.P.; Van Engelen, Tjitske S.R.; Altenburg, Josje; Annema, Jouke T.; Beenen, Ludo F.M.; Boerrigter, Bart; Bomers, Marije K.; Bresser, Paul; Eryigit, Elvin; Groenink, Maarten; Hochheimer, Suzanne M.R.; Holleman, Frits; Kooter, Jos A.J.; Van Loon, Ramon B.; Keijzers, Mitran; Van Der Lee, Ivo; Luijendijk, Paul; Meijboom, Lilian J.; Middeldorp, Saskia; Schijf, Laura J.; Soetekouw, Robin; Sprengers, Ralf W.; Montauban Van Swijndregt, Alexander D.; De Monyé, Wouter; Ridderikhof, Milan L.; Winter, Michiel M.; Bipat, Shandra; Dijkgraaf, Marcel G.W.; Bossuyt, Patrick M.M.; Prins, Jan M.; Stoker, Jaap.

In: Thorax, 09.06.2022.

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Van Den Berk, Inge A.H. ; Kanglie, Maadrika M.N.P. ; Van Engelen, Tjitske S.R. ; Altenburg, Josje ; Annema, Jouke T. ; Beenen, Ludo F.M. ; Boerrigter, Bart ; Bomers, Marije K. ; Bresser, Paul ; Eryigit, Elvin ; Groenink, Maarten ; Hochheimer, Suzanne M.R. ; Holleman, Frits ; Kooter, Jos A.J. ; Van Loon, Ramon B. ; Keijzers, Mitran ; Van Der Lee, Ivo ; Luijendijk, Paul ; Meijboom, Lilian J. ; Middeldorp, Saskia ; Schijf, Laura J. ; Soetekouw, Robin ; Sprengers, Ralf W. ; Montauban Van Swijndregt, Alexander D. ; De Monyé, Wouter ; Ridderikhof, Milan L. ; Winter, Michiel M. ; Bipat, Shandra ; Dijkgraaf, Marcel G.W. ; Bossuyt, Patrick M.M. ; Prins, Jan M. ; Stoker, Jaap. / Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department : a multicentre randomised clinical trial. In: Thorax. 2022.

BibTeX

@article{24f4840c5fe74f689806713c104d90de,
title = "Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department: a multicentre randomised clinical trial",
abstract = "Background: Chest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Methods: Pragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings. Results: 2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1-8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1-8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%). Conclusions: Short-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Trial registration number: NTR6163. ",
keywords = "emergency medicine, imaging/CT MRI etc, pneumonia, respiratory infection",
author = "{Van Den Berk}, {Inge A.H.} and Kanglie, {Maadrika M.N.P.} and {Van Engelen}, {Tjitske S.R.} and Josje Altenburg and Annema, {Jouke T.} and Beenen, {Ludo F.M.} and Bart Boerrigter and Bomers, {Marije K.} and Paul Bresser and Elvin Eryigit and Maarten Groenink and Hochheimer, {Suzanne M.R.} and Frits Holleman and Kooter, {Jos A.J.} and {Van Loon}, {Ramon B.} and Mitran Keijzers and {Van Der Lee}, Ivo and Paul Luijendijk and Meijboom, {Lilian J.} and Saskia Middeldorp and Schijf, {Laura J.} and Robin Soetekouw and Sprengers, {Ralf W.} and {Montauban Van Swijndregt}, {Alexander D.} and {De Mony{\'e}}, Wouter and Ridderikhof, {Milan L.} and Winter, {Michiel M.} and Shandra Bipat and Dijkgraaf, {Marcel G.W.} and Bossuyt, {Patrick M.M.} and Prins, {Jan M.} and Jaap Stoker",
note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
year = "2022",
month = jun,
day = "9",
doi = "10.1136/thoraxjnl-2021-218337",
language = "English",
journal = "Thorax",
issn = "0040-6376",
publisher = "BMJ Publishing Group",

}

RIS

TY - JOUR

T1 - Ultra-low-dose CT versus chest X-ray for patients suspected of pulmonary disease at the emergency department

T2 - a multicentre randomised clinical trial

AU - Van Den Berk, Inge A.H.

AU - Kanglie, Maadrika M.N.P.

AU - Van Engelen, Tjitske S.R.

AU - Altenburg, Josje

AU - Annema, Jouke T.

AU - Beenen, Ludo F.M.

AU - Boerrigter, Bart

AU - Bomers, Marije K.

AU - Bresser, Paul

AU - Eryigit, Elvin

AU - Groenink, Maarten

AU - Hochheimer, Suzanne M.R.

AU - Holleman, Frits

AU - Kooter, Jos A.J.

AU - Van Loon, Ramon B.

AU - Keijzers, Mitran

AU - Van Der Lee, Ivo

AU - Luijendijk, Paul

AU - Meijboom, Lilian J.

AU - Middeldorp, Saskia

AU - Schijf, Laura J.

AU - Soetekouw, Robin

AU - Sprengers, Ralf W.

AU - Montauban Van Swijndregt, Alexander D.

AU - De Monyé, Wouter

AU - Ridderikhof, Milan L.

AU - Winter, Michiel M.

AU - Bipat, Shandra

AU - Dijkgraaf, Marcel G.W.

AU - Bossuyt, Patrick M.M.

AU - Prins, Jan M.

AU - Stoker, Jaap

N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2022/6/9

Y1 - 2022/6/9

N2 - Background: Chest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Methods: Pragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings. Results: 2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1-8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1-8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%). Conclusions: Short-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Trial registration number: NTR6163.

AB - Background: Chest CT displays chest pathology better than chest X-ray (CXR). We evaluated the effects on health outcomes of replacing CXR by ultra-low-dose chest-CT (ULDCT) in the diagnostic work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Methods: Pragmatic, multicentre, non-inferiority randomised clinical trial in patients suspected of non-traumatic pulmonary disease at the emergency department. Between 31 January 2017 and 31 May 2018, every month, participating centres were randomly allocated to using ULDCT or CXR. Primary outcome was functional health at 28 days, measured by the Short Form (SF)-12 physical component summary scale score (PCS score), non-inferiority margin was set at 1 point. Secondary outcomes included hospital admission, hospital length of stay (LOS) and patients in follow-up because of incidental findings. Results: 2418 consecutive patients (ULDCT: 1208 and CXR: 1210) were included. Mean SF-12 PCS score at 28 days was 37.0 for ULDCT and 35.9 for CXR (difference 1.1; 95% lower CI: 0.003). After ULDCT, 638/1208 (52.7%) patients were admitted (median LOS of 4.8 days; IQR 2.1-8.8) compared with 659/1210 (54.5%) patients after CXR (median LOS 4.6 days; IQR 2.1-8.8). More ULDCT patients were in follow-up because of incidental findings: 26 (2.2%) versus 4 (0.3%). Conclusions: Short-term functional health was comparable between ULDCT and CXR, as were hospital admissions and LOS, but more incidental findings were found in the ULDCT group. Our trial does not support routine use of ULDCT in the work-up of patients suspected of non-traumatic pulmonary disease at the emergency department. Trial registration number: NTR6163.

KW - emergency medicine

KW - imaging/CT MRI etc

KW - pneumonia

KW - respiratory infection

UR - http://www.scopus.com/inward/record.url?scp=85132197147&partnerID=8YFLogxK

U2 - 10.1136/thoraxjnl-2021-218337

DO - 10.1136/thoraxjnl-2021-218337

M3 - Article

C2 - 35688623

AN - SCOPUS:85132197147

JO - Thorax

JF - Thorax

SN - 0040-6376

M1 - thoraxjnl-2021-218337

ER -

ID: 23923322