ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompetent Patients

Kirsch, Jacobo; Ramírez, José Manuel León; Mohammed, Tan-Lucien; Amorosa, Judith K.; Brown, Kathleen; Dyer, Debra S.; Ginsburg, Mark E.; Heitkamp, Darel E.; Jeudy, Jean; MacMahon, Heber; Ravenel, James G.; Saleh, Anthony G.; Shah, Rakesh

doi:10.1097/rti.0b013e31820ffe0f

Cited by 17 publications

(16 citation statements)

References 8 publications

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“…Patients with lesions such as pneumothorax (indicated by CXR), rib fractures (indicated by CXR), mediastinal disease, cardiovascular diseases (diagnosed by echocardiography), esophageal lesions (diagnosed by panendoscopy), pleural effusion (diagnosed by chest sonography), and those <18 years of age (to reduce radiation exposure) were excluded from receiving HRCT imaging. Heitkamp et al [18] and Kirsch et al [19] published reports after our study which agree with the inclusion and exclusion criteria used in this study.…”

Section: Methodssupporting

confidence: 89%

A High Resolution Computer Tomography Scoring System to Predict Culture-Positive Pulmonary Tuberculosis in the Emergency Department

et al. 2014

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This study evaluated the use of high-resolution computed tomography (HRCT) to predict the presence of culture-positive pulmonary tuberculosis (PTB) in adult patients with pulmonary lesions in the emergency department (ED). The study included a derivation phase and validation phase with a total of 8,245 patients with pulmonary disease. There were 132 patients with culture-positive PTB in the derivation phase and 147 patients with culture-positive PTB in the validation phase. Imaging evaluation of pulmonary lesions included morphology and segmental distribution. The post-test probability ratios between both phases in three prevalence areas were analyzed. In the derivation phase, a multivariate analysis model identified cavitation, consolidation, and clusters/nodules in right or left upper lobe (except anterior segment) and consolidation of the superior segment of the right or left lower lobe as independent positive factors for culture-positive PTB, while consolidation of the right or left lower lobe (except superior segment) were independent negative factors. An ideal cutoff point based on the receiver operating characteristic (ROC) curve analysis was obtained at a score of 1. The sensitivity, specificity, positivity predictive value, and negative predictive value from derivation phase were 98.5% (130/132), 99.7% (3997/4008), 92.2% (130/141), and 99.9% (3997/3999). Based on the predicted positive likelihood ratio value of 328.33 in derivation phase, the post-test probability was observed to be 91.5% in the derivation phase, 92.5% in the validation phase, 94.5% in a high TB prevalence area, 91.0% in a moderate prevalence area, and 76.8% in moderate-to-low prevalence area. Our model using HRCT, which is feasible to perform in the ED, can promptly diagnose culture-positive PTB in moderate and moderate-to-low prevalence areas.

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Section: Methodssupporting

confidence: 89%

A High Resolution Computer Tomography Scoring System to Predict Culture-Positive Pulmonary Tuberculosis in the Emergency Department

et al. 2014

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“…Radiology and nuclear medicine play an important role in the clinical staging of lung cancer. After a proper medical history and physical examination, chest radiography usually is the first step in the study of many thoracic diseases [14], but contrast-enhanced spiral computed tomography (CT) is the technique of choice in the study of lung cancer [15]. CT should examine the chest and the upper abdomen.…”

Section: Imaging Techniquesmentioning

confidence: 99%

Lung cancer staging: a concise update

et al. 2018

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Diagnosis and clinical staging of lung cancer are fundamental to planning therapy. The techniques for clinical staging, anatomic and metabolic imaging, endoscopies and minimally invasive surgical procedures, should be performed sequentially and with an increasing degree of invasiveness. Intraoperative staging, assessing the magnitude of the primary tumour, the involved structures, and the loco-regional lymphatic spread by means of systematic nodal dissection, is essential in order to achieve a complete resection. In resected tumours, pathological staging, with the systematic study of the resected specimens, is the strongest prognostic indicator and is essential to make further decisions on therapy. In the present decade, the guidelines on lung cancer staging of the American College of Chest Physicians and the European Society of Thoracic Surgeons are based on the best available evidence and are widely followed. Recent advances in the classification of the adenocarcinoma of the lung, with the definition of adenocarcinoma , minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma, and the publication of the eighth edition of the tumour, node and metastasis classification of lung cancer, have to be integrated into the staging process. The present review complements the latest guidelines on lung cancer staging by providing an update of all these issues.

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“…When abnormal, initial CXR most commonly demonstrates a focal opacity, usually involving the peripheral mid to lower lung fields, with multifocal (27%) or diffuse (14%) opacities being less common [55,57,58]. CT has a higher sensitivity for small volume or subtle parenchymal disease and is likely to depict patchy consolidation and ground glass, even in early cases with normal CXR [57,59]. Confluent opacities show rapid progression, often without associated mediastinal adenopathy, pleural effusion, or cavitation [60].…”

Section: Severe Acute Respiratory Syndrome (Sars)mentioning

confidence: 99%