Research
Routine use of chest x-ray for low-risk patients undergoing a periodic health examination: a retrospective cohort study
Zachary Bouck, Graham Mecredy, Noah M. Ivers, Ciara Pendrith, Ben Fine, Danielle Martin, Richard H. Glazier, Joshua Tepper, Wendy Levinson and R. Sacha Bhatia
August 13, 2018 6 (3) E322-E329; DOI: https://doi.org/10.9778/cmajo.20170138
Zachary Bouck
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MPHGraham Mecredy
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MScNoah M. Ivers
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MDCiara Pendrith
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MScBen Fine
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MD SMDanielle Martin
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MDRichard H. Glazier
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MDJoshua Tepper
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MDWendy Levinson
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MDR. Sacha Bhatia
Women’s College Hospital Institute for Health Systems Solutions and Virtual Care (Bouck, Ivers, Bhatia) and Department of Family and Community Medicine (Martin), Women’s College Hospital; Choosing Wisely Canada (Bouck, Levinson, Bhatia); Institute for Clinical Evaluative Sciences (ICES) (Mecredy, Ivers, Glazier, Bhatia), Toronto, Ont.; Cumming School of Medicine (Pendrith), University of Calgary, Calgary, Alta.; Trillium Health Partners (Fine), Mississauga, Ont.; Institute for Health Care Policy Management and Evaluation (Martin, Tepper), University of Toronto; Department of Family and Community Medicine (Glazier), St. Michael’s Hospital; Departments of Diagnostic Imaging (Fine), Family and Community Medicine (Glazier, Tepper) and Medicine (Levinson), University of Toronto, Toronto Ont.
MD MBAOnline appendices
Files in this Data Supplement:
- Appendix 1: Methods
- Appendix 2: Supplemental Figure 1. Routine chest X-ray (CXR) ordering rate based on Local Health Integrated Network (LHIN).
- Appendix 3: Supplemental Figure 2. Routine chest X-ray (CXR) ordering rate by practice (n = 677).
- Appendix 4: Supplemental Table 1. Results of negative binomial regression model analyzing routine chest X-ray (CXR) use over time in Ontario (n = 2,847,508).
- Reviewer comments
- Original submission
- STROBE statement