Public Release: 

Restrictive approach to chest X-rays provides positive outcomes for ICU

American College of Chest Physicians

MONTRÉAL (October 19, 2015)- Researchers from Mount Sinai Beth Israel, in New York, New York, created a quality improvement initiative in 2012, recommending a restrictive approach to ordering chest x-rays (CXRs) compared with ordering them routinely. They hypothesized that this restrictive approach would significantly reduce patients' exposure to radiation and reduce ICU operating costs without adversely affecting patient outcomes.

A restrictive approach to ordering CXRs was implemented at a teaching hospital in January 2012, and a retrospective review was later conducted of all ICU patients from 2011-2014 to examine the effectiveness. Results found that a restrictive approach led to large decreases in total CXRs ordered, correcting for both total number of patients and ventilator days. No negative impact on the total number of patient ventilator days, length of stay, and other outcomes was found.

"A restrictive approach to ordering chest x-rays in the ICU appears to be a safe practice," said Dr. Jason Filopei, Mount Sinai Beth Israel physician and lead researcher. "We believe it will lead to a significant saving of hospital resources."


Further results will be shared during CHEST Annual Meeting 2015 on Wednesday, October 28, at 1:30 pm at Palais des Congrès de Montréal, in the Exhibit Hall. The study abstract can be viewed on the CHEST website.

CHEST Annual Meeting 2015 is the 81st annual meeting of the American College of Chest Physicians, held October 24-28, 2015, in Montréal, Canada. The American College of Chest Physicians, publisher of the journal CHEST, is the global leader in advancing best patient outcomes through innovative chest medicine education, clinical research, and team-based care. Its mission is to champion the prevention, diagnosis, and treatment of chest diseases through education, communication, and research. It serves as an essential connection to clinical knowledge and resources for its 18,700 members from around the world who provide patient care in pulmonary, critical care, and sleep medicine. For more information about CHEST 2015, visit, or follow the CHEST meeting hashtag, #CHEST2015, on social media.

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