Newsom et al reported a clinical decision rule for ordering a chest X-ray in the Emergency Department for a patient with nontraumatic chest pain. This is a modification of the rule of Rothrock et al.
Patient selection: adult with nontraumatic chest pain in the Emergency Department
Criteria - one or more of the following:
(1) age >= 65 years
(2) history of alcohol abuse
(3) history of congestive heart failure (CHF)
(4) temperature > 100.4 °F
(5) respiratory rate > 24 breaths per minute
(6) diminished breath sounds
Performance:
• The sensitivity is 74% and specificity 69%.
• The negative predictive value was 98% (reflecting that only 5% showed a significant finding).
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