Protocol - Chest X-ray

Personnel and Training Required

Physician

Radiologic Technologist

See "Section IV. Qualifications and Responsibilities of Personnel" in the "ACR-SPR Practice Parameter for the Performance of Chest Radiography" Amended 2014 (Resolution 39) at www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Chest_Radiography.pdf

Equipment Needs

See "Section VII. Equipment Specifications" in the "ACR-SPR Practice Parameter for the Performance of Chest Radiography" Amended 2014 (Resolution 39) at www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Chest_Radiography.pdf

Requirements

Requirement Category	Required
Major equipment	Yes
Specialized training	Yes
Specialized requirements for biospecimen collection	No
Average time of greater than 15 minutes in an unaffected individual	No

Mode of Administration

Imaging assessment

Lifestage

Infant, Toddler, Child, Adolescent, Adult, Senior, Pregnancy

Participants

All ages

Selection Rationale

Chest radiograph (i.e., X-ray) is a valid, reliable, sensitive, and well-established imaging method for a comprehensive evaluation and assessment of the chest, including the respiratory, cardiovascular and upper gastrointestinal systems, and the musculoskeletal system of the thorax.

Language

English

Standards

Standard	Name	ID	Source
Human Phenotype Ontology	Sickle Cell Anemia	ORPHA:232	HPO
Human Phenotype Ontology	Anemia	OMIM:603903	HPO
caDSR Form	PhenX PX810201 - Chest Xray	6251746	caDSR Form

Derived Variables

None

Process and Review

Not applicable.

Protocol Name from Source

ACR-SPR, Practice Parameter for the Performance of Chest Radiography, 2014

Source

American College of Radiology - Society for Pediatric Radiology (ACR-SPR). (2014). ACR-SPR Practice Parameter for the Performance of Chest Radiography Amended 2014 (Resolution 39). Retrieved from www.acr.org/~/media/ACR/Documents/PGTS/guidelines/Chest_Radiography.pdf

General References

Desai, P. C., & Ataga, K. I. (2013). The acute chest syndrome of sickle cell disease. Expert Opinion on Pharmacotherapy, 14(8), 991-999.

Mekontso Dessap, A., Deux, J. F., Habibi, A., Abidi, N., Godeau, B., Adnot, S., Brun-Buisson, C., Rahmouni, A., Galacteros, F., & Maitre, B. (2014). Lung imaging during acute chest syndrome in sickle cell disease: computed tomography patterns and diagnostic accuracy of bedside chest radiograph. Thorax, 69(2), 144-151.

Jain, S., Bakshi, N., & Krishnamurti, L. (2017). Acute Chest Syndrome in Children with Sickle Cell Disease. Pediatric allergy, immunology, and pulmonology, 30(4), 191-201.

Protocol ID

810201

Variables

Export Variables

Variable Name	Variable ID	Variable Description	dbGaP Mapping
PX810201_ChestRadiograph_Cardiopulmonary_Symptoms
	PX810201090000	Does the patient display cardiopulmonary more signs and/or symptoms? show less	N/A
PX810201_ChestRadiograph_Date
	PX810201010000	What is today's date?	Variable Mapping
PX810201_ChestRadiograph_Date_Last_Menstrual_Cycle
	PX810201140000	What is the date of the patient's last more menstrual cycle? show less	Variable Mapping
PX810201_ChestRadiograph_Equipment_Requirement1
	PX810201230000	Does the radiograph equipment have a more beam-limiting device that provides rectangular collimation? show less	N/A
PX810201_ChestRadiograph_Equipment_Requirement2
	PX810201240000	For routine upright projections, is there at more least a 72-inch source-image distance (SID) to minimize magnification? show less	N/A
PX810201_ChestRadiograph_Equipment_Requirement3
	PX810201250000	For clinically necessary imaging (e.g. more supine positioning, infants, young children, immobilized patients, etc), is there at least a 40-inch SID? show less	N/A
PX810201_ChestRadiograph_Equipment_Requirement4
	PX810201260000	Does the nominal source (focal spot) exceed 2.0mm?	N/A
PX810201_ChestRadiograph_Equipment_Requirement5
	PX810201270100	Is this procedure part of an analog study?	N/A
PX810201_ChestRadiograph_Equipment_Requirement5a
	PX810201270200	If so, is an intensifying screen being used?	N/A
PX810201_ChestRadiograph_Equipment_Requirement6
	PX810201280100	Is a film-screen image receptor being used?	N/A
PX810201_ChestRadiograph_Equipment_Requirement6a
	PX810201280200	If so, is the image processing being more automated through carefully controlled temperature, densitometry and maintenance settings? show less	N/A
PX810201_ChestRadiograph_Examination_Adult_Correct_Exposure
	PX810201420100	For adult patients, using the appropriate more technical settings, does the exposed radiograph display the lung parenchyma at a mid-gray level? show less	N/A
PX810201_ChestRadiograph_Examination_Child_Correct_Exposure
	PX810201420200	For newborns, infants, and children, using more the appropriate technical settings, does the exposed radiograph display the lung parenchyma at a mid-gray level? show less	N/A
PX810201_ChestRadiograph_Examination_Date
	PX810201320000	What is the examination date?	Variable Mapping
PX810201_ChestRadiograph_Examination_Image_Included
	PX810201400000	Where both lung apices and the costophrenic more sulci included in the radiograph images? show less	N/A
PX810201_ChestRadiograph_Examination_Image_Projection1
	PX810201390100	Was an image of the erect PA projection taken?	N/A
PX810201_ChestRadiograph_Examination_Image_Projection2
	PX810201390200	Was an image of a left lateral projection taken?	N/A
PX810201_ChestRadiograph_Examination_Image_Projection3
	PX810201390300	If an erect PA or left lateral projection more was not taken, what was the reason for the need of an alternative? show less	N/A
PX810201_ChestRadiograph_Examination_Image_Projection3a
	PX810201390400	What projections were taken as an more alternative? Check all that apply show less	N/A
PX810201_ChestRadiograph_Examination_Position_Alternative
	PX810201410000	Was a cross-table lateral radiograph taken, more where the patient was in supine position with his/her arms raised above their head? show less	N/A
PX810201_ChestRadiograph_Examination_Protocols_Shielding
	PX810201380000	Are there policies and procedures for more appropriate shielding of patients? show less	N/A
PX810201_ChestRadiograph_Examination_Protocols_Techniques
	PX810201370000	Are technique charts and/or protocols in more generator memory for all anatomic parts, listing exposure factors that will reliably produce diagnostic-quality images of patients of different sizes available? show less	N/A
PX810201_ChestRadiograph_Examination_Protocols_Views
	PX810201360000	What protocols for the standard view or more views of each anatomic area of interest was used? These should be designed to optimize diagnostic information while minimizing radiation exposure show less	N/A
PX810201_ChestRadiograph_Examination_Side
	PX810201340000	Which side is the imaged anatomic site?	N/A
PX810201_ChestRadiograph_Examination_Side_Collimation
	PX810201350000	What sort of appropriate collimation was more used to limit exposure to the anatomic area of interest? show less	N/A
PX810201_ChestRadiograph_Examination_Time
	PX810201330000	What is the time of examination?	Variable Mapping
PX810201_ChestRadiograph_Facility_Id
	PX810201310000	What is the facility identification number?	N/A
PX810201_ChestRadiograph_Government_Compliance
	PX810201060000	Does the patient need a chest radiograph to more be in compliance with government regulations? show less	N/A
PX810201_ChestRadiograph_Image_Interpretator
	PX810201290000	Is the image being processed and reviewed by more the qualified professional? Is the image being procesed automated by the proprietary software? show less	N/A
PX810201_ChestRadiograph_Image_Metadata
	PX810201450000	Is each film/image permanently marked with more the facility identification, patient's name, identification number, right or left side indication, patient position, and the date and time of the radiographic exposure? show less	N/A
PX810201_ChestRadiograph_Image_Review
	PX810201430000	When the examination is completed, were the more images reviewed by qualified personnel, either a physician or radiologic show less	N/A
PX810201_ChestRadiograph_Image_Review_Not_Optimal
	PX810201440000	Were the images of less than optimal more diagnostic quality? show less	N/A
PX810201_ChestRadiograph_Medical_Physicist_Certification
	PX810201180100	Does the medical physicist have more certification in therapeutic medical physics, diagnostic medical physics, radiological physics, diagnostic radiological physics, and diagnostic imaging physics? show less	N/A
PX810201_ChestRadiograph_Medical_Physicist_Certification_Subfield
	PX810201180200	If no to previous question, is the medical more physicist certified in any other subfield recommended by the American Board of Radiology (ABR), the Canadian College of Physics in Medicine, or by the American Board of Medical Physics (ABMP)? show less	N/A
PX810201_ChestRadiograph_Patient_Age
	PX810201020000	What is the patient's age?	Variable Mapping
PX810201_ChestRadiograph_Patient_Critically_Ill
	PX810201110000	Is the patient critically ill or medically more unstable? show less	N/A
PX810201_ChestRadiograph_Patient_Difficulty_Transporting
	PX810201120000	Is it difficult to transport the patient for more standard chest radiography because of his/her age or clinical condition? show less	N/A
PX810201_ChestRadiograph_Patient_Gestational_Age
	PX810201130200	If patient knows she is pregnant, what is more the gestational age of the patient? show less	Variable Mapping
PX810201_ChestRadiograph_Patient_Id
	PX810201300000	What is the patient identification number?	Variable Mapping
PX810201_ChestRadiograph_Patient_Monitoring_LifeSupport_Devices
	PX810201100000	Is the patient connected to monitoring more and/or life-support devices? show less	N/A
PX810201_ChestRadiograph_Patient_Pregnancy_Test
	PX810201130300	If patient is unsure if pregnant, what is more the result of the pregnancy test? show less	N/A
PX810201_ChestRadiograph_Patient_Pregnant
	PX810201130100	Is the patient pregnant or potentially pregnant?	Variable Mapping
PX810201_ChestRadiograph_Physician_Radiograph_Certification
	PX810201170100	Is the licensed physician certified in more Radiology or Diagnostic Radiology by the American Board of Radiology, the American Osteopathic Board of Radiology, the Royal College of Physicians and Surgeons of Canada, or the College des Medcins du Quebec? show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Certification2
	PX810201170200	If no to previous question, has the licensed more physician completed a diagnostic radiology residency program approved by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada (RCPSC), th show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Qualification2
	PX810201170300	Does the licensed physician have documented more training in and understanding of the physics of diagnostic radiography and have experience with the equipment needed to safely produce the images? show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Qualification3
	PX810201170400	Is the licensed physician familiar with the more principles of radiation protection, the hazards of radiation, and radiation monitoring requirements? show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Qualification4
	PX810201170500	Does the licensed physician have documented more training and understanding of other medical imaging modalities (fluoroscopy, computed tomography, ultrasound, magnetic resonance imaging, nuclear medicine, etc) and their value relative to general radiograp show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Qualification5
	PX810201170600	Has the licensed physician performing these more general radiography examinations demonstrated evidence of continued competence in the interpretation and reporting of these examinations? show less	N/A
PX810201_ChestRadiograph_Physician_Radiograph_Qualified
	PX810201170700	Does the physician meet the last 5 more requirements? If no, then physician is not qualified to perform general radiography examinations. show less	N/A
PX810201_ChestRadiograph_Preoperative_Evaluation
	PX810201070000	Does the patient require a preoperative more radiographic evaluation due to cardiac or respiratory symptoms or because there is a significant potential for thoracic pathology that may influence anesthesia or the surgical result or lead to increased periop show less	N/A
PX810201_ChestRadiograph_Radiograph_Interpreter
	PX810201160000	Which of the following best describes the more individual responsible for interpeting and supervising the generation of these radiographic images? show less	N/A
PX810201_ChestRadiograph_Radiological_Assistant_Certification
	PX810201190000	Is the radiological assistant certified and more registered as a radiological assistant by the American Registry of Radiologic Technologists (ARRT) after successfully completing an advanced academic program encompassing an ACR/ASRT (American Society of Ra show less	N/A
PX810201_ChestRadiograph_Radiological_Assistant_Certification2
	PX810201200000	Is the radiologic technologic certified by more the American Registry of Radiologic Technologist (ARRT) or an unrestricted state licese? show less	N/A
PX810201_ChestRadiograph_Recent_Medical_Events
	PX810201080000	Has the patient recently had cardiac or more thoacic surgery or suffered from trauma? show less	N/A
PX810201_ChestRadiograph_Request
	PX810201210000	Is there a written or electronic request for more chest radiography? show less	N/A
PX810201_ChestRadiograph_Requestor
	PX810201220000	Who was responsible for the request for more radiological examination? show less	N/A
PX810201_ChestRadiograph_SexuallyActive_Contraception
	PX810201150200	If sexually active, were any contraceptive more methods used? show less	N/A
PX810201_ChestRadiograph_SexuallyActive_Last_Menstrual_Cycle
	PX810201150100	Was the patient sexually active after her more last menstrual cycle? show less	N/A
PX810201_ChestRadiograph_SignsSymptoms_Disease
	PX810201030000	Does the patient need to be evaluated for more his/her signs and symptoms related to respiratory, cardiovascular, and upper gastrointestinal systems, and the musculoskeletal system of the thorax? show less	N/A
PX810201_ChestRadiograph_SignsSymptoms_Disease_FollowUp
	PX810201050000	Does the patient need a follow-up of known more thoracic disease processes to assess improvement, resolution, or progression? show less	N/A
PX810201_ChestRadiograph_SignsSymptoms_Thoracic_Disease
	PX810201040000	Does the patient need to be evaluated for more thoracic disease processes, including systemic and extrathoracic diseases that secondarily involve the chest? show less	N/A

Cardiovascular, Pulmonary, and Renal

Measure Name

Chest X-ray

Release Date

July 30, 2015

Definition

Chest radiograph (i.e., X-ray) is a medical imaging assessment of the chest wall, airways, lungs, pulmonary vessels, heart, mediastinum, and pleura.

Purpose

This measure is used to show the size, shape, and structures of the chest. Information from this measure is used to determine the presence and etiology of disorders that involve the chest, evaluate the signs and symptoms potentially related to the respiratory, cardiovascular and upper gastrointestinal systems and the musculoskeletal system of the thorax, and to follow the course of disease.

Keywords

Chest X-ray, Pulmonary, radiology, radiograph, sickle cell disease, SCD, lung, Respiratory, airway, pulmonary vessels, mediastinum, heart, pleura, chest wall, Gastrointestinal, musculoskeletal, thorax, chest, smoking, "Cardiovascular, Pulmonary, and Renal"

Measure Protocols

Protocol ID	Protocol Name
810201	Chest X-ray

Publications

There are no publications listed for this protocol.