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Br Med J. 1976 May 29; 1(6021): 1333–1335.
PMCID: PMC1640313

Routine preoperative chest radiography in non-cardiopulmonary surgery.


Preoperative radiography was performed on 667 consecutive patients undergoing elective non-cardiopulmonary surgery in a large hospital in Wales. Of all significant findings reported 54% were due to cardiomegaly and 19% to chronic respiratory disease, and no appreciable abnormality was found in any patient under 30. Out of a subsample of 152 examined prospectively, 38% had received a chest radiograph within the last year, and the maximum marrow dose had been exceeded in 12-5%. It is concluded that the procedure, as presently practised, is not only being considerably overused but is also exposing many recipients to the potentially harmful effects of over-irradiation. The findings provide further evidence in support of the Royal College of Radiologists' proposal that a national multicentre study of diagnostic radiology should be set up with some urgency.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Ashley JS, Pasker P, Beresford JC. How much clinical investigation? Lancet. 1972 Apr 22;1(7756):890–892. [PubMed]
  • Sagel SS, Evens RG, Forrest JV, Bramson RT. Efficacy of routine screening and lateral chest radiographs in a hospital-based population. N Engl J Med. 1974 Nov 7;291(19):1001–1004. [PubMed]
  • Bull JW, Zilkha KJ. Rationalizing requests for x-ray films in neurology. Br Med J. 1968 Nov 30;4(5630):569–570. [PMC free article] [PubMed]
  • Brill PW, Ewing ML, Dunn AA. The value(?) of routine chest radiography in children and adolescents. Pediatrics. 1973 Jul;52(1):125–127. [PubMed]
  • Simon G. The anterior view chest radiograph-criteria for normality derived from a basic analysis of the shadows. George Simon Lecture delivered at Exeter on 16 March 1974. Clin Radiol. 1975 Oct;26(4):429–437. [PubMed]

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