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Region Hovedstaden - en del af Københavns Universitetshospital
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The impact of chest computed tomography and chest radiography on clinical management of cystic fibrosis lung disease

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

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  1. Amikacin liposome inhalation suspension for chronic Pseudomonas aeruginosa infection in cystic fibrosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Antisense oligonucleotide eluforsen is safe and improves respiratory symptoms in F508DEL cystic fibrosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Markers of bone turnover are reduced in patients with CF related diabetes; the role of glucose

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  • Carla F Bortoluzzi
  • Eleonora Pontello
  • Emily Pintani
  • Karin M de Winter-de Groot
  • Ciro D'Orazio
  • Baroukh M Assael
  • M G Myriam Hunink
  • Harm A W M Tiddens
  • Daan Caudri
  • CF Clinics Study Group
  • Tacjana Pressler (Medlem af forfattergruppering)
Vis graf over relationer

BACKGROUND: Recent standards of care mention chest radiography (CR) but not chest computed tomography (CT) in routine annual follow-up of children with cystic fibrosis (CF). To minimise radiation risk, CT or CR should only be performed if they impact clinical decision making. We investigated whether in addition to a wide range of commonly used clinical parameters, chest CT and/or CR in routine follow-up of CF patients influence clinical decisions.

METHODS: 36 web based clinical vignettes (i.e. case simulations) were designed using clinical data from patients aged 8-18 years, randomly selected from two CF centres in The Netherlands. In a randomized cross-over design, clinicians assessed eight vignettes and suggested therapeutic/diagnostic management on two occasions, with a ten-week interval. Radiological information (CT or CR) was included at only one of the two assessments, in random order. Any differences in management could be attributed to information from CT or CR, and were compared by McNemar analysis.

RESULTS: 44 European and Australian clinicians completed a total of 143 CT vignette pairs and 167 CR vignette pairs. CT was associated with a significant increase in antifungal treatment (Risk Ratio (RR) 2.8 (1.3-6.0, p = .02)), bronchoscopies (RR 1.6 (1.1-2.5, p = .04)), mycobacterial cultures (RR 1.3 (1.0-1.5, p = .02)), and 'need for hospitalization' (i.e. intravenous antibiotics and/or bronchoscopy) (RR 1.4 (1.0-1.9, p = .03)). CR led to a significant increase in inhaled antibiotics only (RR 1.3 (1.0-1.6, p = .04)).

CONCLUSIONS: CT but not CR, at routine biennial follow-up was associated with several changes in treatment and/or diagnostic testing, including the need for hospitalization.

OriginalsprogEngelsk
TidsskriftJournal of cystic fibrosis : official journal of the European Cystic Fibrosis Society
Vol/bind19
Udgave nummer4
Sider (fra-til)641-646
Antal sider6
ISSN1569-1993
DOI
StatusUdgivet - jul. 2020

Bibliografisk note

Copyright © 2019 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.

ID: 59079489