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Editorials |

From Delphi to Knowledge and Comfort: The Devil Is in the Details

Klaus-Dieter Lessnau, MD
Author and Funding Information

New York, NY

Correspondence to: Klaus-Dieter Lessnau, MD, Lenox Hill Hospital, 300 East 93rd St #18B, New York, NY 10128; e-mail: klessnau@pol.net



Chest. 2008;133(5):1060-1062. doi:10.1378/chest.07-2337
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Most of us wish to deliver the highest-quality medicine to our patients while keeping unnecessary testing to a minimum. The advantages of chest radiographs (CXRs) in the ICU include another layer of safety: increased confidence levels of trainees that unsuspected complications are not missed, and so-called medicolegal documentation. The disadvantages of ordering excessive CXRs involve the strain on infrastructure, costs, and radiation. False-positive CXR results may lead to more testing with CT scanning involving transportation of unstable patients. In one study1 from 1998, with the cost of one CXR at $114, there was an average cost saving of $725 per patient from not conducting daily routine CXRs.

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