Related Experiment Video
Updated: Jan 13, 2026
02:09
Multi-modal Pulmonary Imaging: Using Complementary Information from CT and Hyperpolarized 129Xe MRI to Evaluate Lung Structure-Function
Published on: April 12, 2024
983
Trends and Associations of Chest Radiography Utilization in Children With Asthma Exacerbations
Robert M Hoffmann1,2, Michael C Monuteaux1,2, Cynthia A Gravel1,2
1Division of Emergency Medicine, Boston Children's Hospital, Boston, Massachusetts.
Pediatrics
|January 6, 2026
Summary
Chest radiographs (CXRs) are frequently used in pediatric asthma exacerbations, despite guidelines against it. This common, variable practice is linked to more pneumonia diagnoses and return visits, indicating a need for interventions.
Area of Science:
- Pediatric Emergency Medicine
- Radiology and Imaging
- Health Services Research
Background:
- Chest radiographs (CXRs) are often obtained in pediatric emergency departments (EDs) for asthma exacerbations, contrary to guidelines.
- The clinical impact and hospital-level variations in this practice are not well understood.
Purpose of the Study:
- To assess trends and interhospital variations in CXR utilization for pediatric asthma exacerbations.
- To identify patient and hospital factors associated with CXR use.
- To evaluate the downstream outcomes of CXR utilization.
Main Methods:
- Utilized the Pediatric Health Information System (PHIS) database for ED encounters of children (2-18 years) with asthma (2016-2024).
- Identified asthma exacerbations via diagnosis codes and albuterol administration.
- Employed multivariable logistic regression to analyze CXR trends, predictors, and outcomes.
Main Results:
- CXRs were performed in 22.3% of 145,059 children with asthma exacerbations.
- No overall temporal trend in CXR use, but a decline in pneumonia cases.
- Significant hospital variation (13.1%-37.7%); higher use linked to younger age, female sex, white race, private insurance, and winter.
- Hospitals with higher CXR rates had more pneumonia diagnoses and 3-day return visits.
Conclusions:
- CXR use in pediatric asthma exacerbations is common, highly variable, and associated with increased pneumonia diagnoses and return visits.
- Persistent low-value imaging suggests hospital practices influence diagnostic labeling and outcomes.
- Interventions like decision support and benchmarking are needed to reduce unnecessary imaging and promote evidence-based care.
Related Concept Videos
01:30Radiological Investigation I: X-ray and CT
1.0K
Radiological investigations, including X-rays and computed tomography (CT) scans, are critical for diagnosing and evaluating various medical conditions. These imaging techniques provide valuable insights into the body's internal structures, aiding in the detection of abnormalities, assessment of disease progression, and development of treatment strategies. This article delves into two primary radiological investigations, chest X-rays and CT scans, outlining their purpose, procedures, and...
1.0K
01:27Pneumothorax-II
884
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
884
01:20Imaging Studies for Cardiovascular System III: X-Ray
462
The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
462
01:23Assessment of Respiration
1.8K
The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.8K
01:30Asthma-IV: Diagnostic and Management
3.1K
The diagnosis and management of asthma are comprehensive, encompassing clinical assessments, lung function tests, and pharmacological interventions. Here's an overview:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
Clinical Assessment for Asthma:
This is the first step in diagnosing and managing asthma. It includes:
3.1K
01:30Respiratory System Abnormal Finding I: Inspection and Percussion
762
Respiratory system abnormalities are a significant concern in healthcare due to their potential to indicate underlying severe conditions like Chronic Obstructive Pulmonary Disease (COPD), asthma, and pneumonia. These abnormalities can often be detected through physical examination methods like inspection and percussion.
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
Inspection Findings
During an inspection, several findings may suggest the presence of respiratory distress or disease. Pursed-lip breathing, where exhalation is slowed by...
762