Chest radiograph in acute lower respiratory infections in children
Abstract
Background
Chest radiography is widely used in acute lower respiratory infection in children but the benefits are unknown.
Objectives
To assess the effects of chest radiography for children with acute lower respiratory infections.
Search methods
We searched the Cochrane Acute Respiratory Infections Group's Specialised Register, the Cochrane Central Register of Controlled Trials and MEDLINE (to December 2002). We contacted experts in the fields of acute respiratory infections and paediatric radiology to locate additional studies.
Selection criteria
Randomised or quasi‐randomised trials of chest radiography in acute respiratory infections in children.
Data collection and analysis
One reviewer extracted data and assessed trial quality.
Main results
We identified only one trial of 522 participants, performed by the reviewers. The participants were ambulatory children aged two months to five years. Forty six per cent of both radiography and control participants had recovered by seven days ‐ odds ratio 1.03 (95% confidence interval 0.64 to 1.64). Thirty three per cent of radiography participants and 32% of control participants made a subsequent hospital visit within four weeks ‐ odds ratio 1.02 (95% confidence interval 0.71 to 1.48). Three per cent of both radiography and control participants were subsequently admitted to hospital within four weeks ‐ odds ratio 1.02 (95% confidence interval 0.40 to 2.60). There were no deaths in either group.
Authors' conclusions
There is no evidence that chest radiography improves outcome in ambulatory children with acute lower respiratory infection. The findings do not exclude a potential effect of radiography but the potential benefit needs to be balanced against the hazards and expense of chest radiography. The findings apply to ambulatory children only.
Plain language summary
Not enough evidence that chest x‐ray helps children with acute respiratory infections recover
Chest x‐rays are often used to try and determine whether a child has pneumonia. It is not clear how accurate this is yet there is potential harm from radiation exposure. The review only found one trial ‐ of chest x‐rays for children who had symptoms for less than two weeks and were not staying in bed. These children did not recover more quickly as a result of x‐ray results. While it is not possible to say that chest x‐rays have no benefit, the risks of radiation and the expense also need to be considered.
