{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:19:56Z","timestamp":1763446796178,"version":"3.45.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T00:00:00Z","timestamp":1757289600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2025,9]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Chest radiography is often performed preoperatively as a common diagnostic tool. However, chest radiography carries the risk of radiation exposure. Given the uncertainty surrounding the utility of preoperative chest radiographs, physicians require systematically developed recommendations. This systematic review assesses the quality and consistency of guideline recommendations for the timing and indications of preoperative chest radiography to make appropriate decisions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The guideline recommendations on the management of the preoperative chest radiography, August 2024, were retrieved. All the reviewed recommendations were in English. Four reviewers independently assessed the quality of recommendations by using the Appraisal of Guidelines for Research and Evaluation\u2013Recommendations Excellence (AGREE\u2010REX) instrument, which contained three main domains (clinical applicability, values and preferences, and implementability), and their reported evidence was evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Ten eligible recommendations were included. Six and four of the recommendations were of high and moderate quality according to AGREE\u2010REX instrument, respectively. Overall, these guideline statements demonstrated significantly higher quality in the implementability domain (median 5.62, IQR 5.03 to 5.97), followed by the domain of value and preference (median 5.34, IQR 4.45 to 5.48) and the clinical applicability domain (median 4.96, IQR 4.27 to 5.15). Most recommendations on the preoperative chest radiograph were relatively consistent. The overall Krippendorff\u2032s alpha value of 0.824 indicates generally satisfactory agreement and reliable ratings. Although none of the 10 recommendations advocate for routine preoperative chest radiographs, they indicate specific clinical circumstances and patient populations in which such testing may be warranted.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Routine chest radiography before surgery is generally not recommended, except in specific circumstances, as follows: (1) age > 70 years, (2) cardiac or thoracic clinical symptoms or a medical history, (3) surgery involving the chest, (4) ASA levels III to VI, and (5) work environments that may expose individuals to harmful particles. However, the final decision regarding preoperative chest radiographs should remain flexible, should be based on individual patient characteristics, the physician\u2032s expertise, and consultation with other health\u2010care professionals.<\/jats:p>\n \n Clinical Trial Registration.<\/jats:bold>\n Name of the registry: PROSPERO Unique Identifying number or registration ID: CRD42024605618 Hyperlink to your specific registration (must be publicly accessible and will be checked):\n https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?RecordID=605618<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jep.70265","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T09:56:13Z","timestamp":1757325373000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Should We Routinely Take Chest X\u2010Rays Before Surgery? A Systematic Scoping Review of Clinical Recommendations Using the Appraisal of Guidelines for Research and Evaluation\u2013Recommendations Excellence (AGREE\u2010REX) Instrument"],"prefix":"10.1111","volume":"31","author":[{"given":"Ting\u2010Ju","family":"Wu","sequence":"first","affiliation":[{"name":"Cochrane Taiwan Taipei Medical University Taipei Taiwan"},{"name":"Department of family and community medicine Cathay General Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kee\u2010Hsin","family":"Chen","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan Taipei Medical University Taipei Taiwan"},{"name":"Department of Nursing, Wan Fang Hospital Taipei Medical University Taipei Taiwan"},{"name":"Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital Taipei Medical University Taipei Taiwan"},{"name":"Postbaccalaureate Program in Nursing, College of Nursing Taipei Medical University Taipei Taiwan"},{"name":"Evidence\u2010based Knowledge Translation Center, Wan Fang Hospital Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010No","family":"Kang","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan Taipei Medical University Taipei Taiwan"},{"name":"Evidence\u2010Based Medicine Center, Wan Fang Hospital Taipei Medical University Taipei Taiwan"},{"name":"Research Center of Big Data and Meta\u2010Analysis, Wan Fang Hospital Taipei Medical University Taipei Taiwan"},{"name":"Institute of Health Policy and Management, College of Public Health National Taiwan University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khanh Dinh","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Histopathology Hai Phong University of Medicine and Pharmacy Hai Phong VN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsin\u2010Chih","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of family and community medicine Cathay General Hospital Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1595-6553","authenticated-orcid":false,"given":"Chiehfeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Cochrane Taiwan Taipei Medical University Taipei Taiwan"},{"name":"Evidence\u2010Based Medicine Center, Wan Fang Hospital Taipei Medical University Taipei Taiwan"},{"name":"Department of Public Health, School of Medicine, College of Medicine Taipei Medical University Taipei Taiwan"},{"name":"Division of Plastic Surgery, Department of Surgery, Wan Fang Hospital Taipei Medical University Taipei Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0159"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17238783"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.q166"},{"key":"e_1_2_14_5_1","unstructured":"ACR\u2013SPR\u2013STR Practice Parameter for the Performance of Chest Radiography. 2022 https:\/\/www.acr.org\/-\/media\/ACR\/Files\/Practice-Parameters\/ChestRad.pdf."},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-11-191"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmae029"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18-0850"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.5535"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mex.2023.102545"},{"key":"e_1_2_14_12_1","unstructured":"Choosing Wisely Italy. 2022 [cited 2024 24 July] https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/dont-perform-preoperative-chest-x-rays-in-the-absence-of-clinical-signs-or-symptoms-which-indicate-diseases-that-could-affect-the-outcome-of-the-surgery\/."},{"key":"e_1_2_14_13_1","unstructured":"C.Wisely. Chest X\u2010Rays Before Surgery. When You Need One and When You Don\u2032t. [cited 2024 24 July] https:\/\/www.choosingwisely.org\/."},{"key":"e_1_2_14_14_1","unstructured":"Choosing Wisely Canada. Chest X\u2010Rays Before Surgery. When You Need One and When You Don\u2032t. [cited 2024 24 July] https:\/\/choosingwiselycanada.org\/pamphlet\/chest-x-rays-before-surgery\/?highlight=preoperative+x-ray."},{"key":"e_1_2_14_15_1","unstructured":"Essencial \u201cAdding Value to Clinical Practice\u201d https:\/\/essencialsalut.gencat.cat\/en\/detalls\/Article\/radiografia_torax_preoperatoria_2013."},{"key":"e_1_2_14_16_1","unstructured":"Iniciativa NO Hacer. 2014 [cited 2024 24 July] https:\/\/portal.guiasalud.es\/no-hacer\/no-realizar-radiografia-de-torax-en-menores-de-40-anos-con-bajo-riesgo-anestesico-asa-i-o-ii\/#1537307102696-fed4a723-1ad9."},{"key":"e_1_2_14_17_1","unstructured":"Choosing Wisely Australia.201717 March 2017 https:\/\/www.choosingwisely.org.au\/recommendations\/anzca."},{"key":"e_1_2_14_18_1","unstructured":"Choosing Wisely Switzerland.2018 https:\/\/www.smartermedicine.ch\/fr\/liste-top-5\/anesthesiologie-et-medecine-perioperatoire."},{"volume-title":"National Institute for Health and Care Excellence (NICE)","year":"2016","author":"National Guideline, C","key":"e_1_2_14_19_1"},{"key":"e_1_2_14_20_1","unstructured":"Pre\u2010Operative Assessment and Patient Preparation \u2010 The Role of the Anaesthetist.2010 https:\/\/anaesthetists.org\/Home\/Resources-publications\/Guidelines\/Pre-operative-assessment-and-patient-preparation-the-role-of-the-anaesthetist-2."},{"issue":"2","key":"e_1_2_14_21_1","first-page":"81","article-title":"Preoperative Chest Radiography in Elective Surgery: Review and Update","volume":"70","author":"Young E. M.","year":"2017","journal-title":"South Dakota Medicine: The Journal of the South Dakota State Medical Association"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.13.10888"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-838X(13)60074-X"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03015764"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21132"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1586\/erc.10.184"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2019.0105"}],"container-title":["Journal of Evaluation in Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jep.70265","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T06:15:07Z","timestamp":1763446507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jep.70265"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/jep.70265"],"URL":"https:\/\/doi.org\/10.1111\/jep.70265","archive":["Portico"],"relation":{},"ISSN":["1356-1294","1365-2753"],"issn-type":[{"type":"print","value":"1356-1294"},{"type":"electronic","value":"1365-2753"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70265"}}