Portable X-ray has been an useful tool for the diagnosis and monitoring of patients in the intensive care units, in nursing homes, in prisons, or in shelters for the homeless, where transfer to the hospital radiology department may be an obstacle. The diagnostic efficacy of portable chest X-ray - or bedside chest X-ray - (defined as the number of chest X-rays showing new findings or changes to known findings divided by the total number of chest X-rays) for patients admitted to the intensive care unit has been reported to be 84.5%. Mobile radiography services for radiological assessment of patients in nursing homes have shown to be technically feasible, with good image quality, and beneficial factors such as the security and comfort of patients, no need for transportation, and no need for staff to be absent from the nursing home to accompany the patients. One out of 123 patients (241 radiography examinations) had to have repeat radiography at the hospital because of underexposed images while image quality for the rest was adequate for diagnosis. Mobile digital chest X-ray was found to be sensitive and specific in detecting pulmonary tuberculosis for homeless populations, drug users and prisoners. Using culture-confirmed cases as comparator, mobile X-ray had a sensitivity of 81.8% (95% confidence interval [CI] 64.5 to 93.0) and a specificity of 99.2% (95% CI 99.1 to 99.3) for the detection of pulmonary tuberculosis.
Despite the advantages of portable X-ray, the image quality of bedside chest radiograph can be limited, and the image interpretation and appropriate clinical action can be affected due to a decrease in communication between the attending physician and the radiologist.
This Rapid Response report aims to review the clinical- and cost-effectiveness of portable X-ray compared to fixed X-ray. Guidelines associated with the use of portable X-ray will also be examined.
Copyright © 2016 Canadian Agency for Drugs and Technologies in Health.