Identifying Predictor Variables for a Future Clinical Decision Rule for Ordering of Chest X-Rays (CXR) for Non-Traumatic Chest Pain in Adult Emergency Department (ED) Patients.

OBJECTIVE

We sought to identify predictor variables for a future clinical decision rule for CXR ordering in non-traumatic chest pain.

METHODS

Emergency Medicine Physicians were asked to select variables that would result in a CXR being ordered. Inter-rater reliability (using Fleiss' kappa) was calculated for the most commonly agreed upon.

RESULTS

Of the 40 candidate variables, 10 were most agreed upon; however, only three had perfect inter-rater agreement and reliability.

CONCLUSIONS

In this study, only an abnormal lung examination, a suspicion of pneumonia or of acute pulmonary oedema had perfect inter-rater agreement and reliability. Further research is required on a larger scale to refine and identify the optimal candidate variables for inclusion in a clinical decision rule.