title: Incidental chest radiographic findings in adult patients with acute cough.
abstract: OBJECTIVE
  Imaging may produce unexpected or incidental findings with consequences for patients and ordering of future investigations. Chest radiography in patients with acute cough is among the most common reasons for imaging in primary care, but data on associated incidental findings are lacking. We set out to describe the type and prevalence of incidental chest radiography findings in primary care patients with acute cough.
  
  
  METHODS
  We report on data from a cross-sectional study in 16 European primary care networks on 3,105 patients with acute cough, all of whom were undergoing chest radiography as part of a research study workup. Apart from assessment for specified signs of pneumonia and acute bronchitis, local radiologists were asked to evaluate any additional finding on the radiographs. For the 2,823 participants with good-quality chest radiographs, these findings were categorized according to clinical relevance based on previous research evidence and analyzed for type and prevalence by network, sex, age, and smoking status.
  
  
  RESULTS
  Incidental findings were reported in 19% of all participants, and ranged from 0% to 25% by primary care network, with the network being an independent contributor (P <.001). Of all participants 3% had clinically relevant incidental findings. Suspected nodules and shadows were reported in 1.8%. Incidental findings were more common is older participants and smokers (P <. 001).
  
  
  CONCLUSIONS
  Clinically relevant incidental findings on chest radiographs in primary care adult patients with acute cough are uncommon, and prevalence varies by setting.
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, the Netherlands. s.f.vanvugt@umcutrecht.nl
authors.forename: Saskia
authors.initials: S
authors.lastname: van Vugt
authors.forename: Lidewij
authors.initials: L
authors.lastname: Broekhuizen
authors.forename: Nicolaas
authors.initials: N
authors.lastname: Zuithoff
authors.forename: Pim
authors.initials: P
authors.lastname: de Jong
authors.forename: Christopher
authors.initials: C
authors.lastname: Butler
authors.forename: Kerenza
authors.initials: K
authors.lastname: Hood
authors.forename: Samuel
authors.initials: S
authors.lastname: Coenen
authors.forename: Herman
authors.initials: H
authors.lastname: Goossens
authors.forename: Paul
authors.initials: P
authors.lastname: Little
authors.forename: Jordi
authors.initials: J
authors.lastname: Almirall
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.forename: Slawomir
authors.initials: S
authors.lastname: Chlabicz
authors.forename: Mel
authors.initials: M
authors.lastname: Davies
authors.forename: Maciek
authors.initials: M
authors.lastname: Godycki-Cwirko
authors.forename: Helena
authors.initials: H
authors.lastname: Hupkova
authors.forename: Janko
authors.initials: J
authors.lastname: Kersnik
authors.forename: Arthur
authors.initials: A
authors.lastname: Mierzecki
authors.forename: Sigvard
authors.initials: S
authors.lastname: Mölstad
authors.forename: Michael
authors.initials: M
authors.lastname: Moore
authors.forename: Tom
authors.initials: T
authors.lastname: Schaberg
authors.forename: An
authors.initials: A
authors.lastname: De Sutter
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
authors.forename: Pia
authors.initials: P
authors.lastname: Touboul
authors.forename: Theo
authors.initials: T
authors.lastname: Verheij
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003371:Cough / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008168:Lung / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011320:Primary Health Care; D013902:Radiography, Thoracic; D055815:Young Adult