title: Chest x-ray as an essential part of routine medical examination: is it necessary?
abstract: BACKGROUND
  Various studies in primary care and hospitalized patients have discouraged routine use of chest x-ray (CXR) in medical examination.
  
  
  OBJECTIVE
  The study aims to determine the prevalence of abnormal routine CXR and cost of one CXR at a public health clinic and discuss the rationale of CXR in routine medical examination.
  
  
  METHODS
  Data of patients who visited Klinik Kesihatan Bandar Kota Bharu (KKBKB), a public health clinic, from 1 January until 31 December 2010 were examined. The study used cross-sectional design. All patients who came for medical examination and CXR at KKBKB were included. Cost analysis was performed from the perspective of provider.
  
  
  RESULTS
  About 63.1% of 8315 CXR films in KKBKB were produced as part of routine medical examination. Prevalence of abnormal CXR was 0.25%. The cost of producing one CXR ranges from RM15.87 to RM32.34.
  
  
  CONCLUSIONS
  Low yield from CXR screening and high cost of CXR are the main concern. CXR screening would also lead to unnecessary radiation; and false-positive screening resulting in physical risk, unwarranted anxiety and more expenditure. CXR screening is appropriately reserved for high-risk patients and those with relevant clinical findings.
authors.affiliation: Ministry of Health Malaysia, Kota Bharu, Kelantan, Malaysia. drizamin@klt.moh.gov.my.
authors.forename: I
authors.initials: I
authors.lastname: Izamin
authors.forename: A M M
authors.initials: AM
authors.lastname: Rizal
mesh_terms: D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D006801:Humans; D013902:Radiography, Thoracic; D014965:X-Rays