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ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients.

Publication ,  Journal Article
Expert Panel on Thoracic Imaging, ; Lee, C; Colletti, PM; Chung, JH; Ackman, JB; Berry, MF; Carter, BW; de Groot, PM; Hobbs, SB; Johnson, GB ...
Published in: J Am Coll Radiol
November 2019

The immunocompromised patient with an acute respiratory illness (ARI) may present with fever, chills, weight loss, cough, shortness of breath, or chest pain. The number of immunocompromised patients continues to rise with medical advances including solid organ and stem cell transplantation, chemotherapy, and immunomodulatory therapy, along with the continued presence of human immunodeficiency virus and acquired immunodeficiency syndrome. Given the myriad of pathogens that can infect immunocompromised individuals, identifying the specific organism or organisms causing the lung disease can be elusive. Moreover, immunocompromised patients often receive prophylactic or empiric antimicrobial therapy, further complicating diagnostic evaluation. Noninfectious causes for ARI should also be considered, including pulmonary edema, drug-induced lung disease, atelectasis, malignancy, radiation-induced lung disease, pulmonary hemorrhage, diffuse alveolar damage, organizing pneumonia, lung transplant rejection, and pulmonary thromboembolic disease. As many immunocompromised patients with ARI progress along a rapid and potentially fatal course, timely selection of appropriate imaging is of great importance in this setting. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking, or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

Duke Scholars

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

November 2019

Volume

16

Issue

11S

Start / End Page

S331 / S339

Location

United States

Related Subject Headings

  • United States
  • Tomography, X-Ray Computed
  • Societies, Medical
  • Severity of Illness Index
  • Sensitivity and Specificity
  • Respiratory Tract Infections
  • Radiology
  • Radiography, Thoracic
  • Practice Guidelines as Topic
  • Positron Emission Tomography Computed Tomography
 

Citation

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MLA
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Expert Panel on Thoracic Imaging, ., Lee, C., Colletti, P. M., Chung, J. H., Ackman, J. B., Berry, M. F., … Kanne, J. P. (2019). ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients. J Am Coll Radiol, 16(11S), S331–S339. https://doi.org/10.1016/j.jacr.2019.05.019
Expert Panel on Thoracic Imaging, Jeffrey P., Christopher Lee, Patrick M. Colletti, Jonathan H. Chung, Jeanne B. Ackman, Mark F. Berry, Brett W. Carter, et al. “ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients.J Am Coll Radiol 16, no. 11S (November 2019): S331–39. https://doi.org/10.1016/j.jacr.2019.05.019.
Expert Panel on Thoracic Imaging, Lee C, Colletti PM, Chung JH, Ackman JB, Berry MF, et al. ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients. J Am Coll Radiol. 2019 Nov;16(11S):S331–9.
Expert Panel on Thoracic Imaging, Jeffrey P., et al. “ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients.J Am Coll Radiol, vol. 16, no. 11S, Nov. 2019, pp. S331–39. Pubmed, doi:10.1016/j.jacr.2019.05.019.
Expert Panel on Thoracic Imaging, Lee C, Colletti PM, Chung JH, Ackman JB, Berry MF, Carter BW, de Groot PM, Hobbs SB, Johnson GB, Maldonado F, McComb BL, Tong BC, Walker CM, Kanne JP. ACR Appropriateness Criteria® Acute Respiratory Illness in Immunocompromised Patients. J Am Coll Radiol. 2019 Nov;16(11S):S331–S339.
Journal cover image

Published In

J Am Coll Radiol

DOI

EISSN

1558-349X

Publication Date

November 2019

Volume

16

Issue

11S

Start / End Page

S331 / S339

Location

United States

Related Subject Headings

  • United States
  • Tomography, X-Ray Computed
  • Societies, Medical
  • Severity of Illness Index
  • Sensitivity and Specificity
  • Respiratory Tract Infections
  • Radiology
  • Radiography, Thoracic
  • Practice Guidelines as Topic
  • Positron Emission Tomography Computed Tomography