Clinical decision rules for obtaining chest radiography in adult patients presenting to the emergency department with non-traumatic chest pain: a systematic review and meta-analysis

The authors aimed to evaluate existing clinical decision rules (CDRs) for obtaining chest radiography in adult patients with non-traumatic chest pain, given the high rate of non-actionable imaging results. Their systematic review and meta-analysis of seven studies found that while the Hess CDR demonstrated higher sensitivity, neither rule effectively reduced unnecessary imaging, indicating a need for the development of more robust prospective CDRs. The findings were limited by high heterogeneity and a small number of studies, underscoring the necessity for further research.