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.