Patient Care Process Research Articles

Letter: Ethnic Disparities in ST-Segment Elevation Myocardial-Infarction Outcomes and Processes of Care in Patients With and Without Standard Modifiable Cardiovascular Risk Factors

Letter: Ethnic Disparities in ST-Segment Elevation Myocardial-Infarction Outcomes and Processes of Care in Patients With and Without Standard Modifiable Cardiovascular Risk Factors

Charting a course: Use of Electronic Health Records in skills‐based pharmacy education

AbstractIntroductionCompetent navigation of an electronic health record (EHR) has become a critical skill for health professionals, and pharmacists need to be adept in EHR utilization given the extent of EHR involvement in routine medication management. Limited data exists related to current approaches to teaching EHR skills in pre‐Advanced Pharmacy Practice Experiences (pre‐APPE) pharmacy curricula.ObjectivesThe purpose of this study was to describe activities, utilization, and barriers to implementation of teaching EHRs (tEHRs) into pharmacy curricula in skills‐based courses.MethodsFaculty members of the Big Ten Academic Alliance Skills‐Based Education and Assessment Collaborative (BTAA‐SBEAC) were surveyed. The questionnaire included open‐ended questions related to tEHR type, curriculum placement, and current use of tEHRs, as well as barriers to incorporation of tEHRs in the curriculum. Inductive content analysis was used to evaluate qualitative responses.ResultsA representative from all 10 colleges within the BTAA responded. Most programs focused on EHR teaching in the second and third years of the curriculum. All respondents reported having access to a tEHR for internal case building. The tEHR was used by all institutions to allow students to practice in gathering patient information as the first step in the Pharmacists' Patient Care Process. Other activities commonly performed using the tEHR included patient care documentation, medication order verification, prescription processing, and medication reconciliation. Faculty time and cost were barriers identified for successful tEHR implementation.ConclusionMultiple skills are taught through the utilization of a tEHR among the colleges within the BTAA. These activities vary between institutions, and barriers exist that limit expansion and consistent integration across a skills‐based curriculum. Recognition of EHR utilization as an essential pharmacy skill can allow for development of formalized learning outcomes, leading to better support and integration throughout skills‐based courses.

Microstomia- A Review Of Published Case Reports On The Proposed Management Of Microstomia

Introdcution: microstomia, or the reduction of oral opening, can indeed present challenges for patients across various contexts, from eating and speech to prosthetic treatment. It's essential for clinicians to understand the underlying causes and tailor their approach accordingly. By synthesizing existing evidence, this review aims to provide insights into the effectiveness and feasibility of different prosthetic interventions, thereby guiding clinicians in their decision-making process for optimal patient care. Materials and methods: published case reports and case series reporting on prosthetic rehabilitation of microstomia patients were included in the present review. Only cases with a reduction in the size of the oral aperture were included, and cases with reduced mouth opening with a normal oral aperture (e.g., oral submucous fibrosis, temporal-mandibular joint ankylosis, etc.) Were excluded. Case reports: (case report1) a 93-year-old woman without teeth was referred from the local hospital to the department of oral rehabilitation at the faculty of dentistry, university of otago, dunedin, new zealand. The woman's surgeries on her lower lip resulted in a significant reduction in the vertical opening distance between her upper and lower lips, now at 30 mm. This condition, known as microstomia. (case report 2) a 62-year-old male patient, completely without teeth, presented to the prosthodontic department due to functional difficulties. Discussion: a planned and step-by-step approach is crucial when dealing with cases of microstomia. The outcome greatly depends on the complexity of the case and the utilization of recommended materials and equipment hence, diagnosis and treatment planning play pivotal roles in the management process. Conclusion: although the utilization of flexible denture materials holds promise in enhancing patient comfort and treatment outcomes, further research is warranted to evaluate their long-term success rates. Longitudinal studies can furnish valuable insights into the durability, stability, and overall performance of these materials over time, assisting clinicians in decision-making and optimizing patient care.

Innovations in Emergency Nursing: Adapting Patient Flow Management to Emergency Department Overcrowding

IntroductionThe coronavirus disease-2019 pandemic brought greater attention to nurses’ innovation and adaptability. Emergency nurses continue to adjust their patient flow management strategies in response to high levels of overcrowding, but this work has been poorly described. MethodsThis paper describes findings from a grounded theory study that included 29 focus groups and interviews with emergency nurses. Data was also collected through 64 hours of participant observation across 4 emergency departments. ResultsTwo themes emerged to capture how emergency nurses manage patient flow in overcrowded departments. First, emergency nurses creatively adapt their resource use, staffing roles, and patient care processes to expand patient care capacity and expedite throughput. Second, nurses demonstrate cognitive adaptability by modifying their attention and focus. As crowding increases, nurses become more highly engaged in the work of patient flow management until excessive overcrowding may lead to disengagement. Nurses also shift their focus away from proactive and retrospective patient flow management strategies to become more attentive to meeting current patient care needs. DiscussionThe ability of emergency departments to care for high patient volumes depends upon nurses' cognitive and organizational labor. Innovation and adaptability are essential components of emergency nursing work. Although emergency nurses have demonstrated great ingenuity, more work is needed to ensure that emergency patient flow management strategies are evidence-based.

Proses Asuhan Gizi Terstandar pada Pasien dengan Autoimun dan Sirosis Hepatis

Liver cirrhosis is a pathological condition of the liver that defines the end stage of hepatic fibrosis. Liver cell damage will lead to disruption of the liver structure and increased vascularization, causing enlargement of blood vessels in the gastric and esophageal areas. Liver cirrhosis is often caused by history of infection with hepatitis B virus or hepatitis C virus. Other causes include a family history of liver disease, excessive alcohol consumption, and a history of autoimmune disease. Providing a liver diet as one of the standardized Nutrition Care Process (NCP) for this disease aims to achieve and maintain optimal nutritional status without burdening liver function. The purpose of the case study is to find out the process of standardized nutritional care process for patients with autoimmune and liver cirrhosis through providing a liver diet. The case study was conducted in September 2023 at patients in Hospital X Surabaya. After monitoring and evaluation, the patient’s energy, protein, fat, and carbohydrates intake domains increased even though they had not yet reached the fulfillment target (<80%), the patient’s biochemistry domain was not received because the monitoring time was short, the patient’s physical/clinical condition continued to improve until the third day. The progress of the patient’s recovery over three days always increases. Starting with the stabilized appetite, the food intake received by patient increases so the patient’s physical and clinical condition continues to improve.

Empowering Pharmacy Graduates to Diagnose and Prescribe

This commentary underscores the diagnosis and prescribing skills essential to the pharmacists' role on the healthcare team. It advocates for the integration of these skills into pharmacy curricula and emphasizes the urgent need for collaboration among pharmacy educators and the academy to address the omission of diagnosis and prescribing from key frameworks and standards, including the Pharmacists' Patient Care Process (PPCP), the Curricular Outcomes and Entrustable Professional Activities (COEPA), and the Accreditation Council for Pharmacy Education (ACPE) Draft Accreditation Standards 2025. The commentary draws on a case study of one college of pharmacy's integration of diagnosis and prescribing skills into its PharmD curriculum, in a state where pharmacists were granted full diagnostic and prescriptive authority. The integration was achieved through faculty-led modifications to the PPCP and COEPA, making diagnosis and prescribing an explicit part of the curriculum. The commentary concludes with a call to action for educational organizations to recognize and include these aspects in educational outcomes, accreditation standards, and practice frameworks. By doing so, the future of pharmacy education can be reshaped to improve patient care and advance the profession forward.

Fall prevention among adult surgical patients in Tabriz, Iran: a best practice implementation project.

Falling out of bed is the most common unintentional cause of injury among patients and is a major safety problem in health care facilities. Current practices for fall prevention may not always be aligned with established best practices, leading to variability in patient outcomes. This uncertainty underscores the need to assess and improve compliance with best practice guidelines for fall prevention. This project aimed to improve fall prevention in the surgical ward of a general hospital in Tabriz, Iran. This study was guided by the JBI Evidence Implementation Framework. A baseline audit was conducted using eleven audit criteria representing best practices for fall prevention. After the implementation of improvement strategies, a follow-up audit was conducted to evaluate changes in practice. The results revealed significant improvements, notably, fall risk assessment upon admission (87% to 92%), fall risk assessment upon ward transfer (39% to 79%), patient participation in fall risk assessment (26% to 68%), reassessment upon change in condition (53% to 74%), communicating fall prevention information to at-risk patients and their families/caregivers (42% to 63%), engagement of patients (100% to 100%), implementation of targeted strategies (89% to 92%), post-fall assessment and interventions (82% to 87%), revising patient fall risk status and reviewing care management plan (41% to 74%), fall prevention information to patients and their families/caregivers upon discharge (44% to 66%), and person-centered education of health care professionals (77% to 81%). The use of standard clinical audit tools in hospitals can improve the quality of patient care and increase the effectiveness of interventions by identifying weaknesses in the patient care process. http://links.lww.com/IJEBH/A283.

Strategy for scheduled downtime of hospital information system utilizing third-party applications

BackgroundThe widespread adoption of Hospital Information Systems (HIS) has brought significant benefits in healthcare quality and workflow efficiency. However, downtimes for system maintenance are inevitable and pose a considerable challenge to continuous patient care. Existing strategies, including manual prescription methods, are no longer effective due to increasing reliance on digital systems.MethodThis study implemented two main strategies to mitigate the impact of scheduled downtimes. First, we created an “Emergency query program” that switches to a read-only backup server during downtimes, allowing clinicians to view essential patient data. Second, an “Emergency prescription system” was developed based on the Microsoft Power Platform and integrated into Microsoft Teams. This allows clinicians to perform digital prescriptions even during downtimes.ResultsDuring a planned 90-minute downtime, 282 users accessed the Emergency Prescription System, resulting in 22 prescriptions from various departments. Average times for prescription confirmation and completion were 8 min and 3 s, and 18 min and 40 s, respectively. A post-downtime evaluation revealed high user satisfaction.ConclusionEssential maintenance-induced HIS downtimes are inherently disruptive to patient care process. Our deployment of an emergency query program and a Microsoft Teams-integrated emergency prescription system demonstrated robust care continuity during HIS downtime.

Variation in acute cholecystitis outcomes and processes of care in patients with cancer

BackgroundPatients undergoing active cancer therapy or with metastatic cancer are at increased risk for acute cholecystitis and often present to general surgeons for evaluation and management. There is a paucity of data regarding the treatment processes used in these patients and the clinical outcomes achieved. Optimal management of acute cholecystitis in patients with cancer requires understanding their unique risk profile and options for treatment. MethodsEmergency general surgery data were collected at 10 hospitals from July 1, 2019, to February 29, 2024. Patients presenting with acute cholecystitis were selected for analysis. Propensity score matching was used to create matched cohorts of patients by the presence or absence of an active malignancy. The primary outcome was 30-day mortality. Secondary outcomes included complications, length of stay, readmission, and discharge disposition. Processes investigated include treatment modality, time to operation, and surgical technique. ResultsThe analysis included 8,673 patients. Mean age was 53.2 ± 19 years, 61.4% were female, and 17.8% were non-White. In total, 3.3% of patients had an active malignancy. Risk-adjusted 30-day mortality was higher in the cancer cohort (odds ratio: 5.85, 95% confidence interval: 2.38–14.4, P < .001). Patients with cancer also had higher rates of infectious complications (odds ratio: 2.55, 95% confidence interval: 1.54–4.2, P < .001), including sepsis (odds ratio: 2.95, 95% confidence interval: 1.61–5.39, P < .001) and pneumonia (odds ratio: 6.67, 95% confidence interval: 1.75–25.3, P < .005). Patients with cancer were more likely to receive nonoperative management (odds ratio: 2.85, 95% confidence interval: 2.11–3.84, P < .001). ConclusionPatients with cancer presenting with acute cholecystitis experience worse clinical outcomes after controlling for other factors. Furthermore, there is variation in the treatment process with increased rates of nonoperative management. These results have implications for the management of this population, particularly in relation to the impact on concurrent oncologic treatment plans.

Nurse performed bladder ultrasound: a clinical quality improvement initiative

Background: Bladder ultrasound (BUS) provides an accurate measurement of post-void residual (PVR) volume and bladder assessment. Access to BUS is dependent on practitioner availability with delays resulting in poor symptom management, delayed discharge and dissatisfaction. Developing nursing practice to perform BUS can address these patient’s needs. Aims: Through a quality improvement initiative the aims were (1) to develop theoretical knowledge and practical competence of nurses to perform BUS, (2) to evaluate nursing activity in relation to BUS, (3) to evaluate stakeholders perceptions of the initiative. Methods: Based on the Deming Plan-Do-Study-Act (PDSA) cycle, an interprofessional team was created and a theoretical/practical based education program was devised. Activity in relation to the nurse-performed BUS was collected and analysed descriptively. Stakeholder perceptions were evaluated via patient and physician questionnaires subject to descriptive analysis and a focus group with nurses analysed descriptively. Results: The team developed a training program to perform BUS, certifying 11 nurses. Investigation of nursing activity related to BUS (n = 202) showed its use for PVR evaluation, and symptom and catheter assessment. It aided decision-making and nurse-physician communication. Stakeholders were satisfied with the initiative. Patients (n = 30) felt nurses were competent, clearly explaining the procedure, results and inspiring confidence. Physicians (n = 2) saw BUS as enhancing efficiency and care quality, while nurses (n = 7) felt this new skill enhanced nursing care providing a more holistic approach. Team reflection on the results of the evaluation confirmed BUS utility and activity, while nurses requested continuing education and a post-certification refresher course. Conclusion: Through reflection on clinical practice areas for improvement to enhance patient care were identified by the nursing team. Application of the PDSA cycle provided a structured approach to guide the quality improvement initiative. Improvements in nursing care and patient care processes have been observed and this has been a positive experience for stakeholders.

Quantitative evaluation of problem-based learning outcomes on student pharmacists’ patient care process in Japan

Quantitative evaluation of problem-based learning outcomes on student pharmacists’ patient care process in Japan

Standing on FURM Ground: A Framework for Evaluating Fair, Useful, and Reliable AI Models in Health Care Systems

The impact of using AI to guide patient care or operational processes depends on the interplay between the AI model’s output, the decision-making protocol based on that output, the capacity of the stakeholders involved to take the necessary subsequent action, and the benefits and harms of the action taken. Estimating the effects of this interplay before deployment and studying it in real time after deployment are essential for bridging the chasm between AI model development and achievable benefits. To accomplish this, the Data Science Team at Stanford Health Care has developed a testing and evaluation mechanism to identify Fair, Useful, and Reliable AI Models (FURMs) by conducting an ethical review to identify potential value mismatches, running simulations to estimate usefulness, making financial projections to assess sustainability, conducting analyses to determine IT feasibility, designing a deployment strategy, and recommending a prospective monitoring and evaluation plan. The authors report on FURM assessments carried out to evaluate six AI model–guided solutions for potential adoption, spanning both clinical and operational settings, each with the potential to impact up to tens of thousands of patients each year. The authors describe the assessment process, summarize the six assessments, and share their framework, to enable others to conduct similar assessments. Of the six solutions assessed, two have moved into an implementation phase. The novel contributions of this effort — usefulness estimates determined by simulation, financial projections to quantify sustainability, and a process for carrying out ethical assessments — as well as the underlying methods and open-source tools, are available for other health care systems to use to conduct actionable evaluations of candidate AI solutions.

Motivation for patient engagement in patient safety: a multi-perspective, explorative survey

Background and ObjectivesDespite increasing calls for more patient engagement in patient safety, limited knowledge remains on what actually motivates key stakeholders in healthcare to promote patient engagement. We therefore set out to survey key stakeholders of patient engagement in patient safety (i.e., patients, healthcare professionals, and managers). We aimed to identify and explore stakeholder’s distinct and shared motives for patient engagement.MethodsA stepwise Delphi method was applied, utilizing semi-structured online interviews for determination of stakeholder motives for patient engagement in patient safety. In a subsequent online survey, statements were evaluated and identified. 34 subject-matter experts from all relevant stakeholder groups completed the online interviews and 33 the online survey. We used content analysis approaches for qualitative and descriptive analyses for quantitative measures. Further, we evaluated the consensus on distinct and shared motives across stakeholder groups.ResultsSeven key motives for patient engagement in patient safety were identified. Major motives attributed to patients were: (1) To improve experiences and care outcomes for oneself, as well as (2) for future patients, (3) to express gratitude and appreciation, (4) to cope successfully with treatment-related emotions. A motive shared by patients and professionals was (5) to contribute actively to improved delivery of healthcare. To optimize patient safety, costs, and care processes (6) was shared by professionals and managers. Lastly, (7) to improve patient-provider relationships was jointly shared by all stakeholder groups. For four motives (1, 2, 6, 7) consensus was established.ConclusionsIn order to unlock the full potential of future interventions in patient engagement, a deeper understanding of stakeholder motives is essential. We identified a set of distinct and shared motives for patient engagement across relevant stakeholder groups. Our findings may inform future interventions in patient engagement that take account of the motivational foundations and aspirations of all stakeholders who are key for the success for collaborative patient safety and care improvements.Trial registrationID DRKS00031837 (Date May 8, 2023).

Pharmaceutical Care in Chronic Coronary Artery Disease Management

Individuals who suffer from Acute Coronary Artery Disease (CAD) frequently experience related issues, either because of the illness itself or as a side effect. Despite the existence of established criteria, Drug-Related Problems (DRPs) are more likely to arise, which impairs therapy outcomes and overburden patients. The purpose of this study is to assess clinical pharmacist-initiated medication optimisation in ACS patients. In order to optimise pharmacotherapy and the patient care process, a comprehensive clinical pharmacy service was created and deployed for the management of acute coronary syndrome (ACS-CPS). The service activities were prototyped under four primary themes. Our research showed the proactive role of clinical chemists in starting and offering services such as transition care, medication reconciliation, medication optimisation, and evidence-based drug information and interventions

The Caring Process in Patients with Covid-19: A Grounded Theory Study.

The care process involves essential tasks of assisting, supporting, and facilitating nursing activities to meet the comprehensive needs of patients. Coronavirus disease 2019 (COVID-19) is a global infectious disease that has caused a pandemic. Nurses play a crucial role in caring for and treating patients with COVID-19. This study aims to explain the care process in patients with COVID-19. A qualitative study using the grounded theory method was conducted from 2021 to 2022. Eleven nurses providing care to hospitalized patients with COVID-19 were purposively selected from the COVID wards of Shariati Hospital in Tehran, Iran. Data were collected through in-depth semistructured interviews and observation. Data analysis was conducted using the approach developed by Corbin and Strauss (2008). The data analysis phase identified a main theme of "protection and support in the shadow of uncertainty" along with five main categories and ten subcategories. The main categories included "encountering life-threatening crisis", "maintaining safety", "improving the patient's physical health", "encouraging", and "feeling satisfied despite the burden of care". Nurses aimed to improve the physical and psychological conditions of patients with COVID-19 by implementing a comprehensive care plan. The five main categories identified can be considered the primary approach to nursing care in the COVID-19 crisis. Additionally, the nurses' experiences can help establish the necessary infrastructure for care and education during other potential health crises.

Electronic health record downtime responses : One health system’s process for ongoing readiness

Since the implementation of the HITECH Act 2009, the integration of the electronic health record (EHR) with other technology platforms has increased the complexity and necessity of technology downtimes, and the continuity of patient care has become increasingly dependent on an intact EHR. To maintain business continuity and safe patient care during planned or unplanned EHR downtime, it is imperative that organisations have solid downtime and disaster recovery plans. Successful downtime planning will include documenting, with annual reviews, the process for patient care during downtime, as well as an exercise programme that touches all aspects of the downtime process. This paper discusses the experience of a healthcare system based in the US Midwest, which has chosen to exercise part of that process on a quarterly basis, prior to scheduled EHR upgrades. Over the past year of exercises, this healthcare system has collected various data elements in order to identify the education needed and the fine-tuning of the exercise design required to ensure staff competency and patient safety during EHR downtime. The paper describes the process, outcome and the steps the organisation is taking to improve the outcomes of future EHR downtimes.

Improving Safety and Comfort of Healthcare Workers Caring for Patients With High-Consequence Infectious Diseases in a High-Level Isolation Unit Using Innovative Approaches.

Patients with high-consequence infectious diseases (HCIDs) require high-quality care by specially trained staff in a high-level isolation unit (HLIU) that follows strict infection prevention and control (IPC) measures. Caring for patients with (suspected) HCID is challenging, mainly because of the strict personal protective equipment (PPE) and IPC protocols healthcare workers (HCW) must adhere to for protection. The Radboud University Medical Center, located in Nijmegen, the Netherlands, has been a dedicated HLIU facility since 2008. A newly built HLIU opened in May 2022, and encouraged us to review the existing PPE selection, IPC protocols, and HCID training program to improve safety and comfort for HCWs working in the HLIU. Based on a systematic search through (inter)national HCID PPE guidelines and semistructured interviews with end users, we selected an improved, more comfortable set of PPE. Additionally, we developed a more concise and easier-to-use patient care process flow and implemented a new teaching strategy. The new way of working was tested in October 2022 when the first 2 patients with suspected HCID were admitted to our unit. We used surveys to evaluate the experiences of HCWs involved in this care to further improve the workflow of the unit. When optimizing safety and comfort for HCWs, it is important to consider (inter)national guidelines as well as user preferences. By systematically evaluating recent experiences of patient admission to the HLIU and then adjusting protocols and training, we can ensure that the quality of provided healthcare and the safety of HCWs working in the HLIU remains high.

Nursing Care of the Patient Diagnosed with Multiple Myeloma as a Result of Trauma-Induced Fracture Development: A Case Report

Multiple myeloma is a neoplasm of plasma cells. Observed usually in patients over 65 years of age. This case report 41 year old has been prepared in order to determine the nursing diagnoses grouped according to the "Functional Health Patterns" model and to evaluate them in the nursing care plan of a patient who was diagnosed with multiple myeloma as a result of the examination which is that were noticed during a different examination. In the case for the problems; diagnoses of acute pain, sleep disturbance, undernutrition, deterioration of oral mucous membrane, constipation, fatigue, activity intolerance, risk of deterioration in individual identity, risk of deterioration in individual resistance, and nursing interventions for these diagnoses were planned and implemented. Before the study, verbal and written consent was obtained from the patient, and the data were collected by face-to-face interview method. As a result; the patient care process, which was planned and applied in line with the functional health patterns model, provided a positive improvement in the patient's behaviors that would negatively affect the disease process such as facilitated discharge, and guided nurses about care, effectiveness and follow-up of treatment. This model is recommended for the effective implementation of nursing care in clinics such as hematology, oncology, palliative care, where patients need to be followed actively.

Exploring Delays in Cardiac Care Processes Through Electronic Health Records.

Cardiovascular diseases are the leading cause of death globally. Timely health services are fundamental to the appropriate prevention, identification, care and rehabilitation of these diseases. This study aimed to explore the potential of using electronic health records as a data source to help identify health system -related delays in care processes of cardiac patients. This retrospective registry study is based on a sample of electronic health records of 200 cardiac patients admitted to one out of twenty wellbeing services counties in Finland during the years 2021-2022. A total of 426 health system -related delays were identified. All expressions were found in unstructured format and most of these (58.7%) were generated by nurses. These results show that the electronic health records contained a variety of information on health system -related patient care delays, and that most delays were associated with difficulties in finding a bed for the patient in a post-acute care facility (49.8%), but also in-hospital process delays were common (27.7%). These findings show great potential for exploring electronic health record data with natural language processing methods in the future for the development of tools to better identify and monitor different types of delays in care processes. Such tools may support leadership to respond to organisational procedures in need of improvement.

Measurement of Cardiothoracic Ratio on Chest X-rays Using Artificial Intelligence-A Systematic Review and Meta-Analysis.

Background: Chest X-rays (CXRs) are pivotal in clinical diagnostics, particularly in assessing cardiomegaly through the cardiothoracic ratio (CTR). This systematic review and meta-analysis evaluate the efficacy of artificial intelligence (AI) in automating CTR determination to enhance patient care and streamline diagnostic processes. They are concentrated on comparing the performance of AI models in determining the CTR against human assessments, identifying the most effective models for potential clinical implementation. This study was registered with PROSPERO (no. CRD42023437459). No funding was received. Methods: A comprehensive search of medical databases was conducted in June 2023. The search strategy adhered to the PICO framework. Inclusion criteria encompassed original articles from the last decade focusing on AI-assisted CTR assessment from standing-position CXRs. Exclusion criteria included systematic reviews, meta-analyses, conference abstracts, paediatric studies, non-original articles, and studies using imaging techniques other than X-rays. After initial screening, 117 articles were reviewed, with 14 studies meeting the final inclusion criteria. Data extraction was performed by three independent investigators, and quality assessment followed PRISMA 2020 guidelines, using tools such as the JBI Checklist, AMSTAR 2, and CASP Diagnostic Study Checklist. Risk of bias was assessed according to the Cochrane Handbook guidelines. Results: Fourteen studies, comprising a total of 70,472 CXR images, met the inclusion criteria. Various AI models were evaluated, with differences in dataset characteristics and AI technology used. Common preprocessing techniques included resizing and normalization. The pooled AUC for cardiomegaly detection was 0.959 (95% CI 0.944-0.975). The pooled standardized mean difference for CTR measurement was 0.0353 (95% CI 0.147-0.0760). Significant heterogeneity was found between studies (I2 89.97%, p < 0.0001), with no publication bias detected. Conclusions: Standardizing methodologies is crucial to avoid interpretational errors and advance AI in medical imaging diagnostics. Uniform reporting standards are essential for the further development of AI in CTR measurement and broader medical imaging applications.