Cost Effectiveness

Cost is another component to assess when comparing two different modalities. It is an issue for many patients, as the patients are always concerned with the money required to use in the event where visitation to the hospital is inevitable. Cost-effectiveness in digital imaging comprises of direct and indirect effects (Sailer et al., 2015). Hence, when accessing the cost-effectiveness, it is essential to understand that the imaging test must provide added value. Otero et al. (2008) state that the term cost-effectiveness is not just the amount paid for the examination, it also takes into consideration the other causes like the need for further examinations to confirm the diagnosis.

In Tan Tock Seng Hospital, a Singapore government hospital,
However, LUS is not done as the first-line imaging test, as patients would favor a cheaper option like the CXR. Moreover, other factors like the time of the scan have also made an impact on the decision patients have when choosing a choice of modality.

3.4. Accessibility

Having access to medical imaging is also important, as it helps to optimise patient care (World Health Organization, 2012c). Thus, it is important to take into consideration the ability of the patient to be transported to the radiology department (Amanullah, 2015).

Pneumonia patients are usually confined to bed due to their weak immune system, which makes it tough for their body to fight germs. Therefore, these patients are subjected to invasive monitoring equipment and careful monitoring. When evaluating Pneumonia, a CXR examination is the first-line imaging modality. However, it is difficult to use on bedridden patients or ambulatory patients (Cardinale et al., 2012). As a result, when compared to the US, CXR has a restricted access to the patients. Nonetheless, portable X-ray machines are available clinically, and an Anterior-Posterior (AP) portable CXR is usually done in a supine or semirecumbent position for bedridden patients (Loeb et al.,
However, Pereda et al. (2015) and The University of Melbourne (2017) expressed that LUS is a basic sonographic technique that is easy to learn. Furthermore, it is less technically demanding as compared to other sonographic examinations, and it is demonstrated that beginners with approximately 7 hours of training were able to obtain high sensitivity (98%) and specificity (95%). Although the study conducted by Pereda showed high sensitivity and high specificity, the study was performed in a single centre. Therefore, narrowing the external validity of findings, increasing the bias. Furthermore, according to Eisen et al. (2010), LUS is a newly developed tool, hence, there is lack of professionals trained in using this