Diagnostic accuracy of point-of-care lung ultrasound for community-acquired pneumonia in children in ambulatory settings: A systematic review and meta-analysis.

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Helena Hughes-Davies, Umasha Ukwatte, Thomas R Fanshawe, Nia Roberts, Philip J Turner, Gail N Hayward, Chris Bird
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引用次数: 0

Abstract

Introduction: To perform a systematic review of the diagnostic accuracy of point-of-care lung ultrasound, compared to chest radiography, in children and young people (0-21 years) who present to ambulatory settings with suspected community-acquired pneumonia.

Methods: Registration: Prospero June 2021 CRD42021260552. Electronic searching performed on Medline, Embase, CINAHL and Science Citation Index from inception to 20 June 2023. Two researchers independently screened titles, abstracts, and full texts for study selection. Risk of bias was assessed using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-analysis of included studies.

Results: The six studies included in this systematic review described point-of-care lung ultrasound performed primarily by paediatric emergency medicine clinicians on a total of 1099 paediatric patients, with a reference standard of chest radiography or chest radiography with clinical findings. The majority of included studies lacked clarity on training for the index test with potential bias around flow and timing of testing. Meta-analysis of the combined results of the included six studies calculated a pooled sensitivity of 90.9% (95% CI [85.5%, 94.4%]) and pooled specificity of 80.7% (95% CI [63.6%, 91.0%]).

Conclusions: Point-of-care lung ultrasound has high sensitivity but lower specificity to diagnose acute pneumonia in children. Further research is needed which overcomes issues around training in point-of-care lung ultrasound, study design and reliability of the reference test (chest radiography) to better evidence the role of point-of-care lung ultrasound in diagnosing pneumonia in children in ambulatory and resource-limited settings.

门诊儿童社区获得性肺炎护理点肺部超声诊断的准确性:系统回顾和荟萃分析。
内容简介对儿童和青少年(0-21 岁)因疑似社区获得性肺炎而就诊的情况进行系统性回顾,比较护理点肺部超声波与胸部放射摄影的诊断准确性:注册:Prospero 2021 年 6 月 CRD42021260552。在 Medline、Embase、CINAHL 和《科学引文索引》上进行电子检索,检索期从开始至 2023 年 6 月 20 日。两名研究人员独立筛选了研究的标题、摘要和全文。使用诊断准确性研究质量评估工具(QUADAS-2)对偏倚风险进行评估。对纳入的研究进行元分析:本系统综述纳入的六项研究描述了主要由儿科急诊医学临床医生对共计 1099 名儿科患者进行的护理点肺部超声检查,参考标准为胸部放射摄影或胸部放射摄影与临床发现。纳入的大多数研究都没有明确说明指标检测的培训情况,因此在流程和检测时间方面可能存在偏差。对所纳入的六项研究的综合结果进行的 Meta 分析计算得出,汇总灵敏度为 90.9%(95% CI [85.5%,94.4%]),汇总特异度为 80.7%(95% CI [63.6%,91.0%]):结论:护理点肺部超声诊断儿童急性肺炎的灵敏度较高,但特异性较低。为了更好地证明护理点肺部超声波在非卧床和资源有限环境中诊断儿童肺炎的作用,还需要进一步的研究,以克服护理点肺部超声波的培训、研究设计和参考测试(胸部放射摄影)的可靠性等问题。
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来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
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