Diagnostic performance of lung ultrasound in the diagnosis of pneumonia: a bivariate meta-analysis

Int J Clin Exp Med. 2014 Jan 15;7(1):115-21. eCollection 2014.


Background and objective: Pneumonia is a common disease with both high morbidity and mortality, the diagnosis of pneumonia remains a clinical challenge. Many studies have been conducted to identify the usefulness of lung ultrasound for the diagnosis of pneumonia, but with inconsistent and inconclusive results. The present study aimed to establish the overall diagnostic accuracy of lung ultrasound in diagnosing pneumonia.

Methods: Based on a comprehensive search of the Pubmed, Embase, and the Cochrane database, we identified out-come data from all articles estimating diagnostic accuracy with lung ultrasound for pneumonia. Quality was assessed with the Quality Assessment for Diagnostic Accuracy Studies. Results from different studies were pooled using a bivariate meta-analysis. Summary receiver operating characteristic curve was used to assess the overall performance of lung ultrasound-based assays.

Results: Nine studies containing 1080 subjects were included in this meta-analysis. The summary estimates for lung ultrasound in the diagnosis of pneumonia in the studies included were as follows: sensitivity, 0.97 (95% CI: 0.93-0.99); specificity, 0.94 (95% CI: 0.85-0.98); DOR, 507.99 (95% CI: 128.11-2014.34); positive likelihood ratio, 15.62 (95% CI: 6.31-38.68); negative likelihood ratio, 0.03 (95% CI: 0.01-0.08); The area under the summary receiver operating characteristic curve was 0.99 (95% CI: 0.98-1.00).

Conclusion: Lung ultrasound is a capable of diagnosing pneumonia with high accuracy and is a promising attractive alternative to chest radiography and thoracic CT scan.

Keywords: Lung ultrasound; diagnosis; meta-analysis; pneumonia.