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Review
, 10 (6), e0130066
eCollection

Accuracy of Lung Ultrasonography Versus Chest Radiography for the Diagnosis of Adult Community-Acquired Pneumonia: Review of the Literature and Meta-Analysis

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Review

Accuracy of Lung Ultrasonography Versus Chest Radiography for the Diagnosis of Adult Community-Acquired Pneumonia: Review of the Literature and Meta-Analysis

Xiong Ye et al. PLoS One.

Abstract

Lung ultrasonography (LUS) is being increasingly utilized in emergency and critical settings. We performed a systematic review of the current literature to compare the accuracy of LUS and chest radiography (CR) for the diagnosis of adult community-acquired pneumonia (CAP). We searched in Pub Med, EMBASE dealing with both LUS and CR for diagnosis of adult CAP, and conducted a meta-analysis to evaluate the diagnostic accuracy of LUS in comparison with CR. The diagnostic standard that the index test compared was the hospital discharge diagnosis or the result of chest computed tomography scan as a "gold standard". We calculated pooled sensitivity and specificity using the Mantel-Haenszel method and pooled diagnostic odds ratio using the DerSimonian-Laird method. Five articles met our inclusion criteria and were included in the final analysis. Using hospital discharge diagnosis as reference, LUS had a pooled sensitivity of 0.95 (0.93-0.97) and a specificity of 0.90 (0.86 to 0.94), CR had a pooled sensitivity of 0.77 (0.73 to 0.80) and a specificity of 0.91 (0.87 to 0.94). LUS and CR compared with computed tomography scan in 138 patients in total, the Z statistic of the two summary receiver operating characteristic was 3.093 (P = 0.002), the areas under the curve for LUS and CR were 0.901 and 0.590, respectively. Our study indicates that LUS can help to diagnosis adult CAP by clinicians and the accuracy was better compared with CR using chest computed tomography scan as the gold standard.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart for study selection.
Fig 2
Fig 2. Forest plot for pooled sensitivity, specificity and diagnostic odds ratio of lung ultrasonography (a, b, c) and chest radiography (d, e, f) for the detection of pneumonia compared with hospital discharge diagnosis.
Fig 3
Fig 3. Forest plot for pooled sensitivity, specificity and diagnostic odds ratio of lung ultrasonography (a, b, c) and chest radiography (d, e, f) for the detection of pneumonia compared with chest computed tomography diagnosis.
Fig 4
Fig 4. The summary receiver operating characteristic of lung ultrasonography and chest radiography for the detection of pneumonia compared with computed tomography scan.
AUC: areas under the curve; CR: chest radiography; LUS: lung ultrasonography; sROC: summary receiver operating characteristic.

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Grant support

The authors have no support or funding to report.
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