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Table 2 Summary of test accuracy findings in echocardiography

From: Point-of-care ultrasound in primary care: a systematic review of generalist performed point-of-care ultrasound in unselected populations

TestAuthorOp. YearCountry or MA (studies)Train.nPrev (%)Age (years)Criterion standardSn. (%) (95% CI)Sp. (%) (95% CI)LR+ (95% CI)LR− (95% CI)
MAPSE < 10 mmMjølstad et al. [33]GP2012Norway8 h.92NR73Cardiologist echo.83.3 (66.4–92.7)77.6 (64.1–87.1)3.72a0.746a
LVH (ventricular wall > 13 mm)Evangelista et al. [34]GP2013SpainNR3934671Cardiologist echo.89.8 (NR)98.4 (NR)56.1a0.114a
Evangelista et al. [35]GP2016SpainNR13121667Cardiologist echo.71.4 (63.1–79.7)97.4 (96.7–98.6)27.5a0.29a
LVEF < 50–55%Unlüer et al. [41]EP2014TurkeyNR1335670Cardiologist echo.98.7 (91.8–99.9)86.2 (74.1–93.4)7.15 (3.76–13.6)0.015 (0.002–0.109)
Martindale et al. [55]EP2016MA (3)NR32541NRFinal diagnosis80.6 (72.986.9)80.6 (74.386.0)4.1 (2.47.2)0.24 (0.170.35)
Shah et al. [42]EP2016Haiti30 h.1174036Cardiologist echo.93.6 (81.4–98.3)100 (93.5–100)a0.064a
Farsi et al. [43]EP2017Iran10 h.2055161Cardiologist echo.89 (81–99)96 (90–99)22 (8–58)0.12 (0.07–0.20)
LVEF < 40%Dehbozorgi et al. [44]EP2019IranNR1002858Final diagnosis (AHF)100 (88–100)88 (78–94)8 (4.34–14.74)0
LV dysfunctionEvangelista et al. [35]GP2016SpainNR1312467Cardiologist echo.50.0 (30.4–69.6)92.7 (91.3–94.2)6.85a0.539a
LA dilatationEvangelista et al. [35]GP2016SpainNR1312467Cardiologist echo.41.5 (25.2–57.8)97.7 (96.8–98.6)18.0a0.701a
RVDEvangelista et al. [34]GP2013SpainNR3932271Cardiologist echo.80.2 (NR)98.9 (NR)73.9a0.200a
Farsi et al. [43]EP2017Iran10 h.2051661Cardiologist echo.98 (94–99)87 (69–96)41 (15–109)0.07 (0.02–0.27)
RVPFarsi et al. [43]EP2017Iran10 h.205361Cardiologist echo.100 (52–100)100 (98–100)a0a
Aortic valve sclerosisEvangelista et al. [34]GP2013SpainNR3932371Cardiologist echo.81.6 (NR)98.2 (NR)45.3a0.187a
Aortic stenosisEvangelista et al. [35]GP2016SpainNR1312567Cardiologist echo.50.0 (36.1–64.0)98.1 (97.0–99.1)26.3a0.510a
Aortic insufficiencyEvangelista et al. [34]GP2013SpainNR3932771Cardiologist echo.86.1 (NR)95.7 (NR)76.9a0.145a
Evangelista et al. [35]GP2016SpainNR1312467Cardiologist echo.58.3 (43.3–73.3)99.0 (98.3–99.6)58.3a0.421a
Dilated ascending aortaEvangelista et al. [34]GP2013SpainNR3931571Cardiologist echo.89.1 (NR)100 (NR)a0.109a
Evangelista et al. [35]GP2016SpainNR1312967Cardiologist echo.54.1 (37.1–70.2)99.1 (98.4–99.6)60.1a0.463a
Mitral insufficiencyEvangelista et al. [34]GP2013SpainNR3934871Cardiologist echo.89.1 (NR)87.2 (NR)6.96a0.125a
Evangelista et al. [35]GP2016SpainNR1312667Cardiologist echo.72.7 (61.2–84.2)97.7 (96.8–98.6)31.6a0.279a
Mitral stenosisEvangelista et al. [35]GP2016SpainNR1312167Cardiologist echo.62.8 (22.7–100)98.1 (97.3–98.9)33.1a0.379a
Tricuspid insufficiencyEvangelista et al. [35]GP2016SpainNR1312467Cardiologist echo.41.4 (21.7–61.0)98.9 (98.3–99.5)37.6a0.694a
Hypertrophic cardiomyopathyEvangelista et al. [35]GP2016SpainNR1312167Cardiologist echo.44.4 (6.4–82.5)99.8 (99.6–100)222a0.557a
Diastolic heart failureUnlüer et al. [47]EP2012Turkey6 h.697463Cardiologist echo.89 (77–95)80 (51–95)4.5 (1.6–12)0.14 (0.06–0.21)
Ehrman et al. [48]EP2015USA3 h.625256Cardiologist echo.92 (60–100)69 (50–83)2.90.12
Restrictive mitral patternNazerian et al. [50]EP2010Italy4 h.1253578Final diagnosis of AHF82 (73–87)90 (84–94)8.27 (4.57–15.42)0.21 (0.14–0.32)
Wall motion abnormalityFarsi et al. [43]EP2017Iran10 t.2053361Cardiologist echo.97 (89–99)87% (80–92)8 (5–12)0.03 (0.01–0.13)
Croft et al. [52]EP2019USANR756265Cardiologist echo. or ventriculogram88 (75–96)92 (75–99)11.5 (3.1–43.7)0.13 (0.05–0.29)
Speckle trackingReardon et al. [53]EP2018USANR751652Cardiologist echo. or final diagnosis ACS29 (17–46)88 (72–96)2.4a0.81a
Pericardial effusionMandavia et al. [54]EP2001USA5 h.51520NRCardiologist echo.96.0 (90.4–98.9)98.0 (95.8 to 99.1)48.0a0.0408a
Farsi et al. [43]EP2017Iran10 h.2051061Cardiologist echo.86 (63–96)96 (91–98)20 (10–40)0.15 (0.05–0.40)
Shah et al. [42]EP2016Haiti30 h.117836Cardiologist echo.88.9 (50.7–99.4)99.1 (94.2–100)98.8a0.112a
Bustam et al. [39]EP2014Malaysia3 h.1005NRCardiologist echo.60 (15a–95a)100 (96a–100a)a0.40a
  1. MA, meta-analysis (shown in italics with number of studies in brackets); Op., operators; Train., time spent in didactic intervention; n, size of population; Prev., prevalence; Age, median or mean age in years; Sn., sensitivity; Sp., specificity; CI, confidence interval; LR+, positive likelihood ratio; LR−, negative likelihood ratio; NR, not reported; echo., echocardiography; MAPSE, mitral annular plane systolic excursion; GP, general practitioner; LVH, left-ventricular hypertrophy; LVEF, left-ventricular ejection fraction; EP, emergency physician; LV, left ventricle; LA, left atrial; RVD, right-ventricular dilatation; RVP, right-ventricular pressure
  2. aCalculated by the authors