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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

Test

Author

Op. 

Year

Country or MA (studies)

Train.

n

Prev (%)

Age (years)

Criterion standard

Sn. (%) (95% CI)

Sp. (%) (95% CI)

LR+ (95% CI)

LR− (95% CI)

MAPSE < 10 mm

Mjølstad et al. [33]

GP

2012

Norway

8 h.

92

NR

73

Cardiologist echo.

83.3 (66.4–92.7)

77.6 (64.1–87.1)

3.72a

0.746a

LVH (ventricular wall > 13 mm)

Evangelista et al. [34]

GP

2013

Spain

NR

393

46

71

Cardiologist echo.

89.8 (NR)

98.4 (NR)

56.1a

0.114a

Evangelista et al. [35]

GP

2016

Spain

NR

1312

16

67

Cardiologist echo.

71.4 (63.1–79.7)

97.4 (96.7–98.6)

27.5a

0.29a

LVEF < 50–55%

Unlüer et al. [41]

EP

2014

Turkey

NR

133

56

70

Cardiologist 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]

EP

2016

MA (3)

NR

325

41

NR

Final diagnosis

80.6 (72.986.9)

80.6 (74.386.0)

4.1 (2.47.2)

0.24 (0.170.35)

Shah et al. [42]

EP

2016

Haiti

30 h.

117

40

36

Cardiologist echo.

93.6 (81.4–98.3)

100 (93.5–100)

a

0.064a

Farsi et al. [43]

EP

2017

Iran

10 h.

205

51

61

Cardiologist echo.

89 (81–99)

96 (90–99)

22 (8–58)

0.12 (0.07–0.20)

LVEF < 40%

Dehbozorgi et al. [44]

EP

2019

Iran

NR

100

28

58

Final diagnosis (AHF)

100 (88–100)

88 (78–94)

8 (4.34–14.74)

0

LV dysfunction

Evangelista et al. [35]

GP

2016

Spain

NR

1312

4

67

Cardiologist echo.

50.0 (30.4–69.6)

92.7 (91.3–94.2)

6.85a

0.539a

LA dilatation

Evangelista et al. [35]

GP

2016

Spain

NR

1312

4

67

Cardiologist echo.

41.5 (25.2–57.8)

97.7 (96.8–98.6)

18.0a

0.701a

RVD

Evangelista et al. [34]

GP

2013

Spain

NR

393

22

71

Cardiologist echo.

80.2 (NR)

98.9 (NR)

73.9a

0.200a

Farsi et al. [43]

EP

2017

Iran

10 h.

205

16

61

Cardiologist echo.

98 (94–99)

87 (69–96)

41 (15–109)

0.07 (0.02–0.27)

RVP

Farsi et al. [43]

EP

2017

Iran

10 h.

205

3

61

Cardiologist echo.

100 (52–100)

100 (98–100)

a

0a

Aortic valve sclerosis

Evangelista et al. [34]

GP

2013

Spain

NR

393

23

71

Cardiologist echo.

81.6 (NR)

98.2 (NR)

45.3a

0.187a

Aortic stenosis

Evangelista et al. [35]

GP

2016

Spain

NR

1312

5

67

Cardiologist echo.

50.0 (36.1–64.0)

98.1 (97.0–99.1)

26.3a

0.510a

Aortic insufficiency

Evangelista et al. [34]

GP

2013

Spain

NR

393

27

71

Cardiologist echo.

86.1 (NR)

95.7 (NR)

76.9a

0.145a

Evangelista et al. [35]

GP

2016

Spain

NR

1312

4

67

Cardiologist echo.

58.3 (43.3–73.3)

99.0 (98.3–99.6)

58.3a

0.421a

Dilated ascending aorta

Evangelista et al. [34]

GP

2013

Spain

NR

393

15

71

Cardiologist echo.

89.1 (NR)

100 (NR)

a

0.109a

Evangelista et al. [35]

GP

2016

Spain

NR

1312

9

67

Cardiologist echo.

54.1 (37.1–70.2)

99.1 (98.4–99.6)

60.1a

0.463a

Mitral insufficiency

Evangelista et al. [34]

GP

2013

Spain

NR

393

48

71

Cardiologist echo.

89.1 (NR)

87.2 (NR)

6.96a

0.125a

Evangelista et al. [35]

GP

2016

Spain

NR

1312

6

67

Cardiologist echo.

72.7 (61.2–84.2)

97.7 (96.8–98.6)

31.6a

0.279a

Mitral stenosis

Evangelista et al. [35]

GP

2016

Spain

NR

1312

1

67

Cardiologist echo.

62.8 (22.7–100)

98.1 (97.3–98.9)

33.1a

0.379a

Tricuspid insufficiency

Evangelista et al. [35]

GP

2016

Spain

NR

1312

4

67

Cardiologist echo.

41.4 (21.7–61.0)

98.9 (98.3–99.5)

37.6a

0.694a

Hypertrophic cardiomyopathy

Evangelista et al. [35]

GP

2016

Spain

NR

1312

1

67

Cardiologist echo.

44.4 (6.4–82.5)

99.8 (99.6–100)

222a

0.557a

Diastolic heart failure

Unlüer et al. [47]

EP

2012

Turkey

6 h.

69

74

63

Cardiologist echo.

89 (77–95)

80 (51–95)

4.5 (1.6–12)

0.14 (0.06–0.21)

Ehrman et al. [48]

EP

2015

USA

3 h.

62

52

56

Cardiologist echo.

92 (60–100)

69 (50–83)

2.9

0.12

Restrictive mitral pattern

Nazerian et al. [50]

EP

2010

Italy

4 h.

125

35

78

Final diagnosis of AHF

82 (73–87)

90 (84–94)

8.27 (4.57–15.42)

0.21 (0.14–0.32)

Wall motion abnormality

Farsi et al. [43]

EP

2017

Iran

10 t.

205

33

61

Cardiologist echo.

97 (89–99)

87% (80–92)

8 (5–12)

0.03 (0.01–0.13)

Croft et al. [52]

EP

2019

USA

NR

75

62

65

Cardiologist echo. or ventriculogram

88 (75–96)

92 (75–99)

11.5 (3.1–43.7)

0.13 (0.05–0.29)

Speckle tracking

Reardon et al. [53]

EP

2018

USA

NR

75

16

52

Cardiologist echo. or final diagnosis ACS

29 (17–46)

88 (72–96)

2.4a

0.81a

Pericardial effusion

Mandavia et al. [54]

EP

2001

USA

5 h.

515

20

NR

Cardiologist echo.

96.0 (90.4–98.9)

98.0 (95.8 to 99.1)

48.0a

0.0408a

Farsi et al. [43]

EP

2017

Iran

10 h.

205

10

61

Cardiologist echo.

86 (63–96)

96 (91–98)

20 (10–40)

0.15 (0.05–0.40)

Shah et al. [42]

EP

2016

Haiti

30 h.

117

8

36

Cardiologist echo.

88.9 (50.7–99.4)

99.1 (94.2–100)

98.8a

0.112a

Bustam et al. [39]

EP

2014

Malaysia

3 h.

100

5

NR

Cardiologist echo.

60 (15a–95a)

100 (96a–100a)

a

0.40a

  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