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

Sorensen, Bjarte; Hunskaar, Steinar

doi:10.1186/s13089-019-0145-4

The Ultrasound Journal

Table 3 Summary of test accuracy findings in lung ultrasound

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 (no. of studies in MA)	Train.	n	Prev (%)	Age	Criterion standard	Sn. in % (95% CI)	Sp. in % (95% CI)	LR+ (95% CI)	LR− (95% CI)
Diffuse interstitial syndrome in heart failure	Martindale et al. [55]	EP	2016	MA (8)	NR	1914	48	NR	Final diagnosis	85.3 (82.8–87.5)	92.7 (90.9–94.3)	7.4 (4.2–12.8)	0.16 (0.05–0.51)
	McGivery et al. [56]	EP	2018	MA (5)^c	NR	1387	NR	NR	Final diagnosis	88.6 (79.6–94.0)	83.2 (63.2–93.5)	5.27^a	0.14^a
	Lian et al. [57]	EP^d	2018	MA (15)	NR	3309	NR	NR	Final diagnosis	85 (84–87)	91 (89–92)	8.94 (5.64–14.18)	0.14 (0.08–0.26)
	Koh et al. [75]	EP	2018	Singapore	20 h.	231	36	68	Final diagnosis	71.4 (60.5–80.8)	80.9 (72.5–87.6)	3.73 (2.50–5.57)	0.35 (0.25–0.50)
	Maw et al. [58]	EP^d	2019	MA (6)	NR	1827	20–62	NR	Final diagnosis or echoc./BNP	88 (75–95)	90 (88–92)	8.63 (6.93–10.74)	0.14 (0.06–0.29)
	Staub et al. [59]	EP^d	2019	MA (14)	NR	2778	24–88	NR	Final diagnosis	NR (75–90)^b	NR (80–90)^b	NR	NR
	Pivetta et al. [60]	EP	2019	Italy	40 x	518	43	79	Final diagnosis	93.5 (87.7–97.2)	95.5 (90.5–98.3)	20.9 (9.54–45.7)	0.07 (0.03–0.13)
	Bekgoz et al. [76]	EP	2019	Turkey	2 h.	383	22	66	Final diagnosis	87 (79–93)	97 (94–98)	29^a	0.13^a
Pneumonia (adults)	Ye et al. [63]	EP	2015	MA (5)	NR	742	–	NR	Final diagnosis	95 (93–97)	90 (86–94)	9.5^a	0.056^a
	Orso et al. [62]	EP	2018	MA (17)	NR	5108	NR	67	Final diagnosis or CXR and/or CCT	92 (87–96)	93 (86–97)	13^a	0,086^a
	Staub et al. [59]	EP^d	2019	MA (14)	NR	1896	30–85	NR	Final diagnosis or CXR and/or CCT	NR (85–95)^b	NR (75–90)^b	NR	NR
	Amatya et al. [64]	EP	2018	Nepal	1 h.	62	71	59	CCT	91 (78–97)^a	61 (36–83)^a	2.34 (1.30–4.20)^a	0.15 (0.05–0.41)^a
	Koh et al. [75]	EP	2018	Singapore	20 h.	231	21	68	Final diagnosis	65.3 (50.4–78.3)	82.0 (74.9–87.8)	3.63 (2.44–5.40)	0.42 (0.29–0.63)
	Bekgoz et al. [76]	EP	2019	Turkey	2 h.	383	24	66	Final diagnosis	82 (78–89)	98 (97–99)	41^a	0.18^a
Pneumonia (children)	Copetti and Cattarossi [65]	EP	2008	Italy	NR	79	76	5	CXR, CT or final diagnosis	100^a	100^a	∞^a	0^a
Pneumonia (children)	Shah et al. [66]	EP	2013	USA	1 h.	200	18	3	CXR	86 (71–94)	89 (83–93)	7.8 (5.0–12.4)	0.2 (0.1–0.4)
Pneumothorax	Ebrahimi et al. [70]	EP	2014	MA (14)^c	–	1803	NR	NR	CCT	88 (82–94)	99 (98–100)	88^a	0.12^a
	Staub et al. [71]	EP^d	2018	MA (13)	–	2378	14	NR	CXR, CCT or chest tube (with rush of air)	81 (71–88)	98 (97–99)	67.9 (26.3–148)	0.18 (0.11–0.29)
	Riccardi et al. [72]	EP	2019	Italy	–	190	9	59	CXR and/or CCT	94	100	∞^a	0.06^a
	Bekgoz et al. [76]	EP	2019	Turkey	2 h.	383	2	66	Final diagnosis	85	100	∞^a	0.15^a
COPD/Asthma	Koh et al. [75]	EP	2018	Singapore	20 h.	231	27	68	Final diagnosis	64.5 (51.3–76.3)	89.8 (83.4–94.3)	6.31 (3.72–10.72)	0.40 (0.28–0.56)
COPD/Asthma	Bekgoz et al. [76]	EP	2019	Turkey	2 h.	383	28	66	Final diagnosis	96 (90–97)	75 (70–80)	3.8^a	0.05^a

MA, meta-analysis (shown in italics with number of studies in brackets); Op., operators; Train., time spent in didactic intervention; h., hours; x, number of examinations; 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; EP, emergency physician; NR, not reported; echoc., echocardiography; BNP, brain-type natriuretic peptide; CXR, chest X-ray; CCT, chest computed tomography
^aCalculated by the authors
^bThe approximate overall 95% confidence interval based on the area under the curve
^cEP sub-group analyzed separately
^dThe majority of studies included involved EPs

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