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 4 Summary of test accuracy findings in vascular 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)
AAA (> 3 cm)—screening in general practice	Bravo-Merino et al. [90]	GP	2019	Spain	NR	76	17^b/4.6^c	70	Vascular surgical services ultrasound	100^b/93.3 (75.4–99.9)^c	100^b/98.5 (94.3–100)^c	∞^b/62.2^c	0^b/0.07^c
	Blois et al. [88]	GP	2012	Canada	NR	45	4.4	73	Radiologist	100 (15.8–100)^a	100 (91.8–100)^a	∞^a	0^a
	Bailey et al. [89]	GP	2001	USA	2 h.	79	5.1	NR	Radiologist	100 (39.8–100)^a	100 (95.2–100)^a	∞^a	0^a
AAA on clinical indication (cm)
> 3	Rubano et al. [94]	EP	2013	MA (7)	NR	655	23	> 50	CT, MRI, radiologist US, aortography, surgical findings, autopsy	99 (96–100)	98 (97–99)	NR (10.8–∞)	NR (0–0.025)
> 5	Lindgaard and Risgaard [93]	GP	2017	Denmark	2 d.	29	3	NR	Radiologist US	100 (2.5–100)^a	100 (87.7–100)^a	∞^a	0^a
DVT Mixed techniques (2-point, 3-point and duplex US)	Pomero et al. [97]	EP	2013	MA (16)	10 m.–6 h.	2379	23	NR	Colour-flow duplex US by radiology or angiography	96.1 (90.6–98.5)	96.8 (94.6–98.1)	30.0 (17.2–52.2)	0.04 (0.02–0.10)
DVT 2-point compression (CFV and PV)	Lee et al. [98]	EP	2019	MA (9)	NR	1337	20^a	49–73	Radiologist US	91 (68–98)	98 (96–99)	46^a	0.09^a
	Torres-Macho et al. [99]	EP	2012	Spania	10 h.	76	35	NR	Radiologist US	92 (82–100)	98 (94–100)	46^a	0.08^a
	Mumoli et al. [96]	GP	2017	Italy	50 h.	1107	18	64	Vascular ultrasound physician experts	90.0 (88.2–91.8)	97.1 (96.2–98.1)	31.0^a	0.10^a
	Nygren et al. [101]	EP	2018	Sweden	45 m.	65	17	70	Radiologist US	100 (71.5–100)	90.7 (79.7–96.9)	10.8 (4.69–24.9)	0
DVT 3-point compression (CFV, SFV and PV)	Lee et al. [98]	EP	2019	MA (8)	NR	1035	29^a	47–68	Radiologist US and/or contrast venography	90 (83–95)	95 (83–99)	18^a	0.11^a
DVT 3-point compression (CFV, SFV and PV)	Crowhurst and Dunn [100]	EP	2013	Australia	2 h	178	14	57	Radiologist duplex US	77.8 (54.8–91.0)	91.4 (84.9–95.3)	9.04^a	0.24^a

MA, meta-analysis (shown in italics with number of studies in brackets); Op., operators; Train., time spent in didactic intervention; m., minutes; h., hours; d., days; x, examinations; n, size of population; Prev., prevalence; Age, median- or mean age; Sn., sensitivity; Sp., specificity; CI, confidence interval; LR+, positive likelihood ratio; LR−, negative likelihood ratio; GP, general practitioner; EP, emergency physician; NR, not reported; AAA, abdominal aortic aneurysm; DVT, deep vein thrombosis; CFV, common femoral vein; PV, popliteal vein; SFV, superficial femoral vein; CT, computed tomography; MRI, magnetic resonance imaging; US, ultrasound
^aOnly including the 20% that had the criterion standard applied
^bBy posterior probability distribution
^cCalculated by the authors from available data

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