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Table 5 Summary of test accuracy findings in abdominal 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)

Hydronephrosis/nephrolithiasis

Wong et al. [113]

EP

2018

MA (9)

NR

1773

35–84

NR

CT, visualisation of stone or surgical findings

70.2 (67.1–73.2)

75.4 (72.5–78.2)

2.85

0.39

Javaudin et al. [114]

EP

2017

France

16 h.

50

38

47

Radiologist US

100 (82–100)

71 (52–86)

3.4 (2.0–6.0)

0

Pediatric hydronephrosis in UTI

Guedj et al. [115]

EP

2015

France

2 h.

382

5

9 m.

Radiologist US

76.5 (58.1–94.6)

97.2 (95.2–99.2)

27.3

0.25

Scrotal pathology

Blaivas et al. [118]

EP

2001

USA

NR

36

58

45

Radiologist colour doppler US

95 (78–99)

94 (72–99)

16a

0.053a

Cholelithiasis

Esquerrà et al. [121]

GP

2012

Spain

212 h.

115

56

NR

Radiologist US

88.9 (83.2–94.6)

100 (NR)

∞a

0.111

Lindgaard and Risgaard [93]

GP

2017

Denmark

2 d.

62

42

NR

Radiologist US

92 (75–99)a

92 (78–98)a

11a (3.7–33)a

0.08a (0.02–0.32)a

Scruggs et al. [125]

EP

2008

USA

–

575

60

NR

Radiologist US

88 (84–91)

87 (82–91)

6.8a

0.13a

Ross et al. [124]

EP

2011

MA (8)

NR

710

46–80

NR

Radiologist US, CT, MRI or surgical findings

89.8 (86.4–92.5)

88 (83.7–91.4)

7.5 (NR)

0.12 (NR)

Hilsden et al. [126]

EP

2018

Canada

Cert.

283

16

NR

Need for cholecystectomy

55 (40–70)

92 (88–95)

5.6a

0.49a

Cholelithiasis OR Cholecystitis

Schlager et al. [122]

EP

1994

Canada

NR

65

54

NR

Radiologist US or surgical findings

86 (70a–95a)

97 (83–100)a

26a (4–177)a

0.15a (0.07–0.33)a

Cholecystitis

Rosen et al. [127]

EP

2001

USA

NR

193

46

49

Clinical follow-up

92 (73–100)

78 (61–93)

4.2a

0.36a

Summers et al. [128]

EP

2010

USA

NR

113

14

36

Surgical reports or clinical follow-up

87 (66–97)

82 (74–88)

4.7 (3.2–6.9)

0.16 (0.06–0.46)

Shekarchi et al. [129]

EP

2018

Iran

4 h.

342

14

54

Radiologist US

89.58 (76.55–96.10)

96.59 (93.63–98.29)

4.30 (2.42–7.62)

0.017 (0.007–0.041)

Tourghabe et al. [130]

EP

2018

Iran

NR

51

100

42

Surgical and pathology findings

37.84 (22.94–55.2)

100.0 (73.24–100.0)

∞

0.62 (0.48–0.80)

Appendicitis (pediatric)

Benabbas et al. [134]

EP

2017

MA (4)

–

461

31–54

9–12

Final pathology

86 (79–90)

91 (87–94)

9.24 (6.42–13.28)

0.17 (0.09–0.30)

Nicole et al. [135]

EP

2018

Canada

2 d.

121

44

10

Pathology or clinical follow-up

53 (40–66)

82 (71–89)

2.94a

0.57a

Appendicitis (all ages)

Lee and Yun [136]

EP

2019

MA (17)

–

2385

42a

6–37

Surgical or pathological findings

84 (72–92)

91 (85–95)

7.0 (3.2–15.3)

0.22 (0.12–0.42)

Appendicitis (adults)

Fields et al. [137]

EP

2017

MA (11)b

–

1621

NR

NR

CT, surgery, MRI or autopsy

80 (76–83)

92 (90–94)

10.2 (8.2–12.7)

0.22 (0.19–0.26)

Shahbazipar et al. [138]

EP

2018

Iran

8 h.

121

38

34

Pathology or clinical follow-up

63 (48–77)

99 (93–100)

63a

0.37a

Sharif et al. [139]

EP

2018

Canada

NR

90

20

NR

Pathology, laparoscopy, CT and/or radiologist US

69.2 (48.1–84.9)

90.6 (80.0–96.1)

7.4 (3.3–16.5)

0.3 (0.2–0.6)

Corson-Knowles and Russell [140]

EP

2018

USA

20 m

76

37

27a

Pathology results or clinical follow-up

42.8 (25.0–62.5)

97.9 (87.5–99.8)

20.6 (2.8–149.9)

0.58 (0.42–0.80)

Intussusception (pediatric)

Riera et al. [141]

EP

2012

USA

1 h.

82

16

24 m.

Radiologist US

85 (54–97)

97 (89–99)

29 (7.3–117)

0.16 (0.04–0.57)

Lam et al. [142]

EP

2014

USA

1 h.

44

23

31

Radiologist study

100 (66–100)

97 (82–100)

32 (4.65–220)

0

Small bowel obstruction

Unlüer et al. [146]

EP

201

Turkey

6 h.

174

49

56

Surgical findings, CT or clinical follow-up

97.7 (94.5–100)

92.7 (87.0–98.3)

13.4 (6.2–28.9)

0.025a

Jang et al. [147]

EP

2011

USA

10 m.

76

43

NR

Abdominal CT

91 (75–98)

84 (69–93)

5.6 (2.8–11.1)

0.1 (0.04–0.3)

Frasure et al. [148]

EP

2018

USA

NR

47

68

63

Abdominal CT

93.8 (79.2–99.2)

93.3 (68.1–99.8)

14.1 (2.11–93.6)

0.07 (0.02–0.26)

Becker et al. [145]

EP

2019

USA

30 m.

217

43

55

Abdominal CT

88 (80–94)

54 (45–63)

1.92 (1.56–2.35)

0.22 (0.12–0.39)

Ascites

Lindgaard and Riisgaard [93]

GP

2017

Denmark

2 d.

34

9

NR

Radiologist US

100 (29–100)a

100 (89–100)a

∞

0

Constipation in children

Doniger et al. [149]

EP

2018

USA

1.5 h.

50

64

10 ± 4

Rome III questionnaire

86 (67–95)

71 (53–85)

3.0a

0.20a

  1. 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; 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; CT, computed tomography; MRI, magnetic resonance imaging; US, ultrasound
  2. aCalculated by the authors from available data
  3. bEP sub-group analyzed separately