Diagnosing Pneumonia: Ultrasound More Accurate Than Radiology
Point of care lung ultrasounds for pneumonia diagnosis can reduce radiation to patients, researchers say.
Point of care lung ultrasound (LUS) is an accurate tool for the diagnosis of patients with pneumonia compared with radiology, according to a study published in Critical Ultrasound Journal.
Researchers conducted a systematic literature search for all published studies comparing the diagnostic accuracy of LUS against a reference chest radiologic exam (X-ray or CT scan), combined with clinical criteria for pneumonia in all age groups. Community and hospital-acquired pneumonia cases were included, as were those with respiratory disease and symptoms of acute respiratory failure.
Risk of bias was judged as “low,” “high,” or “unclear.” Diagnostic accuracy measures were sensitivity, specificity, and likelihood ratio for positive and negative test (LR+ and LR-).
The authors identified 20 studies that fit the inclusion criteria, which included 2513 patients (5 pediatric patients). Overall pooled sensitivity and specificity for diagnosis of patients with pneumonia by LUS were 0.85 and 0.93, respectively. Overall pooled positive and negative likelihood ratios were 11.05 and 0.08, respectively. The pooled diagnostic odds ratio was 173.64.
According to the researchers, the use of LUS can significantly reduce the number of chest radiographs and CT scans and decreases patients' radiation exposure. LUS can be used at the bedside and provides more accurate diagnostic information than chest X-ray in critically ill and emergency patients with lung consolidation, they noted.
“Lung ultrasound can play a major and valuable role in the diagnosis of pneumonia with high diagnostic accuracy,” stated the researchers.
Alzahrani SA, Al-Salamah MA, Al-Madani WH, Elbarbary MA. Systematic review and meta-analysis for the use of ultrasound versus radiology in diagnosing of pneumonia [published online February 27, 2017]. Crit Ultrasound J. doi: 10.1186/s13089-017-0059-y