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Original Research: PULMONARY PROCEDURES |

Diagnosis of Pneumothorax by Radiography and UltrasonographyDiagnosis of Pneumothorax: A Meta-analysis: A Meta-analysis

Wu Ding, MM; Yuehong Shen, MM; Jianxin Yang, MM; Xiaojun He, MM; Mao Zhang, MD
Author and Funding Information

From the Department of Emergency Medicine (Drs Ding, Yang, He, and Zhang), Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University; and Department of Burns (Dr Shen), Second Affiliated Hospital, Zhejiang University, Hangzhou, China.

Correspondence to: Mao Zhang, MD, Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University, School of Medicine and Research Institute of Emergency Medicine, Zhejiang University, No 88, Jiefang Rd, Hangzhou, China; e-mail: zmhz@hotmail.com


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

For editorial comment see page 837

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(4):859-866. doi:10.1378/chest.10-2946
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Objective:  This study compares, by meta-analysis, the use of anterior-posterior chest radiography (CR) with transthoracic ultrasonography for the diagnosis of pneumothorax.

Methods:  English-language articles on the performance of CR and ultrasonography in the diagnosis of a pneumothorax were selected. In eligible studies, data were recalculated, and the forest plots and summary receiver operating characteristic (sROC) curves were analyzed.

Results:  Pooled sensitivity and specificity were 0.88 and 0.99, respectively, for ultrasonography, and 0.52 and 1.00, respectively, for CR. For ultrasonography performed by clinicians other than radiologists, pooled sensitivity and specificity were 0.89 and 0.99, respectively. The sROC areas under the curve were compared, and no significant differences between ultrasonography and CR were found. Meta-regression analysis implied that the operator is strongly associated with accuracy (relative diagnostic OR, 0.21; 95% CI, 0.05-0.96; P = .0455).

Conclusions:  The meta-analysis indicated that bedside ultrasonography performed by clinicians had higher sensitivity and similar specificity compared with CR in the diagnosis of pneumothorax, but the accuracy of ultrasonography in the diagnosis of pneumothorax depended on the skill of the operators.

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