Some studies suggest that lung ultrasound could be useful for diagnosing pneumonia; moreover, it has a more favorable safety profile and lower cost than chest X-ray (CXR) and computed tomography (CT). The aim of this study is to assess the accuracy of bedside lung ultrasound for diagnosing pneumonia in adults through a systematic review and meta-analysis.
We searched MEDLINE, Scopus, The Cochrane Library, Web of Science, DARE, HTA Database, Google Scholar, LILACS, ClinicalTrials.gov, TESEO and OpenGrey. In addition, we reviewed the bibliographies of relevant studies. Two researchers independently selected studies that met the inclusion criteria. Quality of the studies was assessed in accordance with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The summary receiver operating characteristics (SROC) curve and a pooled estimation of the diagnostic odds ratio (DOR) was estimated using using a bivariate random-effects analysis. The sources of heterogeneity were explored using predefined subgroup analyses and bivariate meta-regression.
Sixteen studies (2359 participants) were included. There was significant heterogeneity of both sensitivity and specificity according to Q test, without clear evidence of threshold effect. The area under the SROC curve was 0.93, with a DOR at the optimal cutpoint of 50 (95% confidence interval (CI): 21, 120). A tendency towards a higher area under the SROC curve in high quality studies was detected, however these differences were not significant after applying the bivariate meta-regression.
Lung ultrasound can help to accurately diagnose pneumonia, and it may be promising as an adjuvant resource to traditional approaches.