Lung ultrasound for the diagnosis of pneumonia in adults: A meta-analysis

Abstract

Background: Pneumonia is a common and serious infectious disease that can cause high mortality. The role of lung ultrasound (LUS) in the diagnosis of pneumonia is becoming more and more important. Methods: In the present study, we collected existing evidence regarding the use of LUS to diagnose pneumonia in adults and conducted a systematic review to summarize the technique's diagnostic accuracy. We specifically searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Embase databases and retrieved outcome data to evaluate the efficacy of LUS for the diagnosis of pneumonia compared with chest radiography or chest computed tomography. The pooled sensitivity (SEN) and specificity (SPE) were determined using the Mantel-Haenszel method, and the pooled diagnostic odds ratio (DOR) was determined using the DerSimonian-Laird method. We also assessed heterogeneity of sensitivity, specificity, and diagnostic odds ratio using the Q and I2 statistics. Results: Twelve studies containing 1515 subjects were included in our meta-analysis. The SEN and SPE were 0.88 (95% CI: 0.86-0.90) and 0.86 (95% CI: 0.83-0.88), respectively. The pooled negative likelihood ratio (LR) was 0.13 (95% CI: 0.08-0.23), the positive LR was 5.37 (95% CI: 2.76-10.43), and the DOR was 65.46 (95% CI: 29.24-146.56). The summary receiver operating characteristic curve indicated a relationship between sensitivity and specificity. The area under the curve for LUS was 0.95. Conclusion: LUS can help to diagnose adult pneumonia with high accuracy. Abbreviations: AUC = area under the curve, CAP = community-acquired pneumonia, CENTRAL = Cochrane Central Register of Controlled Trials, CT = computed tomography, DOR = diagnostic odds ratio, ICU = intensive care unit, LR = likelihood ratio, LUS = lung ultrasound, SEN = sensitivity, SPE = specificity, SROC = summary receiver operating characteristic.