Lung Ultrasound Scan offers high accuracy in detecting pneumonia in children

Lung Ultrasound Scan (LUS) offers high accuracy in detection of pneumonia in children, revealed a study published in the Academic Emergency Medicine.

Childhood pneumonia is one of the leading cause of mortality in children worldwide. Prior researches suggest that Lung Ultrasound Scan can be a good alternative to chest x-rays in detecting childhood pneumonia.

The present study intended to access the diagnostic accuracy of LUS for pneumonia and compare the performance between novice and advanced sonographers with a systematic review and meta‐analysis.

The authors searched PubMed and EMBASE from inception to February 2018 for eligible studies that evaluated the utility of LUS in children suspected of having pneumonia against the reference standard of either imaging results alone or a combination of clinical, laboratory and imaging results. They reported the study using the Preferred Reporting Items for a Systematic Review and Meta‐analysis of Diagnostic Test Accuracy Studies.

QUADAS‐2 was used to appraise the included studies’ methodologic quality and employed a random‐effect bivariate model and a hierarchical summary receiver operating characteristic (HSROC) curve to evaluate LUS’ performance characteristics.

Then they conducted subgroup analyses and meta‐regression based on the level of sonographer training to summarize and compare LUS’ diagnostic accuracy for pneumonia between novice (training ≤ 7 days) and advanced sonographers.

It was observed that found that twenty‐five studies were included in the meta‐analysis. For diagnosing pneumonia, LUS demonstrated an overall sensitivity = 0.94, specificity = 0.92 , positive likelihood ratio = 12.40 and negative likelihood ratio = 0.07, with an area under ROC (AUROC) curve of 0.97 . Meta‐regression revealed a significant difference in the diagnostic accuracy for pneumonia for LUS between novice and advanced sonographers.

Based on the findings the authors conclude: LUS can accurately diagnose pneumonia in children. However, this test demonstrates operator‐dependent variability, with more experienced sonographers having higher diagnostic accuracy. Further work on evidence‐based educational methods to train novice sonographers in LUS is required.

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https://doi.org/10.1111/acem.13818