9 research outputs found
Role of Transthoracic Lung Ultrasonography in the Diagnosis of Pulmonary Embolism: A Systematic Review and Meta-Analysis
<div><p>Background</p><p>Pulmonary embolism (PE) is a potentially life-threatening condition. Although computed tomography pulmonary angiography (CTPA) is the reference standard for diagnosis, its early diagnosis remains a challenge, and the concerns about the radiation exposures further limit the general use of CTPA. The primary aim of this meta-analysis was to evaluate the overall diagnostic accuracy of transthoracic lung ultrasound (TLS) in the diagnosis of PE.</p><p>Methods</p><p>PubMed, Web of science, OvidSP, ProQuest, EBSCO, Cochrane Library and Clinicaltrial.gov were searched systematically. The quality of included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and hierarchical summary receiver operating characteristic (HSROC) curves were used to examine the TS performance. The Bayes analysis was used to calculate the post-test probability of PE. Publication bias was assessed with Deeks funnel plot.</p><p>Results</p><p>The results indicated that the sensitivity, specificity, PLR and NLR were 0.85 (95% confidence interval (CI), 0.78 to 0.90), and 0.83 (95% CI, 0.73 to 0.90). And the DOR and HSROC were 28.82 (95% CI, 17.60 to 47.21), 0.91(95% CI, 0.88, 0.93).</p><p>Conclusions</p><p>The present meta-analysis suggested that transthoracic lung ultrasonography is helpful in diagnosing pulmonary embolism. Although the application of transthoracic lung ultrasound may change some patients’ diagnostic processes, it is inappropriate to generally use transthoracic ultrasonography in diagnosing pulmonary embolism currently.</p></div
Forest plot for sensitivity and specificity.
<p>Forest plot for sensitivity and specificity.</p
Characteristics of Eligible Studies-1.
<p>NR, not reported</p><p>§, mean(SD)</p><p>¶, median(range)</p><p>TP = true positive; FP = false positive; FN = false negative; TN = true negative</p><p>1<sup>†</sup>, = yes</p><p>2<sup>‡</sup>, = no.</p><p>Characteristics of Eligible Studies-1.</p
Summary of QUADAS-2 assessments of included studies.
<p>Summary of QUADAS-2 assessments of included studies.</p
Fagan plot analysis to evaluate the clinical utility of transthoracic ultrasonography (TS) for the detection of pulmonary embolism (PE) from studies published post-2000.
<p>(a) With a pretest probability of PE of 1.3%, the post-test probability of PE, given positive and negative TS results, were 8% and 0%. (b) With a pretest probability of PE of 16.2%, the post-test probabilities of PE, given positive and negative TS results, were 55% and 5%. (c) With a pretest probability of PE of 40.6%, the post-test probability of PE, given positive and negative TS results, were 81% and 15%. The Fagan plot consists of a vertical axis on the left with the pretest probability, an axis in the middle representing the likelihood ratio, and a vertical axis on the right representing the post-test probability.</p
The Deek’s funnel plot for the assessment of potential publication bias.
<p>The Deek’s funnel plot for the assessment of potential publication bias.</p
The relationship between post-test probability and pre-test probability.
<p>The relationship between post-test probability and pre-test probability.</p
Flow chart of study selection for inclusion in the systematic review.
<p>Flow chart of study selection for inclusion in the systematic review.</p
Hierarchical summary receiver operating characteristic (HSROC) curves for the detection of pulmonary embolism using transthoracic ultrasonography.
<p>Hierarchical summary receiver operating characteristic (HSROC) curves for the detection of pulmonary embolism using transthoracic ultrasonography.</p