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Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review

The advent of affordable, portable ultrasound devices has led to increasing interest in the use of point-of-care ultrasound (POCUS) for the detection of pulmonary TB (PTB). We undertook a systematic review of the diagnostic accuracy of POCUS for PTB. Five databases were searched for articles publish...

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Autores principales: Bigio, Jacob, Kohli, Mikashmi, Klinton, Joel Shyam, MacLean, Emily, Gore, Genevieve, Small, Peter M., Ruhwald, Morten, Weber, Stefan Fabian, Jha, Saurabh, Pai, Madhukar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104425/
https://www.ncbi.nlm.nih.gov/pubmed/33961639
http://dx.doi.org/10.1371/journal.pone.0251236
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author Bigio, Jacob
Kohli, Mikashmi
Klinton, Joel Shyam
MacLean, Emily
Gore, Genevieve
Small, Peter M.
Ruhwald, Morten
Weber, Stefan Fabian
Jha, Saurabh
Pai, Madhukar
author_facet Bigio, Jacob
Kohli, Mikashmi
Klinton, Joel Shyam
MacLean, Emily
Gore, Genevieve
Small, Peter M.
Ruhwald, Morten
Weber, Stefan Fabian
Jha, Saurabh
Pai, Madhukar
author_sort Bigio, Jacob
collection PubMed
description The advent of affordable, portable ultrasound devices has led to increasing interest in the use of point-of-care ultrasound (POCUS) for the detection of pulmonary TB (PTB). We undertook a systematic review of the diagnostic accuracy of POCUS for PTB. Five databases were searched for articles published between January 2010 and June 2020. Risk of bias was assessed using QUADAS-2. Data on sensitivity and specificity of individual lung ultrasound findings were collected, with variable reference standards including PCR and sputum smear microscopy. Six of 3,919 reviewed articles were included: five in adults and one in children, with a total sample size of 564. Studies had high risk of bias in many domains. In adults, subpleural nodule and lung consolidation were the lung ultrasound findings with the highest sensitivities, ranging from 72.5% to 100.0% and 46.7% to 80.4%, respectively. Only one study reported specificity data. Variability in sensitivity may be due to variable reference standards or may imply operator dependence. There is insufficient evidence to judge the diagnostic accuracy of POCUS for PTB. There is also no consensus on the optimal protocols for acquiring and analysing POCUS images for PTB. New studies which minimise potential sources of bias are required to further assess the diagnostic accuracy of POCUS for PTB.
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spelling pubmed-81044252021-05-18 Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review Bigio, Jacob Kohli, Mikashmi Klinton, Joel Shyam MacLean, Emily Gore, Genevieve Small, Peter M. Ruhwald, Morten Weber, Stefan Fabian Jha, Saurabh Pai, Madhukar PLoS One Research Article The advent of affordable, portable ultrasound devices has led to increasing interest in the use of point-of-care ultrasound (POCUS) for the detection of pulmonary TB (PTB). We undertook a systematic review of the diagnostic accuracy of POCUS for PTB. Five databases were searched for articles published between January 2010 and June 2020. Risk of bias was assessed using QUADAS-2. Data on sensitivity and specificity of individual lung ultrasound findings were collected, with variable reference standards including PCR and sputum smear microscopy. Six of 3,919 reviewed articles were included: five in adults and one in children, with a total sample size of 564. Studies had high risk of bias in many domains. In adults, subpleural nodule and lung consolidation were the lung ultrasound findings with the highest sensitivities, ranging from 72.5% to 100.0% and 46.7% to 80.4%, respectively. Only one study reported specificity data. Variability in sensitivity may be due to variable reference standards or may imply operator dependence. There is insufficient evidence to judge the diagnostic accuracy of POCUS for PTB. There is also no consensus on the optimal protocols for acquiring and analysing POCUS images for PTB. New studies which minimise potential sources of bias are required to further assess the diagnostic accuracy of POCUS for PTB. Public Library of Science 2021-05-07 /pmc/articles/PMC8104425/ /pubmed/33961639 http://dx.doi.org/10.1371/journal.pone.0251236 Text en © 2021 Bigio et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Bigio, Jacob
Kohli, Mikashmi
Klinton, Joel Shyam
MacLean, Emily
Gore, Genevieve
Small, Peter M.
Ruhwald, Morten
Weber, Stefan Fabian
Jha, Saurabh
Pai, Madhukar
Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title_full Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title_fullStr Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title_full_unstemmed Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title_short Diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: A systematic review
title_sort diagnostic accuracy of point-of-care ultrasound for pulmonary tuberculosis: a systematic review
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104425/
https://www.ncbi.nlm.nih.gov/pubmed/33961639
http://dx.doi.org/10.1371/journal.pone.0251236
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