Pneumonia

Lung ultrasound was an effective technique in diagnosing childhood pneumonia when conducted by experienced sonographers

Reviewing paper: Tsou PY, Chen KP, Wang YH, Fishe J, Gillon J, Lee CC et al. Diagnostic accuracy of lung ultrasound performed by novice vs advanced sonographers for pneumonia in children: A systematic review and meta‐analysis. Acad Emerg Med 2019;26:1074–1088.

Study question

How accurate is ultrasound in the diagnosis of pneumonia? How accurate is the result when comparing sonographers with varying levels of experience?

Study design: systematic review and meta-analysis; 25 studies analysed encompassing 3353 patients; 18 prospective cohort studies, 5 retrospective cohort studies, 1 randomised controlled trial (RCT) and 1 case–control study.

Patients: paediatric patients presenting with symptoms of pneumonia; this included those with ‘rales’, tachypnoea, dyspnoea, cough, decreased breath sounds or fever.

Intervention: lung ultrasound versus standard means of diagnosing pneumonia. Standard means varied between studies, ranging from clinical diagnosis only in 2 studies to a combination of clinical diagnosis and imaging in 6 studies; 20 used chest x-ray (CXR) alone and 1 used CT chest alone. The level of ultrasound training ranged from 1 hour to 7 days in the novice group; expert ultrasonographers had over 7 days–25 …