Ultrasound, a diagnostic tool that avoids harmful radiation, has numerous medical applications. One of those is the diagnosis of lung disease. According to the Los Angeles County Department of Public Health, pneumonia is a leading cause of illness and death in young children and the elderly. Thus, prompt diagnosis and treatment can save lives. A new study compared the effectiveness of lung ultrasound to a chest X-ray for the diagnosis of childhood pneumonia. The findings were published online on March 16 in the journal Pediatrics.
The study authors note that current diagnostic techniques tools include chest X-rays; however, current guidelines do not recommend the use of lung ultrasound for diagnosis. Therefore, they conducted a meta-analysis to assess the diagnostic accuracy of lung ultrasound for childhood pneumonia. (A meta-analysis is a compilation of data from a number of studies to clarify a result.
The authors conducted searches of studies contained in PubMed, Embase, the Cochrane Library, Scopus, Global Health, World Health Organization–Libraries, and Latin American and Caribbean Health Sciences Literature of studies. Included studies were those that compared lung ultrasound diagnostic accuracy against a reference standard. The researchers identified 1475 studies and selected 15 (1%) for further analysis. After further review, 8 studies (765 children) were determined worthy of analysis; among these studies, 6 (75%) were conducted in the general pediatric population and 2 (25%) were conducted in newborns.
The investigators found that five studies (63%) reported using highly skilled sonographers (technicians who perform ultrasound exams). The overall methods for analysis were good; however, the studies were dissimilar. A sensitivity of 96% and a specificity of 93% was found for the diagnosis of childhood pneumonia. Sensitivity is the proportion of patients with disease who test positive. Specificity is the proportion of patients without disease who test negative.
The authors noted the following limitations: most studies included in the analysis had a low number of patients, and the number of eligible studies was also small. However, they concluded that current evidence supports lung ultrasound as an imaging alternative for the diagnosis of childhood pneumonia. They recommended that pediatricians should be apprised of the value of lung ultrasound for the or diagnosis of pneumonia.
The authors are affiliated with: Johns Hopkins University, Baltimore, Maryland; Biomedical Research Unit, A.B. Prisma, Lima, Peru; College of Medicine, University of Cincinnati, Cincinnati, Ohio; and George Washington University, Washington, District of Columbia