Perspectives on Point-of-Care Ultrasound Use in Pediatric Tropical Infectious Disease

Kaminstein, Daniel; Kuhn, Walter; Huang, Deborah; Burleson, Samuel L.

doi:10.1016/j.cpem.2019.06.003

Cited by 2 publications

(1 citation statement)

References 95 publications

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“…Lung ultrasound (LUS) has also been used successfully in the diagnosis of adult pneumonia, with meta-analyses suggesting it has similar or higher sensitivity and specificity to CXR [20][21][22]. There is therefore reason to suspect that POCUS may be a suitable imaging modality for PTB and there has been increasing interest in its use in both adults and children, especially as POCUS becomes cheaper and more widely used in clinical medicine [23,24].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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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Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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A systematic review and meta‐analysis of diagnostic test accuracy of chest ultrasound in diagnosing pediatric pulmonary tuberculosis

Muljadi,

Koesbandono,

Octavius

2024

Pediatric Pulmonology

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IntroductionDespite medical advancement, pediatric pulmonary tuberculosis (PTB) still has high morbidity and mortality, due to challenging detection in clinical practice. Ultrasound has been touted as the next best diagnostic tool but currently, this claim is unfounded. Therefore, this study aims to systematically review the diagnostic parameters of chest ultrasound in diagnosing pediatric PTB.MethodsThe literature search started and ended on December 23, 2023. We searched MEDLINE, Cochrane Library, Pubmed, Science Direct, and Google Scholar. Our research question could be formulated as “In pediatric patients who present with signs and symptoms of PTB such as fever, cough, and poor weight gain, how accurate is chest ultrasound in ruling in and ruling out pediatric PTB when the diagnosis is compared to culture, PCR or CXR?” This systematic review adhered to the PRISMA‐DTA guidelines while the meta‐analysis was conducted with STATA program using the “midas” and “metandi” commands.ResultsThere are five studies included with 137 positive PTB children. The combined sensitivity is 84% (95% confidence interval [CI]: 76–89), specificity of 38% (95% CI: 24–54), and summary receiver operating curve yields an area under the curve of 0.83 (95% CI: 0.80–0.86). The I2 value is 24% (95% CI: 0–100) with a p‐value of 0.13. The combined negative predictive value is 0.68 (95% CI: 0.58–0.79), and the positive predictive value is 0.57 (95% CI: 0.51–0.63). The positive likelihood ratio is 1 with a 6% increase from the baseline while the negative likelihood ratio is 0.43 with a 12% decrease from the baseline.ConclusionChest ultrasound is sensitive but currently could neither exclude nor confirm pediatric PTB.

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Perspectives on Point-of-Care Ultrasound Use in Pediatric Tropical Infectious Disease

Cited by 2 publications

References 95 publications

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

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

A systematic review and meta‐analysis of diagnostic test accuracy of chest ultrasound in diagnosing pediatric pulmonary tuberculosis

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