Journal Article

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

Klinton, Joel Shyam, Pai, Madhukar, Gore, Genevieve, Jha, Saurabh, Small, Peter M., Weber, Stefan Fabian, Ruhwald, Morten, Bigio, Jacob, Kohli, Mikashmi, MacLean, Emily

2021

Overview

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.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accuracy / Adults / Biology and Life Sciences / Culture / Demography / Diagnosis / Diagnostic equipment (Medical) / Editing / Epidemiology / Evaluation / Health care / Health care facilities / HIV / Human immunodeficiency virus / Infectious diseases / Medical diagnosis / Medical imaging / Medicine and Health Sciences / Methodology / Occupational health / Patients / Physical sciences / Pneumonia / Point of care testing / Public health / Pulmonary tuberculosis / Quality assessment / Radiology / Reproducibility / Research and Analysis Methods / Sputum / Systematic review / Tuberculosis / Ultrasonic imaging / Ultrasound