Diagnostic Test Accuracy of Lung Ultrasound for Acute Chest Syndrome in Sickle Cell Disease: A Systematic Review and Meta-analysis
Title
Diagnostic Test Accuracy of Lung Ultrasound for Acute Chest Syndrome in Sickle Cell Disease: A Systematic Review and Meta-analysis
Creator
Mahmoud Omar
Abdur Rahman Jabir
Imadh Khan
Enrico M Novelli
Julia Z Xu
Date
2022
Description
Background: Acute chest syndrome (ACS) is a leading cause of death in patients with sickle cell disease (SCD). Lung ultrasound (LUS) is emerging as a point-of-care method to diagnose ACS, allowing for more rapid diagnosis in the emergency room setting and sparing patients from ionizing radiation exposure.
Research question: What is the diagnostic accuracy of LUS for ACS diagnosis using the current reference standard of chest x-ray?
Study design and methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for this systematic review and meta-analysis. Embase, MEDLINE, Web of Science, and Google Scholar were used to compile all relevant studies. Two reviewers screened the studies for inclusion in this review. Cases of discrepancy were resolved by a third reviewer. Meta-analyses were conducted using both metadta and midas STATA software packages to retrieve summary receiver operating characteristic curves, sensitivities, and specificities. Three reviewers scored the studies with QUADAS-2 for risk of bias assessment.
Results: From a total of 713 unique studies retrieved, 6 studies were included in the final quantitative synthesis. Of these, 5 studies were in pediatric emergency departments. Two studies were conference abstracts and not published manuscripts. Data was available for 625 possible ACS cases (97% of cases in patients aged ≤ 21 years) and 95 confirmed ACS diagnoses (pre-test probability of 15.2%). The summary sensitivity was 0.92 (95% CI, 0.68-0.98) and the summary specificity was 0.89 (95% CI, 0.69-0.97) with an area under the curve of the summary receiver operating characteristic curve of 0.96 (95% CI, 0.94-0.97).
Interpretation: LUS has excellent sensitivity and very good specificity for ACS diagnosis and may serve as an initial point-of-care test to facilitate rapid treatment of ACS and spare pediatric patients from ionizing radiation; however, further research is warranted to improve the generalizability to the adult SCD population.
Research question: What is the diagnostic accuracy of LUS for ACS diagnosis using the current reference standard of chest x-ray?
Study design and methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for this systematic review and meta-analysis. Embase, MEDLINE, Web of Science, and Google Scholar were used to compile all relevant studies. Two reviewers screened the studies for inclusion in this review. Cases of discrepancy were resolved by a third reviewer. Meta-analyses were conducted using both metadta and midas STATA software packages to retrieve summary receiver operating characteristic curves, sensitivities, and specificities. Three reviewers scored the studies with QUADAS-2 for risk of bias assessment.
Results: From a total of 713 unique studies retrieved, 6 studies were included in the final quantitative synthesis. Of these, 5 studies were in pediatric emergency departments. Two studies were conference abstracts and not published manuscripts. Data was available for 625 possible ACS cases (97% of cases in patients aged ≤ 21 years) and 95 confirmed ACS diagnoses (pre-test probability of 15.2%). The summary sensitivity was 0.92 (95% CI, 0.68-0.98) and the summary specificity was 0.89 (95% CI, 0.69-0.97) with an area under the curve of the summary receiver operating characteristic curve of 0.96 (95% CI, 0.94-0.97).
Interpretation: LUS has excellent sensitivity and very good specificity for ACS diagnosis and may serve as an initial point-of-care test to facilitate rapid treatment of ACS and spare pediatric patients from ionizing radiation; however, further research is warranted to improve the generalizability to the adult SCD population.
Source
Chest
. 2022 Dec 9;S0012-3692(22)04217-9. doi: 10.1016/j.chest.2022.11.042. Online ahead of print.
. 2022 Dec 9;S0012-3692(22)04217-9. doi: 10.1016/j.chest.2022.11.042. Online ahead of print.
Language
English
URL
https://doi.org/10.1016/j.chest.2022.11.042
Citation
Mahmoud Omar et al., “Diagnostic Test Accuracy of Lung Ultrasound for Acute Chest Syndrome in Sickle Cell Disease: A Systematic Review and Meta-analysis,” NEOMED Bibliography Database, accessed April 27, 2024, https://neomed.omeka.net/items/show/12192.