Diagnostic Value Of Lung Ultrasound For Pneumonia In Children:A Meta-Analysis

Background And Objective Pneumonia is the leading cause of death in children. Currently guidelines recommend the use of chest radiography as a diagnostic method,but lung ultrasound(LUS) not included.This paper aims to systematically review the clinical value of lung ultrasound for the diagnosis of pneumonia in children.Methods A systematic search in Pub Med,Cochrane Library,Web of Science and Embase was performed to collect the studies of comparing LUS diagnostic accuracy against a reference standard from inception to March,2016.References from included studies and relevant journals were also hand-searched.Two investigators evaluated all relevant studies for eligibility criteria independently.Literature screening according to the inclusion and exclusion criteria,data extraction and methodological quality assessment were completed by two reviewers independently.Meta-analysis was then conducted using Meta-Di Sc1.4 software.Results We identified 2660 studies, 8 studies(816 children)were included for analysis,of which 6(75%)were conducted in the general pediatric population and 2(25%)in neonates.The results of meta-analysis showed that:Overall methodologic quality was high,but heterogeneity was observed across studies.LUS had a sensitivity of 0.98(95% confidenceinterval[CI]:0.96-0.99)and specificity of 0.92(95%CI:0.87-0.96),and positive and negative likelihood ratios were 14.26(95%CI:2.63-77.27)and 0.04( 95%CI : 0.02-0.09),respectively.SROC area under the curve(AUC)was 0.9900, Q*was 0.9585.Limitations included the following:most studies included in our analysis had a low number of patients and the number of eligible studies was also small.All of the included studies are single-center study.Conclusions Current evidence supports LUS as an imaging alternative for the diagnosis of childhood pneumonia.