How does the diagnostic accuracy of chest ultrasonography (CUS) compare to chest X-ray (CXR) for detecting pneumothorax in trauma patients in the emergency department (ED)?
Study design: Systematic review and meta-analysis of 13 prospective, paired comparative accuracy studies
Population
- Number of patients studied: 1271 patients (410 traumatic pneumothorax patients)
- Inclusion criteria: Prospective, paired comparative accuracy studies comparing CUS performed by frontline non‐radiologist physicians to supine CXR in trauma patients in the ED suspected of having pneumothorax, with CT of the chest or tube thoracostomy as the reference standard
- Exclusion criteria: Non-prospective, non-paired comparative accuracy studies, studies not using CT or tube thoracostomy as reference standards, or studies not in ED settings
Interventions
- Experimental group: Chest ultrasonography (CUS) performed by frontline non‐radiologist physicians
- Control group: Supine chest X-ray (CXR)
Primary outcome: Sensitivity and specificity of CUS and CXR for pneumothorax detection
Conclusion
The diagnostic accuracy of CUS performed by frontline non‐radiologist physicians for the diagnosis of pneumothorax in ED trauma patients is superior to supine CXR, independent of the type of trauma, type of CUS operator, or type of CUS probe used.