Lorentzen Morten Jongshøj, Kristensen Anne Heltborg, Kaldan Frida Poppius, Cartuliares Mariana Bichuette, Hertz Mathias Amdi, Specht Jens Juel, Posth Stefan, Lindberg Mats Jacob Hermansson, Skaarup Søren Helbo, Hansen Meinhard Reinert, Spile Camilla Stræde, Andersen Michael Brun, Graumann Ole, Mogensen Christian Backer, Skjøt-Arkil Helene, Laursen Christian B
Department of Emergency Medicine, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark.
Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark.
Diagnostics (Basel). 2024 Aug 30;14(17):1921. doi: 10.3390/diagnostics14171921.
The diagnostic accuracy of handheld ultrasound (HHUS) devices operated by newly certified operators for pneumonia is unknown. This multicenter diagnostic accuracy study included patients prospectively suspected of pneumonia from February 2021 to February 2022 in four emergency departments. The index test was a 14-zone focused lung ultrasound (FLUS) examination, with consolidation with air bronchograms as diagnostic criteria for pneumonia. FLUS examinations were performed by newly certified operators using HHUS. The reference standard was computed tomography (CT) and expert diagnosis using all medical records. The sensitivity and specificity of FLUS and chest X-ray (CXR) were compared using McNemar's test. Of the 324 scanned patients, 212 (65%) had pneumonia, according to the expert diagnosis. FLUS had a sensitivity of 31% (95% CI 26-36) and a specificity of 82% (95% CI 78-86) compared with the experts' diagnosis. Compared with CT, FLUS had a sensitivity of 32% (95% CI 27-37) and specificity of 81% (95% CI 77-85). CXR had a sensitivity of 66% (95% CI 61-72) and a specificity of 76% (95% CI 71-81) compared with the experts' diagnosis. Compared with CT, CXR had a sensitivity of 69% (95% CI 63-74) and a specificity of 68% (95% CI 62-72). Compared with the experts' diagnosis and CT diagnosis, FLUS performed by newly certified operators using HHUS devices had a significantly lower sensitivity for pneumonia when compared to CXR ( < 0.001). FLUS had a significantly higher specificity than CXR using CT diagnosis as a reference standard ( = 0.02). HHUS exhibited low sensitivity for pneumonia when used by newly certified operators.
新获得认证的操作人员使用手持式超声（HHUS）设备诊断肺炎的准确性尚不清楚。这项多中心诊断准确性研究纳入了2021年2月至2022年2月期间在四个急诊科前瞻性怀疑患有肺炎的患者。索引测试为14区聚焦肺超声（FLUS）检查，以实变伴空气支气管征作为肺炎的诊断标准。FLUS检查由新获得认证的操作人员使用HHUS进行。参考标准为计算机断层扫描（CT）以及使用所有病历进行的专家诊断。使用McNemar检验比较FLUS和胸部X线（CXR）的敏感性和特异性。在324例接受扫描的患者中，根据专家诊断，212例（65%）患有肺炎。与专家诊断相比，FLUS的敏感性为31%（95%CI 26-36），特异性为82%（95%CI 78-86）。与CT相比，FLUS的敏感性为32%（95%CI 27-37），特异性为81%（95%CI 77-85）。与专家诊断相比，CXR的敏感性为66%（95%CI 61-72），特异性为76%（95%CI 71-81）。与CT相比，CXR的敏感性为69%（95%CI 63-74），特异性为68%（95%CI 62-72）。与专家诊断和CT诊断相比，新获得认证的操作人员使用HHUS设备进行的FLUS对肺炎的敏感性显著低于CXR（<0.001）。以CT诊断作为参考标准时，FLUS的特异性显著高于CXR（=0.02）。新获得认证的操作人员使用HHUS时，其对肺炎的敏感性较低。
