• Am J Emerg Med · Sep 2019

    Review Meta Analysis

    Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis.

    Point-of-care ultrasound performed by emergency physicians to diagnose intussusception has a diagnostic accuracy equivalent to radiology-performed ultrasound.

    pearl
    • Po-Yang Tsou, Yu-Hsun Wang, Yu-Kun Ma, Julia K Deanehan, Jason Gillon, Eric H Chou, Tzu-Chun Hsu, Yuan-Chun Huang, Judy Lin, and Chien-Chang Lee.
    • Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Pediatrics, Driscoll Children's Hospital, Corpus Christi, TX, USA.
    • Am J Emerg Med. 2019 Sep 1; 37 (9): 1760-1769.

    ObjectiveIt is unclear whether point-of-care ultrasound (POCUS) by emergency medicine physicians is as accurate as radiology-performed ultrasound (RADUS). We aim to summarize the diagnostic accuracy of ultrasonography for intussusception and to compare the performance between POCUS and RADUS.MethodsDatabases were searched from inception through February 2018 using pre-defined index terms. Peer-reviewed primary studies that investigated the diagnostic accuracy of ultrasound for intussusception in children were included. The study is reported using Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). Meta-analysis of the diagnostic accuracy of ultrasound for intussusception was conducted using the random-effects bivariate model. Subgroup analysis (POCUS vs RADUS) was also performed. Meta-regression was utilized to determine if the diagnostic accuracy between POCUS and RADUS was significantly different.ResultsThirty studies (n = 5249) were included in the meta-analysis. Ultrasonography for intussusception has a sensitivity: 0.98 (95% CI: 0.96-0.98), specificity: 0.98 (95% CI: 0.95-0.99), positive likelihood ratio: 43.8 (95% CI: 18.0-106.7) and negative likelihood ratio: 0.03 (95% CI: 0.02-0.04), with an area under ROC (AUROC) curve of 0.99 (95% CI: 0.98-1.00). Meta-regression suggested no significant difference in the diagnostic accuracy for intussusception between POCUS and RADUS (AUROC: 0.95 vs 1.00, p = 0.128).ConclusionsCurrent evidence suggested POCUS has a high diagnostic accuracy for intussusception not significantly different from that of RADUS.Copyright © 2019. Published by Elsevier Inc.

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    Point-of-care ultrasound performed by emergency physicians to diagnose intussusception has a diagnostic accuracy equivalent to radiology-performed ultrasound.

    Daniel Jolley  Daniel Jolley
     
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