The following is a summary of “Diagnostic Test Accuracy of Lung Ultrasound for Acute Chest Syndrome in Sickle Cell Disease: A Systematic Review and Meta-analysis,” published in the June 2023 issue of the Chest by Omar et al.
Acute chest syndrome (ACS) is the primary cause of death for sickle cell disease patients. Lung ultrasound (LUS) is emerging as a point-of-care method for diagnosing Acute Coronary Syndrome (ACS), allowing for more rapid diagnosis in the ED and sparing patients from ionizing radiation. What is the diagnostic accuracy of LUS for diagnosing ACS, using chest radiography as the current gold standard? The 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.
The studies were screened by two examiners for inclusion in this review. A third reviewer resolved discrepancy cases. The metadata and Midas STATA software applications extracted summary receiver operating characteristic curves, sensitivities, and specificities. Three evaluators assessed the risk of bias in the studies using QUADAS-2. The final quantitative synthesis included six studies from 713 unique studies retrieved. Five of these investigations were conducted in pediatric EDs. Two investigations were abstracts from conferences rather than published manuscripts. About 625 possible ACS cases (97% of subjects in patients aged 21 years) and 95 validated ACS diagnoses (15.2% pretest probability) were accounted for.
Summary sensitivity was 0.92 (95% CI, 0.68-0.98), specificity was 0.89 (95% CI, 0.69-0.97), and the area under the summary receiver operating characteristic curve was 0.96 (95% CI, 0.94-0.97). LUS has excellent sensitivity and specificity for diagnosing ACS and may serve as an initial point-of-care test to facilitate rapid treatment of ACS and spare pediatric patients from ionizing radiation; however, additional research is necessary to improve the generalizability to the adult sickle cell disease population.
Source: sciencedirect.com/science/article/abs/pii/S0012369222042179