For a study, researchers sought to evaluate whether lung ultrasonography (US) performed in primary care was beneficial and practicable for diagnosing community-acquired pneumonia (CAP) compared to chest radiography. A prospective observational cohort study of lung ultrasound was conducted in 12 primary care centers. On the same day, patients aged 5 and older with symptoms suggesting CAP had a lung ultrasound (done by 21 family physicians and 7 primary care pediatricians) and a chest radiograph. Given that the latter is the most common imaging test performed for suspected CAP in primary care, investigators compared lung US findings to the radiologist’s chest radiograph report as the reference standard. The doctors had varying levels of prior US experience, but they all went through a 5-hour lung US training program. A total of 82 patients were involved in the study. Positive lung US findings (consolidation >1 cm or a focal/asymmetrical B-lines pattern) had a sensitivity of 87.8%, a specificity of 58.5%, a positive likelihood ratio of 2.12, and a negative likelihood ratio of 0.21 when compared to chest radiography. The findings were comparable regardless of the physicians’ previous US training or experience. Patients with greater than 1 cm of consolidation or normal results on lung US might forgo chest radiography. However, patients with a B-line pattern without consolidation (low specificity) would require chest radiography to ensure optimal therapy. The average time for a lung ultrasound was 10 minutes or less. Point-of-care lung ultrasound in primary care could effectively investigate suspected CAP (avoiding chest radiography in most cases) and was likely viable in everyday practice due to short training programs and scan time.
Source:www.annfammed.org/content/20/3/227
