16 studies were included – significant heterogeneity, but of 2359 patients. Heterogeneity was assessed graphically and with a Q test. The Q test should only be used once in a data set to exclude outliers. The reference standard, we considered it to be of high quality if based on CT alone or when it consisted of a final diagnosis made by experts using an integrated synthesis of radiology and laboratory or microbiological data (or both).
The highest risk of bias stemmed from the flow of patients within each study because of an uneven application of the reference test (differential verification bias).
The dispersion of studies in the ROC plane suggests marked heterogeneity.
The 95% CI of the overall effect indicates a sensitivity of approximately 80% to 90% and a specificity of 70% to 90%.
Accuracy of Lung Ultrasonography in the Diagnosis of Pneumonia in Adults: Systematic Review and Meta-Analysis – Ana M. Llamas-Álvarez, MD; Eva M. Tenza-Lozano, MD; and Jaime Latour-Pérez, MD, PhD; . Chest 2017; 151(2):374-382