Chest ultrasound for the diagnosis of paediatric pulmonary diseases: a systematic review and meta-analysis of diagnostic test accuracy.

BACKGROUND: Chest ultrasound is an emerging imaging modality, for several paediatric pulmonary diseases. SOURCES OF DATA: MEDLINE and EMBASE (1946-47 to 10 March 2017) were searched to collect evidence on the diagnostic accuracy of chest ultrasound, compared to other imaging modalities, for the diagnosis of paediatric pulmonary diseases. AREAS OF AGREEMENT: Eighteen pneumonia studies, comprising 2031 children, were included for meta-analysis; the summary estimate sensitivity was 95.0% (95%CI: 90.7-97.3%) and specificity was 96.1% (95%CI: 89.1-98.7%). AREAS OF CONTROVERSY: Other pulmonary diseases also yielded high sensitivity and specificity, but a meta-analysis could not be conducted due to a limited number of studies includable, and their heterogeneity. GROWING POINTS: Chest ultrasound should be considered as a first-line imaging modality for children with suspected pneumonia. AREAS TIMELY FOR DEVELOPING RESEARCH: Further research should focus on the diagnostic accuracy of chest ultrasound for the diagnosis of paediatric pulmonary diseases, other than pneumonia, comparing against a valid gold standard.